title: Does gastrostomy tube feeding in children with cerebral palsy increase the risk of respiratory morbidity?
abstract: BACKGROUND
  Children with severe neurological impairment may have significant oral motor dysfunction and are at increased risk of nutritional deficiencies, poor growth, and aspiration pneumonia. Gastrostomy tube feeding is increasingly being used for nutritional support in these children.
  
  
  OBJECTIVE
  To examine the occurrence of respiratory morbidity before and after gastrostomy feeding tube insertion in children with severe neurological disabilities.
  
  
  METHODS
  This study was nested in a longitudinal, prospective, uncontrolled, multicentre cohort study designed to investigate the outcomes of gastrostomy tube feeding in 57 children with severe neurological disabilities. Parents completed a questionnaire prior to (visit 1) and 6 and 12 months (visits 2 and 3) following the gastrostomy, detailing number of chest infections requiring antibiotics and/or hospital admission.
  
  
  RESULTS
  Mean number of chest infections requiring antibiotics was 1.8 on visit 1 and 0.9 on visit 3. Hospital admissions for chest infections fell significantly from 0.5 to 0.09.
  
  
  CONCLUSIONS
  This study provides no evidence for an increase in respiratory morbidity following insertion of a feeding gastrostomy in children with cerebral palsy.
authors.affiliation: Department of Paediatrics, University of Oxford, Oxford, UK. peter.sullivan@paediatrics.ox.ac.uk
authors.forename: P B
authors.initials: PB
authors.lastname: Sullivan
authors.forename: J S
authors.initials: JS
authors.lastname: Morrice
authors.forename: A
authors.initials: A
authors.lastname: Vernon-Roberts
authors.forename: H
authors.initials: H
authors.lastname: Grant
authors.forename: M
authors.initials: M
authors.lastname: Eltumi
authors.forename: A G
authors.initials: AG
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D016331:Parenteral Nutrition, Home; D018570:Risk Assessment / Q000379:methods