EC Nutrition

Cerebral palsy (CP), is not a single disease but its the co-existance of more than one permenant disorders with no progression in neonatal brain resulted from certain neurological damages and its commonly seen in children. Neurological damages in brain may result in motor dysfunction and impaired posture as well as limited physical activity in affected children. Oral motor dysfunction and limited physical activity can diminish the total amount of food intake and oral motor dysfunction itself is the major factor associated with malnutrition which is the reason for poor growth in children with CP. According to the disease specific growth charts, children with CP have poor growth compared with their typically developing peers and there are multiple reasons behind this. There are different nutrition-dependent and nutrition-independent factors that responsible from growth retardation in children with CP, however these factors may affect each other throuhgh different pathways. For example, endocrine problems such as damages in hypothalamacortical linkages and changed homeostasis of hunger-satiety signals as a nutrition-independent factor may lead to malnutrition in children with CP. Difficulties in chewing, swallowing and saliva control due to oral motor dysfunction can decrease the amount of food intake orally, therefore, to prevent further weight loss and malnutrition, enteral feeding may be considered for severely affected children. In adddtion, the presence of extended duration of mealtime and stressful environment during feeding for both children and caregiver may indicate the need for enteral feeding. Administiration of enteral feeding may vary depending on the tolerance of the children and the duration of feeding, however, gastrostomy tube feeding is often preffered over nasogastric tube due to its safe administiration and easy tolerance. Selecting the suitable enteral formulas in accordance to the toleration of the children is also important. It is necessary to plan an individual based nutrition program via taking the anamnesis and analysing the food records of the children. While determining the nutritional needs, disease specific growth charts and special equations developed for energy requirement calculations in children with CP can be a good “starting point”.

Keywords: Cerebral Palsy; Oral Motor Dysfunction; Growth Retardation; Malnutrition; Gastrostmoy Tube Feeding; Neurological Damage

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