UCL Institute for Global Health
The effectiveness of a low-tech approach to the management of feeding difficulties in children with Cerebral Palsy in Dhaka
Dhaka Shishu (Children) Hospital, Bangladesh
Feeding difficulties are a common consequence of Cerebral Palsy and have far-reaching effects on the children and their caregivers. Feeding difficulties are known to result in severe malnutrition, poor general health and recurrent chest infections, with pneumonia cited as the commonest cause of death in this population.
Feeding difficulties also result in caregiver frustration, upset and stress, which often leads to aggressive feeding practices and distressing mealtimes for the child.
The aims of this study were to design a training programme for caregivers living in a low income environment, where alternative feeding options, such as gastrostomy-tube feeding, are not available.
We therefore aimed to maximise oral feeding for children with CP by teaching caregivers feeding methods that would improve nutritional intake, reduce the risks of aspiration during feeding and making mealtimes more enjoyable and less stressful.
Preliminary results show averages of 60-70% achievement in the attainment of individual caregiver training goals, including changes in diet provided to their children and the caregivers¹ feeding manner.
Caregivers report a marked decrease in the number of chest infections in their children since attending the training, which is mirrored by a significant decrease in signs of aspiration observed in the children during post-training feeding.
Caregivers reported stress levels have decreased by 76.5% and children¹s observed distress during feeding has been reduced by 66.75%. Conversations have already begun with policy-holders in Bangladesh to raise awareness of these issues and to lobby for the integration of children with disabilities in health and nutrition programmes.