Feeding problems, growth and nutritional status in children with cerebral palsy: A population based study in Norway

Abstract

Background: Impaired growth and feeding problems are common among children with cerebral palsy. The aim of the present study was to estimate the prevalence and severity of feeding and nutritional problems in children with cerebral palsy Norway.

Methods: We used data recorded in the Norwegian Cerebral Palsy Register for children born 1996-2003 and the main study population consisted of 661 children (mean age 6.6 years (SD: 1.5); 368 (56%) boys). For children born after 1998 growth data were available.

Results: 132 children (21 %; CI: 18-24) were completely dependent on help or were tube fed. The prevalence of gastrostomy tube feeding was 13 % (CI: 11-16). Children who had their gastrostomy tube at an earlier age where less growth retarded then those who were older (p<0.001). Children with less severe impairments had mild growth deviation, while those with more severe impairments were significantly growth retarded. A total of 63 % (CI: 57-69) of the children with cerebral palsy had normal BMI,5 % (CI: 3-9) 7% had severe thinness, while the prevalence of overweight and obesity in our study was 16 %. Among the most severely affected children (GMFCS IV-V) 20 % (CI: 12 -32) were severely thin and 5% (CI: 2-13) were thin.

Interpretation: Feeding problems in children with cerebral palsy were common and associated with poor growth. A high proportion of the children were undernourished. Moreover, our results suggest that gastrostomy tube feeding may have been introduced too late. These findings are worrying since appropriate feeding is one of the most powerful prognostic factors for survival