Mathisen B A, Shepherd K
Department of Rehabilitation Medicine, Royal Children's Hospital, Herston, Queensland, Australia.
Pediatr Rehabil. 1997 Apr-Jun;1(2):117-22. doi: 10.3109/17518429709025854.
Oral motor function and feeding problems have received little attention in infants with myelomeningocele (MMC). We compared objective video assessments of oral motor skills, diet and feeding function of 20 infants (aged 6 months) with MMC, with data from 20, age, gender, and socioeconomically matched healthy infants using the Feeding Assessment Schedule (FAS), Feeding Environment Check (FEC), Tester's Ratings of Infant Behaviour (TRIB), an Infant Feeding Questionnaire (IFQ), and a 24 hour dietary analysis (DQA). MMC infants had significant feeding difficulty, related to sensory motor integration problems such as hypotonicity, positioning, and hand function. Despite these problems, there was minimal behavioural disruption in infants with MMC and their mothers experienced no marked food aversion or negative feeding experiences. MMC infants consumed feedings which were significantly lower in energy than controls, with possible imbalance of other nutrients. These studies indicate that compared with healthy infants MMC infants have significantly altered oral motor function which we speculate could be early features of the Chiari II malformation. The dietary changes may reflect altered energy requirement. Early identification and management of feeding problems associated with this condition is emphasized.
脊髓脊膜膨出（MMC）婴儿的口腔运动功能和喂养问题很少受到关注。我们使用喂养评估量表（FAS）、喂养环境检查表（FEC）、测试者对婴儿行为的评分（TRIB）、婴儿喂养问卷（IFQ）以及24小时饮食分析（DQA），比较了20名患有MMC的6个月大婴儿的口腔运动技能、饮食和喂养功能的客观视频评估结果与20名年龄、性别和社会经济状况相匹配的健康婴儿的数据。患有MMC的婴儿存在明显的喂养困难，这与感觉运动整合问题有关，如张力减退、姿势和手部功能。尽管存在这些问题，但患有MMC的婴儿的行为干扰最小，他们的母亲也没有明显的食物厌恶或负面喂养经历。患有MMC的婴儿摄入的能量明显低于对照组，其他营养素可能存在失衡。这些研究表明，与健康婴儿相比，患有MMC的婴儿的口腔运动功能有显著改变，我们推测这可能是Chiari II畸形的早期特征。饮食变化可能反映了能量需求的改变。强调了对与这种情况相关的喂养问题的早期识别和管理。
