Feeding difficulties in young paediatric intensive care survivors: A scoping review

Abstract

Background: Although feeding difficulties are commonly described amongst children with chronic diseases, those admitted to a paediatric intensive care unit (PICU) represent a mix of previously healthy children as well as those with pre-existing diseases. There is, however, a lack of evidence describing the prevalence and type of feeding difficulties amongst healthy children who survive a period of critical illness and the subsequent impact on growth and family life. The aim of this work was to complete a scoping review of evidence describing feeding difficulties amongst PICU-survivors. Method: Six electronic databases were searched from January 2000eOctober 2018. NICE Healthcare Databases Advanced Search website (https://hdas.nice.org.uk/) was used as a tool to complete multiple searches within multiple databases, including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo and Medline. Any studies considering feeding difficulties amongst previously healthy children following discharge from PICU or those which explored the parental/caregiver experiences were included. Results: As the initial search yielded only one study which fulfilled the inclusion criteria, the criteria was extended to include studies relating to feeding difficulties (post-discharge) amongst otherwise healthy ex-preterm infants (born < 37 weeks gestational age) and infants/children with chronic diseases where feeding difficulties were described following a PICU admission. A review team screened and extracted the data of published qualitative and quantitative studies, using content analysis techniques. Of the 9622 articles identified from the searches, 22 full-text studies were reviewed with seven studies included. Four overarching categories represented the results: prevalence of feeding difficulties; risk factors and predictors for developing feeding difficulties; parental/carer experience and emotional response to feeding difficulties; and challenges in accessing feeding support. Conclusions: The results of this scoping review suggest there are gaps in the research, particularly those exploring the prevalence of feeding difficulties amongst previously healthy children and the negative impact this may have on family life. Future research should focus on addressing the extent of the problem and identifying risk factors, in addition to the potential development of toolkits for health care professionals to better support parents.

Factors Impacting on Eating in Pediatric Intestinal‐Transplant Recipients: A Mixed‐Methods Study

“…Study participants were of short stature (common following long-term PN), 3 PN was weaned within 2 months, 3,28 many children were slow or unable to transition from tube feeding to an oral diet following transplant, 4,5 and many were food avoidant. 1,5,17,18 Eating difficulties have been demonstrated in healthy children following a delay in lumpy textures, 32 in tube-fed infants with limited food exposure, 33 and in pediatric intensive care survivors, 34 whereas an association with repeated food exposure and acceptance has been widely described. 35,36 Eating difficulties have been associated with aversive experiences such as reflux and vomiting in those with allergies 37 and eosinophilic disease 38 and with the frequency or severity of aversive experiences.…”

Considerations for nutrition support in critically ill children with COVID-19 and paediatric inflammatory multisystem syndrome temporally associated with COVID-19

“…In addition, the impact of paediatric critical illness on feeding and feeding difficulties post-discharge remains unknown [ 30 ]. Adult survivors of critical care report significant changes to their ability to eat, with reduced appetite, altered taste and food preferences lasting up to 3 months post ICU discharge, which is likely to be an important consideration in children [ 31 ].…”

Protocol for a multicentre longitudinal mixed-methods study: feeding and survivorship outcomes in previously healthy young paediatric Intensive care survivors (the PIES Study)

“…3 24 There is, however, no evidence looking at feeding difficulties and parental-child feeding interactions associated with feeding in the previously healthy PICU population. 25 Although there is some information describing feeding outcomes in children born prematurely and young children with coronary heart disease (CHD), there remains a lack of high-quality evidence. The consequence of an admission to PICU on the ability of young children to eat and drink initially after PICU discharge and then once home, and the implications this has for young children and their families, is not known.…”