Dietary considerations in osteopenia in tube-fed nonambulatory children with cerebral palsy

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