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Jeff Brody
Litigators Inc.

Incidence of Malnutrition in Individuals with Cerebral Palsy

The incidence of malnutrition in individuals with cerebral palsy is far more common than originally perceived. A condition called oral motor dysfunction (OMD) results in impaired muscular function that affects swallowing, chewing, speaking, or facial posture. The condition of OMD is present in a high percentage of individuals with cerebral palsy. OMD causes extreme difficulty when attempting to feed an affected person, leading to the incidence of malnutrition in individuals with cerebral palsy.

Feeding problems are very common in children with cerebral palsy as 30 to 80 percent of disabled individuals feed with difficulty. In addition, because of communication difficulties many of them are unable to request food and drink causing incidence of malnutrition in individuals with cerebral palsy. As a result of not receiving adequate nutrition 48 percent suffer from growth retardation. Fortunately, nutritional rehabilitation can be quite rewarding for these individuals. The main issue remains that lack of awareness of parents regarding the need and possible corrective measures overshadows any hope to improve their nutrition and stop incidence of malnutrition in individuals with cerebral palsy.

Parents' perception of their child’s nutrition is usually not as accurate as they think. In a study of 100 children with cerebral palsy, 17% of parents though their child’s nutrition was bad, while another 49% felt their child’s nutrition was unsatisfactory. Another 34% thought their child’s nutrition was satisfactory. Out of the “satisfactory” group it was found that a significant number had poor nutrition and 35% of them had severe malnutrition.

The incidence of malnutrition in individuals with cerebral palsy is a combination of factors, which directly or indirectly result in reduced food and nutrient intake. Feeding problems are not easily recognizable in children and in order to optimally utilize the impaired feeding potential in these children, early identification of the incidence of malnutrition in individuals with cerebral palsy is necessary. It also requires regular assessment of feeding and nutritional status and appropriate nutritional rehabilitation.

Feeding problems are usually complicated by the lack of awareness of parents about disease and the incidence of malnutrition in individuals with cerebral palsy. The main reasons for lack of awareness in parents were illiteracy, misconception about disease and associated complications of cerebral palsy. It is evident that the psychological impact of having a child with severe chronic neurological disease is so deep that parents do not appreciate the feeding problems to the extent they should.

Interviews with parents of cerebral palsy children revealed that instead of being an enjoyable family event, meals were stressful and time consuming for the children and those caring for them. Feeding took in between 4 and 6 hours a day and featured repeated spillage of food, bouts of cough, choking, and regurgitation.

Although its not known what is the best food to be offered to children with OMD, recommendations include food that can be eaten with the least frustration or distress. Overall, foods of liquid or semisolid consistency should be the main focus for nutritional rehabilitation. The identification of nutritional problems has great potential to help improve weight, muscle mass, decreased irritability, and circulation in order to halt the incidence of malnutrition in individuals with cerebral palsy.

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