title: Feeding dysfunction in children with single ventricle following staged palliation.
abstract: OBJECTIVE
  To determine the prevalence of feeding dysfunction in children with single ventricle defects and identify associated risk factors.
  
  
  METHODS
  Patients aged 2-6 years with single ventricle physiology presenting for routine cardiology follow-up at the Children's Hospital of Wisconsin were prospectively identified. Parents of the patients completed 2 validated instruments for assessment of feeding dysfunction. Chart review was performed to retrospectively obtain demographic and diagnostic data.
  
  
  RESULTS
  Instruments were completed for 56 patients; median age was 39 months. Overall, 28 (50%) patients had some form of feeding dysfunction. Compared with a normal reference population, patients with single ventricle had statistically significant differences in dysfunctional food manipulation (P < .001), mealtime aggression (P = .002), choking/gagging/vomiting (P < .001), resistance to eating (P < .001), and parental aversion to mealtime (P < .001). Weight and height for age z-scores were significantly lower in subjects with feeding dysfunction (-0.84 vs -0.33; P < .05 and -1.46 vs -0.56; P = .001, respectively). Multivariable analysis identified current gastrostomy tube use (P = .02) and a single parent household (P = .01) as risk factors for feeding dysfunction.
  
  
  CONCLUSIONS
  Feeding dysfunction is common in children with single ventricle defects, occurring in 50% of our cohort. Feeding dysfunction is associated with worse growth measures. Current gastrostomy tube use and a single parent household were identified as independent risk factors for feeding dysfunction.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI. Electronic address: GHill@chw.org.
authors.forename: Garick D
authors.initials: GD
authors.lastname: Hill
authors.affiliation: Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Silverman
authors.affiliation: Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Noel
authors.affiliation: Division of Quantitative Health Sciences, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Pippa M
authors.initials: PM
authors.lastname: Simpson
authors.affiliation: Division of Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Julie
authors.initials: J
authors.lastname: Slicker
authors.affiliation: Division of Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Ann E
authors.initials: AE
authors.lastname: Scott
authors.affiliation: Division of Cardiology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI; Division of Adult Cardiovascular Medicine, Department of Internal Medicine, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bartz
mesh_terms: D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D004750:Enteral Nutrition / Q000379:methods*; D005247:Feeding Behavior / Q000502:physiology*; D001068:Feeding and Eating Disorders / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006352:Heart Ventricles / Q000002:abnormalities* / Q000601:surgery; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods*; D011184:Postoperative Period; D015995:Prevalence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014922:Wisconsin / Q000453:epidemiology
keywords: AYCE; About Your Child's Eating; G; Gastrostomy; HAZ; Height for age z-score; MBQ; Mealtime Behavior Questionnaire; S1P; S2P; Stage 1 palliation; Stage 2 palliation; WAZ; Weight for age z-score