Gastrointestinal and nutritional issues in children with neurological disability

C Romano, V Dipasquale, F Gottrand… - … Medicine & Child …, 2018 - Wiley Online Library
C Romano, V Dipasquale, F Gottrand, PB Sullivan
Developmental Medicine & Child Neurology, 2018Wiley Online Library
Neurological disability is often associated with feeding and gastrointestinal disorders
leading to malnutrition and growth failure. Assessment of nutritional status represents the
first step in the clinical evaluation of children with neurological disability. The European
Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) recently issued a
consensus statement on gastrointestinal and nutritional management in children with
neurological disability. Here we critically review and address implications of this consensus …
Neurological disability is often associated with feeding and gastrointestinal disorders leading to malnutrition and growth failure. Assessment of nutritional status represents the first step in the clinical evaluation of children with neurological disability. The European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) recently issued a consensus statement on gastrointestinal and nutritional management in children with neurological disability. Here we critically review and address implications of this consensus for clinical practice, including assessment and monitoring of nutritional status, definition of nutritional requirements, diagnosis and treatment of gastro‐oesophageal reflux disease, and indications for and modalities of nutritional support. There is a strong evidence base supporting the ESPGHAN guidelines; their application is expected to lead to better management of this group of children.
What this paper adds
  • Assessment of nutritional status in children with neurological disability should include the evaluation of body composition.
  • Standard polymeric formula via gastrostomy tube is an effective, long‐term nutritional intervention.
  • Tube feeding should be started early, before the development of malnutrition.
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