Prevalence and severity of feeding and nutritional problems in children with neurological impairment: Oxford Feeding Study

Abstract

The aim of this study was to estimate the prevalence and severity of feeding and nutritional problems in children with neurological impairment within a defined geographical area. In a cross-sectional study, a validated questionnaire was sent to 377 parents of children (aged 4 to 13 years) on the Oxford Register of Early Childhood Impairments with oromotor dysfunction. The return rate was 72%. Of these, 93% had cerebral palsy; 47% were unable to walk; 78% had speech difficulty; and 28% continuous drooling of saliva. Gastrointestinal problems were commonly encountered: 59% were constipated; 22% had significant problems with vomiting, and 31% had suffered at least one chest infection in the previous 6 months. Feeding problems were prevalent: 89% needed help with feeding and 56% choked with food; 20% of parents described feeding as stressful and unenjoyable. Prolonged feeding times (3h/day) were reported by 28%. Only 8% of participants received caloric supplements and 8% were fed via gastrostomy tube. Even though 38% of respondents considered their child to be underweight, 64% of children had never had their feeding and nutrition assessed. The results highlight that feeding problems in children with neurological impairment are common and severe, causing parental concern. Many of these children would benefit from nutritional assessment and management as part of their overall care.

Feeding disorders in ex-prematures: causes - response to therapy - long term outcome

“…Other studies did not focus ex-prematures only [23] or assess feeding related interaction problems systematically [24].…”

“…Feeding problems are common in children with neurological impairment. In the Oxford feeding study 440 out of 776 children with neurological impairment -mainly cerebral palsy -had some degree of feeding problems [24]. These studies are confined to risk factors for feeding disorders but, to our knowledge, there are no long term studies on feeding problems and their response to treatment in ex-prematures.…”

Quantification of Intraoral Pressures During Nutritive Sucking: Methods with Normal Infants

“…Infants with severe feeding problems often require repeated hospitalization and tube feeding [2,7,8]. Refractory feeding problems contribute significantly to the high cost of health care; the cost of caring for a sick infant averages about ten times that for a normal infant [9].…”

“…Dysfunctional sucking in the newborn, in the absence of any focal neurological symptoms, is known to correlate with developmental delay evident at 24 months of age [2,5,6]. It is estimated that up to 92% of infants with brain damage have dysphagia [7][8][9][10] and are at higher risk of long-term malnutrition, growth failure, and higher mortality rates.…”

Nutritional Management bei schwerstbehinderten Kindern

“…Fütter-störungen, Schluckstörungen und Dysfunktionen im Gastrointestinaltrakt füh-ren zu Problemen, die eine adäquate Ernährung beeinträchtigen [18]. Die Folgen einer Mangelernährung sind vielfäl-tig (.…”