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Gastrostomy – neurological impairment — RACP Paediatrics MCQ

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ModerateGIGastrostomy – neurological impairmentRACP Paediatrics

A 2-year-old with cerebral palsy (GMFCS level V) has chronic faltering growth despite optimal oral intake with modified textures. Aspiration risk is manageable with positioning. Oral feeding takes over 1 hour per meal. What is the most appropriate long-term nutritional intervention?

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Correct answer: D — Gastrostomy (PEG/RIG)

Gastrostomy feeding (PEG or RIG placement) is the recommended long-term enteral feeding route for children with neurological impairment who cannot achieve adequate nutrition orally. It is preferred over long-term NG tubes due to comfort, cosmesis, and reduced tube displacement risk. Oral feeding for pleasure can continue alongside gastrostomy feeds if aspiration risk is manageable.

Reference: RCH Melbourne – 2023 – Enteral Nutrition CPG; RACP Paediatric Curriculum – GI/Neurodisability