Growth in Children With Cerebral Palsy Fed Via Gastrostomy

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Abstract
Growth characteristics of 57 children with feeding gastrostomies attending the cerebral palsy clinic at a regional medical facility were evaluated. All children had severe neuromotor and orofacial involvement and mental retardation. More than 90% of the patients were less than fifth percentile for height and weight, and 80% were underweight for height before gastrostomy tube placement. Following gastrostomy, 33% remained underweight for height and 21% became overweight for height. The majority of children remained at less than the fifth percentile for height and weight. Improvement in linear growth was much less common than improvement in weight. Children with gastrostomies placed in the first year of life were most likely to exceed the fifth percentile for height and weight. The mechanisms of growth retardation in children severely affected by cerebral palsy are not known, but poor nutrition is thought to be the major contributor. Gastrostomy feeding in children severely affected by cerebral palsy can improve nutritional status but does not eliminate growth retardation. The importance of growth and adequate nutrition in reducing morbidity in children with severe neuromotor involvement remains to be established.