Oral-motor dysfunction and feeding problems in infants with myelodysplasia

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.