Feeding dysfunction in children with single ventricle following staged palliation

J Pediatr. 2014 Feb;164(2):243-6.e1. doi: 10.1016/j.jpeds.2013.09.030. Epub 2013 Oct 22.

Abstract

Objective: To determine the prevalence of feeding dysfunction in children with single ventricle defects and identify associated risk factors.

Study design: Patients aged 2-6 years with single ventricle physiology presenting for routine cardiology follow-up at the Children's Hospital of Wisconsin were prospectively identified. Parents of the patients completed 2 validated instruments for assessment of feeding dysfunction. Chart review was performed to retrospectively obtain demographic and diagnostic data.

Results: Instruments were completed for 56 patients; median age was 39 months. Overall, 28 (50%) patients had some form of feeding dysfunction. Compared with a normal reference population, patients with single ventricle had statistically significant differences in dysfunctional food manipulation (P < .001), mealtime aggression (P = .002), choking/gagging/vomiting (P < .001), resistance to eating (P < .001), and parental aversion to mealtime (P < .001). Weight and height for age z-scores were significantly lower in subjects with feeding dysfunction (-0.84 vs -0.33; P < .05 and -1.46 vs -0.56; P = .001, respectively). Multivariable analysis identified current gastrostomy tube use (P = .02) and a single parent household (P = .01) as risk factors for feeding dysfunction.

Conclusion: Feeding dysfunction is common in children with single ventricle defects, occurring in 50% of our cohort. Feeding dysfunction is associated with worse growth measures. Current gastrostomy tube use and a single parent household were identified as independent risk factors for feeding dysfunction.

Keywords: AYCE; About Your Child's Eating; G; Gastrostomy; HAZ; Height for age z-score; MBQ; Mealtime Behavior Questionnaire; S1P; S2P; Stage 1 palliation; Stage 2 palliation; WAZ; Weight for age z-score.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Body Weight
  • Child
  • Child, Preschool
  • Enteral Nutrition / methods*
  • Feeding Behavior / physiology*
  • Feeding and Eating Disorders / epidemiology
  • Feeding and Eating Disorders / etiology*
  • Feeding and Eating Disorders / physiopathology
  • Female
  • Follow-Up Studies
  • Heart Defects, Congenital / surgery*
  • Heart Ventricles / abnormalities*
  • Heart Ventricles / surgery
  • Humans
  • Male
  • Palliative Care / methods*
  • Postoperative Period
  • Prevalence
  • Retrospective Studies
  • Surveys and Questionnaires
  • Treatment Outcome
  • Wisconsin / epidemiology