For 71 children with spinal muscular atrophy, a dietitian on a screen eased some feeding problems. The study could not say how much that changed daily life

Spinal muscular atrophy can make feeding much more than a matter of choosing what is on the plate. Depending on the child, chewing and swallowing, tube feeding, growth, constipation and the practical work of caregiving can all be part of the picture. A randomised trial published in October asked whether a dietitian could provide some of that support remotely, either in live sessions or through an asynchronous format, rather than only through usual care.

The researchers enrolled 71 children with spinal muscular atrophy and their mothers in Türkiye. They randomly allocated 24 families to synchronous tele-nutrition, 24 to asynchronous tele-nutrition and 23 to a control group. Sixty-six children completed follow-up, leaving 22 in each group for analysis. The study measured three investigator-developed scores: nutrition-related problems in the child, tube-feeding-related problems, and caregiver feeding problems. It also examined growth measures, caregiver quality of life and satisfaction with remote support.

Both tele-nutrition groups had larger reductions in caregiver feeding-problem scores than the control group. Compared with control, the adjusted difference in change was -2.36 points for asynchronous support and -2.86 points for live support. Nutrition-related-problem scores also fell more: -0.86 and -1.09 points respectively. The two remote formats did not differ clearly from one another on either of those outcomes. Families reported high satisfaction: 38 of the 44 people offered remote support, or 86.4%, said they were satisfied.

The promising part is not proof that a video appointment or messages will improve nutrition, growth or quality of life for every child with SMA. The primary scores were created by the investigators and do not yet have established cut-offs for a clinically meaningful change. The tube-feeding comparison did not differ from control, and among several secondary outcomes only the environmental quality-of-life domain had a between-group difference that excluded no effect. A larger, longer trial would need to confirm the findings. For families, the practical takeaway is simply that remote dietitian access may be a useful support option to discuss with the child’s specialist team, not a replacement for individual medical and feeding care.