A comprehensive analysis of the functional difficulties in feeding children with cerebral palsy: A tertiary care centre experience in Sri Lanka

Objectives: To identify functional difficulties in feeding children with cerebral palsy (CP), and associations with disease characteristics and consequences.
Method: This study from a tertiary care unit in Sri Lanka surveyed 226 children (2–17 years) with CP at a tertiary care centre. Feeding difficulties were assessed using the functional evaluation of eating difficulties scale (FEEDS) and CP severity using the gross motor function scale (GMFCS). Anthropometric measurements were taken. Data were analysed with ANOVA and Chi-square tests. Results with p<0.05 were considered significant.
Results: From the cohort, 88.5% of children were found to have one or more positive findings related to feeding difficulties. The FEEDS tool mean score was 12.9 out of 136 and there was a significant association of the score in the morphological and functional domains with GMFCS (χ2=27.2, p<0.01) and limb distribution (χ2=31.1, p<0.01). Prolonged feeding time was the most frequently reported (31.1%) difficulty, and recurrent respiratory infections were reported in 14.7%. Severe and moderate acute malnutrition were observed in 45.6% of the children, with 88.3% of those who were undernourished exhibiting one or more positive findings in at least one of the four domains of feeding difficulties assessed.
Conclusions: Functional difficulties in feeding were found in 88.5% of children with CP. There was a significant association between the morphological and functional domains of FEEDS with GMFCS (p<0.01) and limb distribution (p<0.01). Prolonged feeding time was the most frequently reported difficulty. Other findings were recurrent respiratory infections and acute malnutrition.