Delayed Development of Feeding Skills in Children with Feeding Difficulties—Cross-sectional Study in a Brazilian Reference Center

Abstract

BackgroundDelays in gross motor development, sensory processing issues, and organic and behavioral problems are known to interfere in the development of feeding skills (FS); and—therefore—in the success of the process of feeding a child. Children with feeding difficulties (FD) commonly present inadequacy of FS.ObjectivesAssessment of five FS in Brazilian children with FD, and search of associations with types of FD.MethodsCross-sectional study with 70 children below 10 years old. Data were obtained from medical records: age, gender, age at texture transitions, feeding phase (breastfeeding, weaning to solids or full solids) at first complaint; characteristics of the meal (duration, environment, and shared meals with adults), self-feeding practices, use of feeding equipment and bottle, mouthing, feeding position and FD diagnosis. Skills were categorized according to standards for age. Chi-Square, Anova Test (or non-parametric equivalent) and Multinomial logistic regression tests were used, with a significance level of 5%.ResultsThere was no difference in FS (p > 0.05) or in the number of FS inadequateness (p = 0.84) according to FD diagnosis. The majority (94%) of children presented at least one delayed development of FS; 1/3 presented delays in more than half of the FS. The most prevalent inadequacies in FS were inadequate feeding position (73.5%), prolonged bottle feeding (56.9%), and inadequate self-feeding practices (37.9%). Feeding complaints first appeared at 10.9 ± 11.4 months, and picky eating was the most prevalent type of FD (37.1%). Most children were fed in inadequate environments (55.2%), without the company of adults (78%). Transition to solid foods occurred at 16 ± 5.6 months. Multinomial logistic regression showed no difference in likelihood of presenting any type of FD compared to picky eating, according to FS. Age at texture transition both from breastfeeding to complementary feeding (p = 0.95), and from complementary feeding to solid foods (p = 0.43) did not vary according to FD diagnosis.ConclusionFS development or number of FS inadequateness did not vary according to FD diagnosis. Identification of these inadequacies could help the discussion for multi-professional treatment of patients with FD.

Cross-Cultural Adaptation and Validation of the Montreal Children’s Hospital Feeding Scale Into Brazilian Portuguese

“…These rates can reach 80% in populations at risk, such as those with developmental delays, premature births and/or chronic and complex medical conditions. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 Feeding difficulties are a high-impact clinical problem, with negative consequences for the child, 3 , 8 , 9 including failure to thrive, malnutrition, lethargy, developmental delay, aspiration, invasive medical procedures, admission to the inpatient unit and even death. 10 Likewise, feeding difficulties significantly affect family relationships, 7 leading to excessive stress during meals, 1 , 2 , 8 , 9 , 11 hindering many aspects of the life and general well-being of both children and their families.…”

“…Due to the high prevalence 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 12 and the negative consequences of feeding difficulties, health professionals should have access to a valid and reliable screening instrument, of clinical applicability, able to quickly identify the complaints of parents or legal guardians on their children’s feeding difficulties. Thus, referral to specialists can be carried out as soon as the problem is identified.…”

Aspectos comportamentais e ambientais associados às dificuldades alimentares na infância: Estudo com grupo controle

“…8,9 Há evidências de que famílias com queixas de DA tendem a exercer práticas consideradas não responsivas (o que pode exacerbar a queixa e/ou dificultar seu manejo), 9 de que há perfil específico de práticas de refeições em família na presença de recusa alimentar (incluindo estresse e recusa em partilhar as refeições) 10 e de que estas crianças apresentam padrões de atraso no desenvolvimento de algumas habilidades de alimentação, como habilidades para comer sozinho e manusear utensílios, entre outros. 11 Considerando os aspectos expostos, o objetivo do presente estudo foi investigar os fatores associados à presença de dificuldades alimentares na infância, dentre dinâmicas de refeições e práticas parentais.…”

Disfunção motora oral e dificuldade alimentar durante a alimentação complementar em crianças nascidas pré-termo

“…We found no studies in the literature that sought to associate these variables in this specific population. However, the study (19) that characterized the profile of varied oral skills for feeding in a group of children with different gestational ages and diagnosis of feeding difficulty (FD) demonstrated association only between the inappropriate use of utensils and the caregivers' misperception about the difficulties investigated, according to the classification by Kerzner et al (20) .…”