NUTRITION IN SEVERELY DISABLED CHILDREN

Key words: Nutrition, Disability, Oropharyngeal function, Enteral nutrition (EN), Gastroesophageal reflux (GER), Gastrostomy

As many as 90% of severely disabled children suffer from nutritional problems. Deglutition problems and gastroesophageal reflux hamper nutrition and cause frequent lower respiratory infections. Malnutrition follows in many cases. Appropriate management is based on early assessment of oropharyngeal function, GER and nutritional status. Nutritional status can be improved by appropriate feeding techniques and enteral nutrition (EN). EN is indicated when severe feeding problems or severe GER are present. The article also discusses the indications for gastrostomy or jejunostomy are discussed and provides recommendations for minimizing the risk of aspiration, bacterial contamination and ostruction of the EN tube.