Nutritional Management of Children With Neurological Impairment in China: Current Status and Future Directions

Li Hong; Kaishou Xu; Dengna Zhu; Lingxia Sun; Valeria Dipasquale; Claudio Romano

doi:10.1097/PG9.0000000000000164

Nutritional Management of Children With Neurological Impairment in China: Current Status and Future Directions

JPGN Rep. 2021 Dec 10;3(1):e164. doi: 10.1097/PG9.0000000000000164. eCollection 2022 Feb.

Authors

Li Hong¹, Kaishou Xu², Dengna Zhu³, Lingxia Sun⁴, Valeria Dipasquale⁵, Claudio Romano⁵

Affiliations

¹ From the Department of Clinical Nutrition, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China/ Fujian Children's Hospital, Fujian, China.
² Department of Rehabilitation, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
³ Department of Rehabilitation, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
⁴ Nestle Health Medical Science, Medical and Clinical Affairs, Beijing, China.
⁵ Department of Human Pathology and Pediatrics, University of Messina, Messina, Italy.

Abstract

The aim of this study is to assess the awareness of Chinese physicians on gastrointestinal and nutritional management of children with neurological impairment (NI) and to assess the practical application of the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines on the management of nutritional and gastrointestinal problems in children with NI in Asian countries, particularly in several major medical centers in China.

Methods: A web-based questionnaire was distributed between November 2020 and January 2021 among Chinese healthcare professionals involved in the clinical management of children with NI. Fifteen questions covering the most relevant aspects of nutritional management and gastrointestinal issues of children with NI were surveyed. A descriptive analysis of responses was performed.

Results: A total of 577 healthcare professionals from over 28 provinces in China answered the questionnaire. Anthropometrics were the most used parameters (n = 539) to assess nutritional status. Most respondents (n = 455) indicated weight faltering and/or failure to thrive as definition of undernutrition. Direct observation of meals was considered the recommended method for diagnosing oropharyngeal dysfunction by 542 professionals. Fundoplication was indicated at the time of gastrostomy placement in patients with uncontrolled gastroesophageal reflux disease by 437 respondents.

Conclusions: The clinical practice of Chinese healthcare professionals does not completely match the European Society of Pediatric Gastroenterology, Hepatology, and Nutrition guidelines, probably due to the medical system and the economic, social, and cultural differences. Further studies are needed to improve clinical practice and knowledge. Multidisciplinary approach is crucial to optimize the overall medical care and quality of life for children with NI.

Keywords: children; dysphagia; enteral nutrition; gastroesophageal reflux disease; neurological impairment; survey.

Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.