Nutritional status of children with infantile cerebral palsy receiving gastrostomy tube feeding

Abstract

Objective. To assess the nutritional status, dietary intake, and effectiveness of nutritional support in children with infantile cerebral palsy (ICP) receiving gastrostomy tube feeding. Patients and methods. The study included 46 children with spastic ICP between 2 and 18 years of age. All children belonged to GMFCS level V and were fed by gastrostomy tube. Nutritional status, energy and macronutrient intake were evaluated. Body composition was determined by caliperometry (n = 46) and bioelectrical impedance analysis (bioimpedanceometry) (n = 18). Considering the disorders revealed, specialized formulas for enteral feeding were introduced into the diet. To assess the effectiveness of diet therapy, we observed 14 children for 6–9 months. Results. Weight loss was detected in 33 (71.7%) children: 14 (30.4%) children had mild weight loss, 1 (2.2%) child had moderate weight loss and 18 (39.1%) children had severe weight loss. Growth delay was observed in 5 (10.9%) children, in 3 (6.5%) of them the degree of delay appeared more severe. Protein-energy malnutrition by 17–50% from the recommended norm was detected in all children: all children had carbohydrate deficiency and 37 (80.4%) children had protein and fat deficiency. In the observational period against the background of diet therapy there were statistically significant positive dynamics of weight and height parameters, an increase in body fat mass (2.4 [1.6; 5.3] kg and 3.3 [1.3; 4.6] kg at the beginning and at the end of observation) and phase angle values (3.9 [3.5; 4.4] and 5.0 [3.6; 5.6], respectively); a decrease in body cell mass and skeletal muscle mass was revealed. Conclusion. The diet of children with ICP should meet their individual needs and correspond to their functional abilities. Key words: infantile cerebral palsy, gastrostomy, motor activity level, weight loss, nutritional support