Nutrition and growth in children with cerebral palsy: setting the scene

The early text books on cerebral palsy in children made little or no mention of the feeding and nutritional problems that are common in this group of children. Even today the nutrition and growth deficits in this group of children are often under recognised or considered to be of low priority. It is really only in the last couple of decades that the nutritional needs of children with cerebral palsy have been the subject of research interest. It is also important to note that neurological impairment in children is here to stay. Epidemiological data on the prevalence of cerebral palsy show that in those who are premature, weighing <1500 g at birth, cerebral palsy occurs in up to 65 per 1000 live births. 1 The recent EPICURE 2 study showed that although the survival of preterm neonates of 22–25 weeks gestation has improved from 1995 to 2006, the proportion with severe disability is unchanged. 2 Moreover, the life expectancy of these children is gradually improving, with survival curves for 10-year old boys with cerebral palsy showing a 50% survival into their late 20s ( http://www.lifeexpectancy.org/survival.shtml ). The prevalence and consequences of feeding difficulties in individuals with cerebral palsy therefore should not be underestimated. Reilly et al. 3 showed feeding difficulties in up to 85% of children with spastic quadriplegia, and the North American Growth and Cerebral Palsy Project showed that two-thirds of such children were stunted and 44% had low fat stores. These growth deficits were found to correlate with the severity of cerebral palsy. 4