Feeding problems and malnutrition associated factors in a North African sample of multidisabled children with cerebral palsy.

BACKGROUND: In European and North American countries, stunting and malnutrition are common in children with cerebral palsy (CP), especially those with multiple disabilities. The extent of this problem in children with CP in North African countries is still unknown. AIMS: To evaluate feeding problems and growth in a sample of North African multidisabled children with CP and to determine the factors associated with malnutrition in this population. METHOD: We conducted a cross-sectional study including multidisabled children with severe CP. Anthropometric measurements (body weight, height, mid-upper arm circumference and triceps skinfold thickness) were performed. In addition, a thorough nutritional survey was conducted including feeding time and the presence of signs in favor of gastrointestinal problems. RESULTS: We included 40 children, mainly boys (60 %) with a mean age of 6.4 ± 3.7 (range 2-16 years). The nutritional survey had revealed the presence of dysphagia, constipation and gastroesophageal reflux in 55 %, 67.5 % and 70 % of cases, respectively. Sixty-five percent of children had a mealtime over 30 min. Based on World Health Organization (WHO) growth charts, 67.5 % of children were underweight. Forty percent of the children had their weight below the 20th percentile, 5 % and 7.5 % had their height and BMI below the 5th percentile according to CP specific growth charts. Triceps skinfold thickness and mid-upper arm circumference were below the 5th percentile in 50 % and 55 % of cases, respectively. Age (p = 0.047) and constipation (p = 0.003) were identified as predictors of malnutrition. CONCLUSIONS: Growth parameters and nutritional status are significantly altered in in our sample of North African multidisabled children with CP with a high prevalence of feeding problems represented especially by dysphagia, constipation and GER. Among the studied factors age and constipation may predict the existence of undernutrition.