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Clinical Pediatrics
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Dietary Considerations in Osteopenia in Tube-Fed Nonambulatory Children with Cerebral Palsy

Burris Duncan, MD

Department of Pediatrics and The Steele Memorial Children's Research Center, University of Arizona, Tucson; Department of Pediatrics, University of Arizona Health Sciences Center, 1501 N. Campbell Ave., PO Box 245073, Tucson, Arizona 85724-5073

Leslie L. Barton, MD

Department of Pediatrics and The Steele Memorial Children's Research Center, University of Arizona, Tucson

Janel Lloyd, MD

Catalina Pediatrics, Tucson

Marjorie Marks-Katz

Childrens' Clinic for Rehabilitative Services, Tucson, AZ

Children with nonambulatory cerebral palsy are frequently found to be osteopenic. We sought factors, in addition to immobility and anticonvulsant therapy, that may contribute to the osteopenia. A retrospective chart review of 19 children with nonambulatory cerebral palsy who received gastrostomy tube feedings of standard commercial formulas was performed. Less than 75% of the Recommended Daily Allowance (RDA) was administered to 95% of the children for calories, 58% for calcium, 68% for phosphorus, and 74% for vitamin D. Five of the 19 chidren sustained fractures without major trauma. This study suggests that inadequate intake of crucial vitamins and minerals may contribute to the severe osteopenia observed in many children with nonambulatory cerebral palsy. The nutritional needs of these children, including those for micronutrients, must be defined and appropriate supplementation given.

Clinical Pediatrics, Vol. 38, No. 3, 133-137 (1999)
DOI: 10.1177/000992289903800302
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