Outcomes of Feeding Training to Mothers Having Child with Cerebral Palsy Admitted at A Tertiary Level Hospital in Bangladesh

Abstract

Background: The majority of children with Cerebral Palsy have feeding difficulties. It has a great impact on growth and development in children with cerebral palsy. Feeding difficulties may leads to chronic respiratory disease, malnutrition and reduce quality of life of both children and caregiver. Feeding difficulties cause stressful meal time for caregivers and fear of food for children. In well resource country many hi-tech equipments for the management of feeding difficulties are available but which is not available in low resource country like Bangladesh. Though some of low tech approaches have started a little but the effectiveness or outcomes of these technologies are not evaluated. This study is aimed to evaluate the effect of feeding training on feeding difficulties in children with cerebral palsy. Methods: This is a quasi experimental study. Twenty children with cerebral palsy aged 2 -9 years having feeding difficulties enrolled as study subjects. Initially degree of feeding difficulties were assessed by evaluating body posture and frequency of aspiration during feeding which is scored according to the response of the child. After giving feeding training to the mother feeding difficulties were reevaluated. Mean score of feeding difficulties before and after intervention were compared by paired 't' test. Results were analyzed by SPSS. Results: Among the study subject 14(70%) were male and 6(30%) were female. Most of them were found to have hemiplegic CP 7(35%). The mean score in terms of positioning and frequency of aspiration were significantly changed after intervention (14.15 vs. 15.85 p = <0.0005), (11.6 vs 15.5 p = < 0.0005). Conclusion: Low-tech strategies and therapies are helpful for the management of feeding difficulties in children with cerebral palsy. Foods and drinks modifications should need to get extra attention for the nutritional improvements of those children. Government and international and national health NGOs should studied more about these low tech strategies to improve the condition of the children with cerebral palsy and to reduce the stress and sufferings of the parents.

What are the implications of Zika Virus for infant feeding? A synthesis of qualitative evidence concerning Congenital Zika Syndrome (CZS) and comparable conditions

“…Several studies examine training programmes, often in low-cost settings, to improve feeding of children with cerebral palsy [ 41 , 42 , 43 , 44 , 46 ]. Programmes include training on head positioning[ 42 , 43 ] and on mixing foods to an appropriate consistency.…”

The effect of a practical nutrition education programme on feeding skills of caregivers of children with cerebral palsy at Muhimbili National Hospital, in Tanzania

“…Caregivers were able to feed their children slowly with a spoon and cup held at the right angle. Das et al () in their study reported gaining of new skills on positioning and improved feeding process after caregivers training sessions. Caregivers are able to provide support and involve their children during feeding including verbal communication and encouragement.…”

“…However, it is unclear if these approaches can work in resource‐constrained settings; Tanzania being one of them where the health system is overburdened with infectious diseases and limited human resources for health. Previous studies done in poor resource settings (Adams et al, ; Das et al, ) revealed positive outcomes on feeding skills. This study focused on behavioural approaches by providing practical caregiver training on child positioning and feeding skills to improve feeding skills and caregiver–child interactions during feeding.…”

“…& Hill, 2001;Vik, Skrove, Dollner, & Helland, 2001;Yousafzai et al, 2003). It has also been shown that with proper interventions on knowledge and caregiver support in the positioning and use of utensils, feeding skills and child-caregiver interactions during feeding can be improved (Adams et al, 2012;Bailey & Angell, 2005;Das, Zaman, Hasan, Barua, & Chowdhury, 2016;Gisel, Applegate-Ferrante, Benson, & Bosma, 1995;Gisel, Applegate-Ferrante, Benson, & Bosma, 1996;Johnson et al, 2004;Marchand & Motil, 2006;Vekerdy, 2007).…”

“…A number of studies have investigated feeding skills patterns and health outcomes in children with CP (Gisel, Alphonce, & Ramsay, ; Reilly, Skuse, & Plobete, ; Sullivan et al, ; Troughton & Hill, ; Vik, Skrove, Dollner, & Helland, ; Yousafzai et al, ). It has also been shown that with proper interventions on knowledge and caregiver support in the positioning and use of utensils, feeding skills and child–caregiver interactions during feeding can be improved (Adams et al, ; Bailey & Angell, ; Das, Zaman, Hasan, Barua, & Chowdhury, ; Gisel, Applegate‐Ferrante, Benson, & Bosma, ; Gisel, Applegate‐Ferrante, Benson, & Bosma, ; Gisel, Haberfellner, & Schwartz, ; Haberfellner, Schwartz, & Gisel, ; Johnson et al, ; Marchand & Motil, ; Vekerdy, ).…”