Feeding difficulties are common in early life and in addition to causing considerable family stress may adversely affect growth and health. They are also a frequent feature of chronic childhood illness, particularly in neurodisability. While various different multidisciplinary approaches to assessment and management are described, none have been directed to managing the whole spectrum of feeding problems in children with and without underlying disease.
Children with developmental disabilities are at increased risk for developing feeding-related difficulties, including gastroesophageal reflux (GER), oral motor dysfunction, pharyngoesophageal dyskinesia, and aversive feeding behavior. Protein energy intake and nutritional status often are compromised as a consequence of feeding impairment, particularly among the most severely disabled patients.
If not adequately treated, feeding disorders may result in additional complications including esophagitis, reactive airway disease, aspiration pneumonia, and bedsores.7,8 Previous reports indicate that enteral feeding regimens for nutrition support in developmentally disabled children improve overall nutritional status.
To date, however, few investigations have evaluated the effects of diagnosis-specific nutritional therapies on clinical outcomes with respect to the frequency of feeding disorder-related complications and rates of acute care hospitalization. Accordingly, the objectives of the present study were to assess feeding problems in a large group of children with developmental disabilities and to determine the effects of nutritional management on growth, weight gain, and feeding-associated morbidity.
Children with developmental disabilities, diagnosis-specific treatment of feeding disorders results in significantly improved energy consumption and nutritional status. These is also indicate that decreased morbidity (reflected by a lower acute care hospitalization rate) may be related, at least in part, to successful management of feeding problems. The importance of a structured approach to these problems, and we propose a diagnostic and treatment algorithm for children with developmental disabilities and suspected feeding disorders.children, developmental disabilities, fundoplication, gastroesophageal reflux, gastrostomy, hospitalization, nutrition.
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