DIAGNOSIS AND TREATMENT OF FEEDING DISORDERS IMPROVE NUTRITIONAL STATUS AND DECREASE MORBIDITY IN CHILDREN WITH DEVELOPMENTAL DISABILITIES (DD)

Abstract

102 Children with DD are at increased risk for developing feeding disorders including GER, oromotor discoordination, pharyngoesophageal dyskinesia and behavioral feeding problems (Acta Paediatr Scand 85:697, 1996 ). Resulting malnutrition and other complications (aspiration, esophagitis) heighten morbidity. To study outcomes of nutritional assessment and therapy, 79 children with moderate-severe motor and/or cognitive dysfunction (M:F=38:41;age=5.8±0.8 y) were evaluated and treated for feeding disorders. Management included: GT placement (36), medical/surgical treatment of GER (38), dietary supplements (17), and feeding therapy (14). After 24.6±1.6 m relative calorie intake, expressed as: Intake (kcal/d)÷RDA (kcal/d for children with DD), increased significantly (initial:final= 0.78±0.23:1.23±0.16; p<0.01). Z-scores (m±sem) for weight and height demonstrated: (Table) Therapeutic response was also assessed by acute-care hospitalization rates. Following nutritional intervention, admissions decreased from 0.4 to 0.15 per patient-year (p<0.01). Conclusions: 1. In children with DD, feeding disorders are important causes of reduced intake and malnutrition; 2. Treatment of feeding problems results in significantly increased calorie intake and improved overall nutritional status; 3. Diagnosis-specific approaches reduce morbidity related to feeding disorders. Speculations: 1. Treatment of feeding disorders in children with DD improves quality of life and lowers costs of care, by preventing complications and decreasing the frequency of acute-care hospitalizations. 2. Feeding assessment should be a routine management objective in caring for children with DD.TABLE