Chewing Disorders and Related Nutritional Problems in Children with Cerebral Palsy

Abstract

Cerebral palsy (CP) is a clinical picture that occurs as a result of brain damage before, during or after birth. Cerebral palsy is one of the most common causes of childhood disability. Sensory, motor and mental problems accompany the condition in CP. Sensory and motor involvement, especially in the orofacial region, causes serious problems in chewing function, which is an important stage of nutrition. Chewing refers to the process of breaking down food and making it ready for swallowing. Chewing disorder, on the other hand, refers to the problems seen during accepting food by mouth, keeping it in the mouth, and turning it to a swallowable consistency. Chewing function begins to be observed around 4-6 months in children with normal development, and it develops until the age of 8 years with increased tongue movements, teeth eruption and solid food experiences. Oromotor dysfunctions, abnormal neurological development, postural disorders and cognitive impairment which were seen in children with CP adversely affect their ability to manage age-appropriate food textures and turn foods into swallowable consistency, and cause chewing disorders. The solid food intake can be limited in children with CP due to chewing disorders, and mostly semi-solid or liquid foods that do not require chewing skills are preferred. This can restrict the necessary energy intake and cause malnutrition. At the same time, considering the process of preparing meals, it causes negative social interaction and a decrease in the quality of life for both the child and the family. Therefore, the nutritional status of children with CP with chewing disorder should be determined early and appropriate treatment approaches should be planned.