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

Feeding dysfunction in children with single ventricle following staged palliation.

Author information

1
Division of Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI. Electronic address: GHill@chw.org.
2
Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
3
Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
4
Division of Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
5
Division of Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI; Division of Adult Cardiovascular Medicine, Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI.

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

PMID:
24161218
PMCID:
PMC3946833
DOI:
10.1016/j.jpeds.2013.09.030
[Indexed for MEDLINE]
Free PMC Article

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