Growth and nutrition disorders in children with cerebral palsy

Abstract

Growth and nutrition disorders are common secondary health conditions in children with cerebral palsy (CP). Poor growth and malnutrition in CP merit study because of their impact on health, including psychological and physiological function, healthcare utilization, societal participation, motor function, and survival. Understanding the etiology of poor growth has led to a variety of interventions to improve growth. One of the major causes of poor growth, malnutrition, is the beststudied contributor to poor growth; scientific evidence regarding malnutrition has contributed to improvements in clinical management and, in turn, survival over the last 20 years. Increased recognition and understanding of neurological, endocrinological, and environmental factors have begun to shape care for children with CP, as well. The investigation of these factors relies on advances made in the assessment methods available to address the challenges inherent in measuring growth in children with CP. Descriptive growth charts and norms of body composition provide information that may help clinicians to interpret growth and intervene to improve growth and nutrition in children with CP. Linking growth to measures of health will be necessary to develop growth standards for children with CP in order to optimize health and well-being.

Nutritional management of children with cerebral palsy

“…[1][2][3] Determining the need for nutrition intervention in children with CP requires the use of multiple methodologies. 4,5 Indicators may include the following: 2,6 Plateaus in weight gain or growth resulting in deviation from an established 'pattern'. Evidence of low body-fat stores in combination with low weight in respect to height or length.…”

Morbimortalidad asociada al estado nutricional y vía de alimentación en niños con parálisis cerebral

“…Its mortality is fifty times greater than other causes in the pediatric population, according to its severity and associated comorbidities 4,5 , rating a survival of 60% at 19 years, at date 5 . These patients need a complex multidisciplinary care 6 , in which the nutritional treatment is fundamental, since they present high prevalence of malnutrition 7 , deficient staturo-ponderal rates and even overweight or obesity 8 , as well as deficits of micronutrients 9,10 , osteopenia and osteoporosis 12 . They commonly present swallowing disorders, oral motor dysfunctions and gastroesophageal reflux 7 .…”

“…They commonly present swallowing disorders, oral motor dysfunctions and gastroesophageal reflux 7 . Malnutrition affects respiratory and cardiac function, decreases immunity, brain growth, cognitive development, and social participation 12 .…”

“…For their nutritional evaluation, it is necessary to consider that children with CP present different growth to healthy, due to factors that do not depend only on nutrition, but also on the type and severity of neurological deficit, ambulation, cognitive ability and neuro-endocrine factors 12 . They also have different body composition and sexual maturation 13,14 .…”

Qualidade de Vida do Cuidador e Saúde Bucal do Indivíduo com Necessidade Especial

“…A alimentação pastosa, higienização precária dos dentes, deglutição atípica, uso prolongado de mamadeira e de medicamentos, que contém sacarose em sua fórmula ou que provocam xerostomia, podem levar ao comprometimento da sua saúde bucal desses pacientes, aumentando a prevalência e gravidade das doenças cárie e doença periodontal 11 . Transtornos de crescimento e de nutrição são as condições secundárias de saúde mais comuns em crianças com PC, provocando forte impacto sobre a saúde em geral, incluindo funções psicológicas e fisiológicas, a participação social, a função motora e a própria sobrevivência 12 , contribuindo para uma higiene bucal insatisfatória e a possibilidade de má-formações dento-faciais. Os centros de reabilitação que trabalham com crianças com necessidades complexas devem abordar não somente a criança como também seus pais e cuidadores 13 Os critérios de inclusão foram participação voluntária dos cuidadores de indivíduos normoreativos e com necessidades especiais, sem distinção de gênero e etnia.…”