Date of Award:

2005

Document Type:

Thesis

Degree Name:

Master of Science (MS)

Department:

Nutrition, Dietetics, and Food Sciences

Advisor/Chair:

Nedra K. Christensen

Abstract

PURPOSE: A retrospective chart review was conducted to determine if nutritional source of feeding and/or infant age at diagnosis of cystic fibrosis had any effect on nutritional status and subsequent growth accretion. Additionally, an attempt was made to identify predictors for poor growth in patients with undiagnosed cystic fibrosis.

METHODS: Data was collected from medical and clinic charts at Primary Children's Medical Center (PCMC), Salt Lake City, Utah, for subjects born between January 1, 1995 and December 31, 200 I, who were diagnosed with cystic fibrosis before 1 year of age. Thirty-one subjects met inclusion parameters. These subjects were divided into two groups: an "early" diagnosis group (N= 13) included those who were diagnosed before 9 weeks of age, and a "late" diagnosis group (N= 18) included those who were diagnosed after 9 weeks of age. "Breastfed at diagnosis" (N=7) and "not breastfed at diagnosis" (N= 17) groups were established as well, with nutritional source of feeding remaining unknown for 7 of the 31 subjects.

RESULTS: Paired t-tests indicated that children who were primarily breastfed at time of diagnosis did not grow significantly more than children who were formula-fed at time of diagnosis, although regression analysis indicated that nutritional source of feeding at time of diagnosis was a significant predictor of growth later in life. This contradiction could have come about due to the small sample size. Age at diagnosis had a significant effect on growth, at diagnosis, at age 2 years, and age 6 years. Children who were diagnosed early grew taller and weighed more than the children who were diagnosed after 9 weeks of age, both at the 2-year mark and at the 6- year mark. Additionally, low blood albumin levels at diagnosis were predictive of more growth at age 2 years and 6 years. Other identified predictors of growth included gender, age at diagnosis, and whether the child had a family history of cystic fibrosis. This research highlights the crucial need for early detection and correction of malnutrition in infants and children with cystic fibrosis. It should be viewed as a pilot study, with more research needed in this area.

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