Anthropometric and nutritional assessment of children with severe cerebral palsy: About a Tunisian population

Abstract

The aim of this study was to estimate the prevalence and severity of feeding and nutritional problems in children with severe CP (with multiple disabilities), in addition to assessing the presence of predictors factors, associated with nutritional status. This was a cross-sectional study of children with severe CP. Anthropometric measurements (body weight, knee height, mid-upper arm circumference, and triceps skin-fold thickness) were taken. Serum levels of ferritin, total proteins, albumin, lipid and vitamin D were measured. In addition, feeding times, the presence of gastrointestinal problems (drooling of saliva, vomiting, dysphagia, etc.). We evaluated 46 children with a mean age of 6.8 years. Sixteen children had seizures and 34 children had orthopedic problems. The presence of oromotor dysfunction were noted in 70% of cases. 65% were constipated, and 65% had drooling of saliva. The meal was given in the majority of cases by the mother and feeding mean times was 40 minutes. The majority of parents described feeding time as stressful and unenjoyable. The average value of triceps skin-fold was 7.6 mm and mid-upper arm circumference was 15 cm. 42 patients had low serum ferritin and vitamin D deficiency was noted in 43.4% of cases. Anthropometric and values of biochemical markers were significantly lower in patients with severe comorbidities and gastrointestinal problems. The results highlight that feeding problems, anthropometric, and biochemical markers of the nutritional status in children with severe cerebral palsy are common and severe. Many of these children would benefit from nutritional assessment and management as part of their overall care.