Feeding Dysfunction in Children with Single Ventricle Following Staged Palliation

• Published in: The Journal of pediatrics Vol. 164; no. 2; pp. 243 - 246.e1
• Main Authors: Hill, Garick D., Silverman, Alan H., Noel, Richard J., Simpson, Pippa M., Slicker, Julie, Scott, Ann E., Bartz, Peter J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2014
• Subjects: Body Weight; Child; Child, Preschool; Enteral Nutrition - methods; Feeding and Eating Disorders - epidemiology; Feeding and Eating Disorders - etiology; Feeding and Eating Disorders - physiopathology; Feeding Behavior - physiology; Female; Follow-Up Studies; Heart Defects, Congenital - surgery; Heart Ventricles - abnormalities; Heart Ventricles - surgery; Humans; Male; Palliative Care - methods; Pediatrics; Postoperative Period; Prevalence; Retrospective Studies; Surveys and Questionnaires; Treatment Outcome; Wisconsin - epidemiology; Wisconsin; HAZ; S2P; WAZ; S1P; AYCE; G; MBQ; Gastrostomy; About Your Child's Eating; Stage 2 palliation; Weight for age z-score; Height for age z-score; Mealtime Behavior Questionnaire; Stage 1 palliation
• ISSN: 0022-3476; 1097-6833; 1097-6833
• DOI: 10.1016/j.jpeds.2013.09.030

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