Pediatr Gastroenterol Hepatol Nutr.  2019 Mar;22(2):122-131. 10.5223/pghn.2019.22.2.122.

Evaluation and Treatment of Malnutrition and Associated Gastrointestinal Complications in Children with Cerebral Palsy

Affiliations
  • 1Referral Center for Pediatric Gastroenterology and Nutrition, Children's Hospital Zagreb, Zagreb, Croatia. ivahojsak@gmail.com
  • 2University of Zagreb, School of Medicine, Zagreb, Croatia.
  • 3Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia.

Abstract

The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.

Keyword

Children; Cerebral palsy; Malnutrition; Nutritional assessment; Diet therapy

MeSH Terms

Body Composition
Cerebral Palsy*
Child*
Deglutition
Diet Therapy
Enteral Nutrition
Gastrostomy
Humans
Malnutrition*
Nutrition Assessment
Nutritional Status
Nutritional Support

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