Eating and drinking abilities and nutritional status in children with cerebral palsy: A population‐based study

Aim To investigate the prevalence of eating and drinking difficulties as classified with the Eating and Drinking Ability Classification System (EDACS) in a large population‐based cohort of children with cerebral palsy (CP) at all levels of motor function, and how EDACS classifications relate to undernutrition. Method This was a cross‐sectional study based on data from the Swedish CP follow‐up programme of children aged 19 years and younger. EDACS ratings were compared to z‐scores for weight for age and height for age, calculated using standard references. Regression models were used to estimate how height for age was affected by EDACS levels when controlling for gross motor function and CP subtype. Results We included 2280 children with CP (945 females, 1335 males), median age 10 years 2 months. Almost a third (30.6%) had safety concerns during mealtimes (EDACS levels III–V). Most children (57.5%) could eat and drink independently, 20.2% required assistance, and 22.4% were totally dependent. One in five had undernutrition (19.9%) and there was an association between EDACS level and nutrition ( p < 0.001). Height for age decreased from EDACS level II and also when controlling for gross motor function and CP subtype. Interpretation Almost one in three children with CP have dysphagia. Growth is affected in children with CP already from EDACS level II.