Feeding the Disabled ChildUpplaga 1

Disabled children often have feeding difficulty. Choking, food spillage and protracted mealtimes can pose enormous problems for their carers and the accompanying nutritional deficit imposes additional burdens on the affected child. The aetiology of these problems is placed in context by a detailed description of normal feeding development in infants. The often under-recognised nutritional and neurodevelopmental consequences of inadequate nutrient intake together with the respiratory complications and the important problems of constipation and drooling which may accompany oro-motor dysfunction are detailed. The clinical and nutritional assessment and the application of diagnostic imaging techniques in the evaluation of such children are described. The methods of management of these children's problems form the core of this volume and they range from oro-motor therapy to various techniques for enteral feeding. The ethical issues raised by the vigorous intervention needed to improve the nutritional state of severely disabled children is explored, together with the need to provide ongoing psychological support for their carers.