Feeding Children with Neurodisabilities

Almond, Sarah; Allott, Liz; Hall, Kate

doi:10.1002/9780470692004.ch30

Cited by 4 publications

(5 citation statements)

References 65 publications

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“…Other children were weighed together with a parent and then the parent’s weight was subtracted. Following ESPGHAN guidelines, height was estimated from the knee height by using the Almond equation [ 56 ] for children younger than 12 years ( n = 15) and the Chumlea equation [ 57 , 58 ] for students over 12 years of age. The knee height was measured with the child seated or in a supine position, with the knee and ankle at a 90° angle.…”

Section: Methodsmentioning

confidence: 99%

Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

et al. 2021

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Background: Special needs schools (SNS) educate children and young people with major neurological disabilities who are at high risk of oropharyngeal dysphagia (OD) and malnutrition (MN). We aimed to assess the prevalence of OD, MN, dehydration (DH), and oral health (OH) in students at an SNS. Methods: A cross-sectional observational study was conducted at SNS L’Arboç, Catalonia, Spain. We assessed (a) demographics, health status, comorbidities, and gross motor function classification system (GMFCS), (b) swallowing function, oral-motor evaluation, masticatory capacity, and EDACS classification for eating and drinking abilities, (c) nutritional and DH status (anthropometry, bioimpedance and dietary records), and (d) OH (Oral Hygiene Index Simplified). Results: A total of 33 students (mean age 13.3 years; 39.4% level V of GMFCS) were included. Main diagnosis was cerebral palsy at 57.6%. All students presented OD, 90.6% had impaired safety, 68.7% were at levels II–III of EDACS, and 31.3% required PEG; furthermore, 89.3% had chronic MN, 21.4% had acute MN, 70% presented intracellular DH, and 83.9% presented impaired OH. Conclusion: MN, DH, OD, and poor OH are highly prevalent conditions in students with cerebral palsy and other neurological disabilities and must be specifically managed through nutritional and educational strategies. The multidisciplinary team at SNS should include healthcare professionals specifically trained in these conditions.

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Section: Methodsmentioning

confidence: 99%

Assessment of Swallowing Disorders, Nutritional and Hydration Status, and Oral Hygiene in Students with Severe Neurological Disabilities Including Cerebral Palsy

et al. 2021

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“…Dietitians need to make an individualised ‘best guess’ to establish energy requirements using the equation: total energy expenditure = REE (measured if possible) × physical activity level (Department of Health, 1991). Individual longitudinal monitoring of body weight will provide a crude indication on the accuracy of energy prescription (Almond et al. , 2007).…”

Section: Nutritional Requirementsmentioning

confidence: 99%

“…A multidisciplinary team should be involved in the management of feeding difficulties (Stewart et al. , 2006; Almond et al. , 2007) with individual preference being paramount.…”

Section: Managementmentioning

confidence: 99%

“…Stewart et al (2006) suggest that height and weight should be measured at a minimum of every 6 months and plotted on growth charts. Standard growth charts, such as the 'UK 90' or the 'CDC 2000', can be used in clinical practice to monitor longitudinal growth and development in NMD (Almond et al, 2007). In 1988, a specific DMD weight chart was created (Griffiths and Edwards).…”

Section: Body Compositionmentioning

confidence: 99%

“…Modifications include cutting food into smaller pieces and changing the texture to smooth foods (Pane et al, 2006). A multidisciplinary team should be involved in the management of feeding difficulties (Stewart et al, 2006;Almond et al, 2007) with individual preference being paramount. Gonzalez-Bermejo et al (2005) analysed dietary intake in an older group of boys (aged 22-33 years) reporting that, although they ate slowly and with difficulty, these inconveniences were largely compensated for by the pleasure of eating a normal meal.…”

Section: Malnutritionmentioning

confidence: 99%

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A review of nutrition in Duchenne muscular dystrophy

Davidson

Truby

2009

J Human Nutrition Diet

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Duchenne muscular dystrophy (DMD) is a recessive X linked genetic disorder characterised by progressive muscle weakness and reduced muscle tone. Affecting only boys, it limits life expectancy to approximately 20 years. A literature review was conducted using MEDLINE and the Cochrane Library, employing the term 'Duchenne muscular dystrophy'. A total of 1491 articles in English were recovered. These papers were searched thematically under the headings: body composition (n = 10), energy expenditure (n = 10), nutrition (n = 6), corticosteroid therapy (n = 55) and gene therapy (n = 199). Key dietetic practice points were identified relevant to nutritional management. Papers supporting these key themes were assigned a level of evidence and grade of recommendation. There is limited high-quality evidence to guide the nutritional management of boys with DMD. Currently, the majority of evidence is based on expert opinion and clinical expertise. Delayed growth, short stature, muscle wasting and increased fat mass are characteristics of DMD and impact on nutritional status and energy requirements. The early introduction of steroids has altered the natural history of the disease, but can exacerbate weight gain in a population already susceptible to obesity. Prior to commencing steroids, anticipatory guidance for weight management should be provided. Malnutrition is a feature of end stage disease requiring a multidisciplinary approach, such as texture modification and supplemental feeding. Micronutrient requirements are yet to be determined but, as a result of corticosteroid treatment, vitamin D and calcium should be supplemented. Some evidence exists supporting supplementation with creatine monohydrate to improve muscle strength. More research is needed to provide a higher quality of evidence for dietitians working within this area.

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