Demographic and Clinical Parameters Are Comparable Across Different Types of Pediatric Feeding Disorders

Background: Knowledge and understanding of risk mechanisms associated with pediatric feeding disorders (PFD) remain limited. We aimed to investigate causative factors associated with PFD and their relation to specific PFD types according to the recent consensus WHO-based definition. Methods: We retrospectively reviewed the medical records of children with PFD and retrieved their demographic and clinical characteristics. Healthy age- and sex-matched children served as controls. Results: Included were 254 children with PFD [median (interquartile range) age 16.4 (9.5-33) months at diagnosis] and 108 children in the control group [median age 24.85 (14.5-28.5) months]. According to the WHO-based definition, disturbances in oral intake were predominantly related to nutritional dysfunction in 118 (46.6%), feeding skill dysfunction in 83 (32.3%), medical conditions in 42 (16.7%) and psychosocial dysfunction in 11 (4.4%). In multivariate analysis, children with PFD had a higher risk for lower socioeconomic background (P<0.01) and low birth weight (26.8% compared to 7.4% ,P<0.001). Moreover, significantly fewer children in the PFD group were breastfed (75% versus 89%, P=0.003). There were no significant differences in any of those variables between PFD types. Conclusions: Low socioeconomic status, lack of breastfeeding, and low birth weight were significantly more frequent in children with PFD. PDF manifest as multiple dysfunctions, thus highlighting the need to offer these children and their families multidisciplinary care.

Qualitative Exploration of Mealtime Routines and Parental Stress of Children with Pediatric Feeding Disorders: Analysis of Occupational Performance

Pediatric feeding disorders (PFD) affect approximately 25-35% of children with typical development, 40-80% of children with developmental disabilities, and 90% of children with autism spectrum disorder (ASD). Feeding disorders affect families by disrupting mealtime routines, changing family dynamics, and increasing parental stress. Occupational therapy (OT) focuses on client-centered care that facilitates independence in meaningful occupations, including feeding and eating. OTs also play an essential role in assisting, training, and educating parents on effective mealtime strategies that can be implemented and carried over into the home environment. Few research studies show how parents manage behaviors and stress during mealtime routines, and little attention has been placed on how PFD can affect parental stress. This study reinforces the value of OT services that focus on family-based interventions and family-based training, considering rituals, routines, and environment to help decrease parental stress during mealtime routines. Data was collected during face-to-face interviews with parents of children diagnosed with PFD. The data gathered was used to identify and analyze how parents of children with PFD manage behaviors and stress during mealtimes. This study benefits families of children with PFD because it will provide additional resources and advocacy for parents. The benefit of having more resources available for parents regarding mealtime stress and mealtime behaviors is that parents will have more opportunities to find a strategy that will benefit the family routine and dynamic. This study will benefit OT practitioners because it will help guide OT family-based interventions reinforcing the importance of carry-over strategies for parents. Analysis of the data suggested that parents of children with PFD perceive mealtime behaviors as highly stressful. The analysis also showed that parents tend to ignore maladaptive mealtime behaviors during mealtime. However, when this was not successful, they would soothe the child or use punishment such as taking away electronic devices. To relieve stress, parents reported getting outdoors and talking to family or friends as the primary way of reducing stress. The findings from this qualitative study support the need for OTs to incorporate families’ unique habits, routines, and cultural and social norms into parent training to ensure the carry-over of strategies into the respective home environment.