| The purpose of this study was to examine the effects of nutrition, oral vs. nasogastric, on growth and development in children with biliary atresia who are waiting for a liver transplant. Also examined was how the chronic illness impacted on the family. The subjects were a convenience sample of 24 children with biliary atresia who were awaiting liver transplant. Twelve of the received nutrition by mouth only. The other twelve received oral as well as nasogastric feedings.; At the time of referral for transplant evaluation, which served as baseline for this study, the ages of the children ranged from 2 months to 30 months. The mean age of those who received oral feedings was 10.6 months and was 4.6 months among those who also received nasogastric feedings.; A prospective design was implemented to follow the children from their transplant evaluation to six months post evaluation. Anthropometrics growth measurements of length, standard deviation scores for height (SDS), weight, head circumference, midarm circumference (MAC), tricep skinfold thickness (TSF), and nutritional assessment were recorded bimonthly. The children served as their own controls.; Developmental evaluation using the Mullen Scales for Early Learning, were performed at the baseline evaluation and six months later. A family assessment, using the Stein Impact of the Illness of the Family Scale, was used to evaluate the family's level of stress at six months post baseline evaluation.; Repeated measures analysis of variance were performed separately on the oral and nasogastric feeding groups to evaluate changes in body length, SDS, weight, head circumference, MAC, TSF and nutritional intake (calorie per kilogram of body weight). Both groups demonstrated significant gains over time in height, weight, head circumference, and midarm circumference. The results of a paired t-test did not show a significant developmental change among the children in the oral feeding group. However, the children in nasogastric group, demonstrated a significant decline in expressive language, and visual reception raw scores. Based on the results of an independent t-test, utilizing the Stein Impact of the Illness of the Family scale there were no significant differences in the level of stress between the two feeding groups. |
