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Thompson KL, Clarke EC, Wasser H, Schenkelberg MA, Agrawal S, Willis EA. Complementary feeding practices of caregivers of infants with Down syndrome as compared to caregivers of typically developing infants. Appetite 2024; 198:107356. [PMID: 38636668 DOI: 10.1016/j.appet.2024.107356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
Caregiver feeding practices during the complementary feeding period (6 months-2 years) may be particularly important for infants with Down syndrome (DS) as they are at higher risk for later health conditions (e.g., obesity, diabetes) that can be influenced by early feeding practices. However, how well caregivers of infants with DS are meeting infant feeding evidence-based practices is relatively unknown. Caregivers of infants with DS (N = 75) and caregivers of typically developing (TD) infants (N = 66) aged 0-2 years completed an online survey about their infant feeding practices and information sources. Caregiver practices and information sources were statistically compared between groups. Results indicated that there are significant differences in the feeding practices of caregivers of infants with DS when compared to caregivers of TD infants. Caregivers of infants with DS were less likely to meet infant feeding evidence-based practices than caregivers of TD infants. Caregivers of infants with DS were also more concerned about their infant's food intake and later weight status. Some individual feeding practices also significantly differed between groups, with caregivers of infants with DS more likely to meet evidence-based practices of purchasing iron rich foods and avoiding added salt, but less likely to use responsive feeding practices than caregivers of TD infants. Caregivers of infants with DS were also less likely to receive information about how to navigate the complementary feeding period than caregivers of TD infants. Coupled with existing research, the results of the present study suggest that infant feeding evidence-based practices should be reviewed for their appropriateness for this population and additional support for caregivers of infants with DS should be implemented to help them navigate this important period.
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Affiliation(s)
- Kelsey L Thompson
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 MLK Jr Blvd, Chapel Hill, NC, 27514, USA.
| | - Emily C Clarke
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 MLK Jr Blvd, Chapel Hill, NC, 27514, USA
| | - Heather Wasser
- Gillings School of Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27514, USA
| | - Michaela A Schenkelberg
- School of Health and Kinesiology, University of Nebraska at Omaha, 6001 Dodge Street, Omaha, NE, 68182, USA
| | - Seema Agrawal
- Gillings School of Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC, 27514, USA
| | - Erik A Willis
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 MLK Jr Blvd, Chapel Hill, NC, 27514, USA
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Genovesio MCRS, Monteiro LS, da Silva AV, Rodrigues PRM, Baumblatt AP, Ribas SA. Feeding practices and dietary intake in Brazilian children with Down syndrome: A cross-sectional study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024. [PMID: 38740558 DOI: 10.1111/jir.13148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/13/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Studies investigating the quality of the diet and dietary intake of children with Down syndrome (DS) are required because the features attributed to the syndrome can affect growth, development and quality of life. METHODS This cross-sectional study was conducted with 77 Brazilian children with DS between 5 and 36 months of age receiving care at the multidisciplinary outpatient clinic of the University Hospital. Participants' sociodemographic, dietary and anthropometric data were collected from the care protocols. Dietary data were collected from 24-h recalls and dietary practices were assessed according to the WHO dietary guidelines. Associations between inadequate feeding practices and demographic variables were assessed using logistic regression models. RESULTS Fruits, milk or infant formula, vegetables, beans and meat were among the five most consumed foods by the children investigated. Overall, we observed a high number of cases of early weaning (50.6%), low minimum dietary diversity (MDD; 40.3%), inadequate consistency for age (64.9%), early presence of ultra-processed foods (76.6%), sugars and sweets (33.8%) in the diet of the children with DS. In the associations of inadequate feeding practices by age group, low MDD [odds ratio (OR): 18.6; 95% confidence interval (CI): 3.4; 57.1] and inadequate consistency (OR: 6.65; 95% CI: 1.8; 24.7) were more frequent among children aged below 12 months while this relationship was inverse for early introduction of sugar and sweets (OR: 0.04; 95% CI: 0.01; 0.29). CONCLUSION Our findings showed a high number of cases of inadequate dietary practices in children with DS investigated, which could adversely affect the long-term health of this population.
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Affiliation(s)
- M C R S Genovesio
- Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - L S Monteiro
- Institute of Food and Nutrition, Federal University of Rio de Janeiro, Macaé, Brazil
| | - A V da Silva
- Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - P R M Rodrigues
- Food and Nutrition Department, Federal University of Mato Grosso, Mato Grosso, Brazil
| | - A P Baumblatt
- Pedro Ernesto University Hospital, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - S A Ribas
- Department of Public Health Nutrition, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
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Ross CF, Bernhard CB, Surette V, Hasted A, Wakeling I, Smith-Simpson S. The influence of food sensory properties on eating behaviours in children with Down syndrome. Food Res Int 2024; 175:113749. [PMID: 38128994 DOI: 10.1016/j.foodres.2023.113749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023]
Abstract
Developing new food products for children is challenging, particularly in vulnerable groups including children with Down syndrome (DS). Focusing on children with DS, the aim of this study was to study the influence of parent liking on acceptance of food products by children with DS and demonstrate the influence of food sensory properties on indicators of food acceptance, food rejection, and challenging eating behaviours. Children (ages 1158 months) with DS (n = 111) participated in a home use test evaluating snack products with varying sensory properties as profiled by a trained sensory panel. Parents recorded their children's reactions to each food product; trained coders coded videos for eating behaviours. To understand the influence of each sensory modality on eating behaviour, ordered probit regression models were run. Results found a significant correlation between the parent liking and overall child disposition to the food (p < 0.05). From the regression analysis, the inclusion of all food sensory properties, including texture, flavour, taste, product shape and size, improved the percentage of variance explained in child mealtime behaviours and overall disposition over the base model (containing no sensory modalities), with texture having the largest influence. Overstuffing the mouth, a challenging eating behaviour, was most influenced by product texture (children ≥ 30 months), and product texture and size (children < 30 months). In both age groups, coughing/choking/gagging was most influenced by food texture and was associated with a product that was grainy and angular (sharp corners). In both age groups, product acceptance was associated with a product that was dissolvable, crispy, and savoury while rejection was associated with a dense, gummy and fruity product. These results suggest that a dissolvable, crispy texture, with a cheesy or buttery flavour are the sensory properties important in a desirable flavoured commercial snack product for children with DS; however, overall disposition must be balanced against mouth overstuffing.
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Affiliation(s)
- Carolyn F Ross
- School of Food Science, Washington State University, Pullman, WA, USA.
| | - C B Bernhard
- School of Food Science, Washington State University, Pullman, WA, USA
| | - Victoria Surette
- School of Food Science, Washington State University, Pullman, WA, USA
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Brantley C, Knol LL, Douglas JW, Hernandez-Rief M, Lawrence JC, Wind SA. Feeding Stressors and Resources Used by Caregivers of Children With Down Syndrome: A Qualitative Analysis. J Acad Nutr Diet 2023; 123:1713-1728. [PMID: 37429414 DOI: 10.1016/j.jand.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 06/16/2023] [Accepted: 07/05/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Challenging eating behaviors or feeding difficulties, commonly displayed in children with Down syndrome (DS), may amplify perceived stress in caregivers. If caregivers lack resources on how to accommodate the needs of the child with DS, they may find feeding the child stressful and resort to negative coping strategies. OBJECTIVE The aim of this study was to understand the feeding stressors, resources, and coping strategies used by caregivers of children with DS. DESIGN A qualitative analysis of interview transcripts was undertaken, framed around the Transactional Model of Stress and Coping. PARTICIPANTS/SETTING Between September to November 2021, 15 caregivers of children (aged 2 through 6 years) with DS, were recruited from 5 states located in the Southeast, Southwest, and West regions of the United States. ANALYSIS Interviews were audio-recorded, transcribed verbatim, and analyzed using deductive thematic analysis and content analysis approaches. RESULTS Thirteen caregivers reported increased stress around feeding the child with DS. Stressors identified included concern about adequacy of intake and challenges associated with feeding difficulties. Stress related to feeding was higher among caregivers whose child was learning a new feeding skill or in a transitional phase of feeding. Caregivers used both professional and interpersonal resources in addition to problem- and emotion-based coping strategies. CONCLUSIONS Caregivers identified feeding as a stressful event with higher stress reported during transitional phases of feeding. Caregivers reported that speech, occupational, and physical therapists were beneficial resources to provide support for optimizing nutrition and skill development. These findings suggest that caregiver access to therapists and registered dietitian nutritionists is warranted.
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Affiliation(s)
- Caroline Brantley
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, Alabama.
| | - Linda L Knol
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, Alabama
| | - Joy W Douglas
- Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, Alabama
| | - Maria Hernandez-Rief
- Pediatric Development Research Laboratory, Department of Human Development and Family Studies, University of Alabama, Tuscaloosa, Alabama
| | - Jeannine C Lawrence
- Human Environmental Sciences, Department of Human Nutrition and Hospitality Management, University of Alabama, Tuscaloosa, Alabama
| | - Stefanie A Wind
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, University of Alabama, Tuscaloosa, Alabama
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Hielscher L, Irvine K, Ludlow AK, Rogers S, Mengoni SE. A Scoping Review of the Complementary Feeding Practices and Early Eating Experiences of Children With Down Syndrome. J Pediatr Psychol 2023; 48:914-930. [PMID: 37738668 PMCID: PMC10653358 DOI: 10.1093/jpepsy/jsad060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE Children with Down syndrome may experience more challenges in their early feeding and may be introduced to complementary foods comparatively later than typically developing (TD) children. This scoping review aimed to identify and synthesize the existing literature that describes feeding problems and early eating experiences relating to the period of complementary feeding for children with Down syndrome. METHODS Scopus, PubMed, Medline, Web of Science, and PsycInfo were searched. Journal articles published between January 1991 and June 2022 that reported on the complementary feeding period with children with Down syndrome were included. RESULTS Eighteen journal articles met the inclusion criteria. Children with Down syndrome were introduced to complementary foods later than TD children and progressed to more challenging food textures at a slower rate. Gross and fine motor skill delays and sensory difficulties contributed to secondary feeding problems such as difficulties chewing, biting, and reduced awareness of food on lips and tongue. Parents of children with Down syndrome reported exercising more caution and employing more controlling feeding practices compared to TD and had higher levels of concern regarding their child's weight. CONCLUSIONS Guidelines and early feeding support specific to children with Down syndrome should be available before the first complementary foods are introduced and throughout this period. Feeding support should aim to address parental concerns and provide assistance when feeding problems occur, to minimize delays and encourage the optimum development of eating abilities. Future research should address the development of feeding problems during this period and explore possible interventions.
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Affiliation(s)
- Laura Hielscher
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Karen Irvine
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Amanda K Ludlow
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Samantha Rogers
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
| | - Silvana E Mengoni
- Department of Psychology, Sport and Geography, University of Hertfordshire, UK
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Surette VA, Smith‐Simpson S, Fries LR, Forde CG, Ross CF. Observations of feeding practices of US parents of young children with Down syndrome. MATERNAL & CHILD NUTRITION 2023; 19:e13548. [PMID: 37458153 PMCID: PMC10483950 DOI: 10.1111/mcn.13548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
Parental behaviours influence food acceptance in young children, but few studies have measured these behaviours using observational methods, especially among children with Down syndrome (CWDS). The overall goal of this study was to understand parent feeding practices used during snack time with young CWDS (N = 111, aged 11-58 months). A coding scheme was developed to focus on feeding practices used by parents of CWDS from a structured home-use test involving tasting variously textured snack products. Behavioural coding was used to categorise parental feeding practices and quantify their frequencies (N = 212 video feeding sessions). A feeding prompt was coded as successful if the child ate the target food product or completed the prompt within 20 s of the prompt being given without a refusal behaviour. CWDS more frequently consumed the test foods and completed tasks in response to Autonomy-Supportive Prompts to Eat (49.3%), than to Coercive-Controlling Prompts to Eat (24.2%). By exploring the parent-CWDS relationship during feeding, we can identify potentially desirable parent practices to encourage successful feeding for CWDS. Future research should build upon the knowledge gained from this study to confirm longitudinal associations of parent practices with child behaviours during feeding.
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Affiliation(s)
| | - Sarah Smith‐Simpson
- Sensory and Consumer InsightsNestlé Nutrition North America (Gerber)FremontMichiganUSA
| | | | - Ciarán G. Forde
- Department of Agrotechnology and Food SciencesWageningen University & ResearchWageningenthe Netherlands
| | - Carolyn F. Ross
- School of Food ScienceWashington State UniversityPullmanWashingtonUSA
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Caldwell AR, Kim Y, Alshahwan N, Vellody K, Bendixen RM, Renz K, Duong T, Dodd J, Terhorst L, Must A. Parental perception of facilitators and barriers to health among young children with down syndrome: a qualitative study. Front Pediatr 2023; 11:1155850. [PMID: 37497298 PMCID: PMC10366365 DOI: 10.3389/fped.2023.1155850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023] Open
Abstract
Background Despite high rates of obesity and weight-related conditions observed in children with Down syndrome, little is known about how to prevent these conditions. Purpose The purpose of this study was to identify parent-perceived facilitators and barriers to health for toddlers (12-36 months old) with Down syndrome. Materials and methods We conducted in-depth, semi-structured interviews with the mothers of 25 toddlers with Down syndrome. All interviews were conducted using Zoom Video Technology, audio recorded and transcribed before being coded in NVivo software using a structured protocol. Thematic analysis was used to identify themes in perceived facilitators and barriers to health at the level of the child, family, and community. Data were triangulated using reflective journaling, video review of child meals, and member-checking techniques. Results We identified unique themes for facilitators (on the move and sound sleep) and barriers (co-occurring conditions and eating behaviors) at the level of the child. At the level of the family and community, overarching themes that were viewed as either a facilitator or barrier, depending on the context, were identified (role models matter, time is critical, the importance of place, and social support). Conclusion These themes can help clinicians and researchers tailor their health promotion interventions to meet the unique needs of children with Down syndrome by using strength-based approaches and providing families with the tools to overcome barriers.
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Affiliation(s)
- Angela R. Caldwell
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Yeook Kim
- Families and Autism Research Lab, Department of Occupational Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, United States
| | - Nada Alshahwan
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kishore Vellody
- Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| | - Roxanna M. Bendixen
- Department of Rehabilitation Sciences, College of Health Professions, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kayley Renz
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Tiffany Duong
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Judith Dodd
- Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Lauren Terhorst
- Pediatric Health Promotion Laboratory, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
- SHRS Data Center, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States
| | - Aviva Must
- Department of Public Health and Community Medicine, School of Medicine, Tufts University, Boston, MA, United States
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de Vries IAC, Guillaume CHAL, Penris WM, Eligh AM, Eijkemans RMJC, Kon M, Breugem CC, van Dijk MWG. The relation between clinically diagnosed and parent-reported feeding difficulties in children with and without clefts. Eur J Pediatr 2023; 182:2197-2204. [PMID: 36862223 PMCID: PMC10175319 DOI: 10.1007/s00431-023-04852-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 03/03/2023]
Abstract
A cleft lip and/or palate (CL/P) is one of the most common craniofacial malformations, occurring worldwide in about one in 600-1000 newborn infants. CL/P is known to influence the feeding process negatively, causing feeding difficulties in 25-73% of all children with CL/P. Because there is a risk for serious complications in these children regarding feeding difficulties, there is often a need for intensive medical counseling and treatment. At this moment, adequate diagnosis and measurement remain a challenge and often lead to a delayed referral for professional help. Since parents play a big part in reporting feeding difficulties, it is important to help objectify parents' experiences, as well as the use of a frontline screening instrument for routine check-ups during medical appointments. The aim of this study is to investigate the relationship between parent perspective and standardized observation by medical professionals on feeding difficulties in 60 children with and without clefts at the age of 17 months. We focus on the information from parents and health professionals by comparing the Observation List Spoon Feeding and the Schedule for Oral Motor Assessment with the validated Dutch translation of the Montreal Children's Hospital Feeding Scale. Conclusion: There is a need for timely and adequate diagnosis and referral when it comes to feeding difficulties in children with CL/P. This study underscores the importance of combining both parental observations and measurements of oral motor skills by healthcare professionals to enable this. What is Known: • Early identification of feeding difficulties can prevent adversely affected growth and development. • Clefts increase the probability of feeding difficulties; however, the diagnostic trajectory is unclear. • The Observation List Spoon Feeding (OSF) and Schedule for Oral Motor Assessment (SOMA) are validated to measure oral motor skills. The Montreal Children's Hospital Feeding Scale Dutch version (MCH-FSD) has been validated for the parental perception of infant feeding difficulties. What is New: • Parents of children with CL/P experience relatively few feeding problems in their child on average. • Oral motor skills for spoon feeding are associated with oral motor skills for solid foods in children with CL/P. • The extent of the cleft is associated with experiencing more feeding difficulties in children with CL/P.
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Affiliation(s)
- Iris A C de Vries
- Department of Paediatric Plastic Surgery, Wilhelmina Children's Hospital, University Medical Centre, PO Box 85500, 3508 GA, Utrecht, the Netherlands.
| | - Camille H A L Guillaume
- Department of Paediatric Plastic Surgery, Wilhelmina Children's Hospital, University Medical Centre, PO Box 85500, 3508 GA, Utrecht, the Netherlands.,Department of Paediatric Plastic Surgery, Emma Children's Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | - Wouter M Penris
- Faculty of Behavioral and Social Sciences/Applied Linguistics, University of Groningen, Groningen, the Netherlands
| | - Anne Merijn Eligh
- Department of Paediatric Plastic Surgery, Wilhelmina Children's Hospital, University Medical Centre, PO Box 85500, 3508 GA, Utrecht, the Netherlands
| | - Rene M J C Eijkemans
- Department of Biostatistics and Research Support, Julius Centre, University Medical Centre, Utrecht, the Netherlands
| | - Moshe Kon
- Department of Paediatric Plastic Surgery, Wilhelmina Children's Hospital, University Medical Centre, PO Box 85500, 3508 GA, Utrecht, the Netherlands
| | - Corstiaan C Breugem
- Department of Paediatric Plastic Surgery, Emma Children's Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | - Marijn W G van Dijk
- Heymans Institute for Psychological Research, University of Groningen, Groningen, the Netherlands
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Serel Arslan S. Swallowing Related Problems of Toddlers with Down Syndrome. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2022; 35:1-11. [PMID: 36118664 PMCID: PMC9465136 DOI: 10.1007/s10882-022-09875-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 06/15/2023]
Abstract
The study was aimed to define swallowing related problems of toddlers with Down syndrome (DS) by comparing toddlers with typically developing children (TDC). A total of 127 children (96 DS, 31 TDC), and their mothers included in the study. The presence of chewing disorders, food selectivity, drooling, coughing during swallowing was scored as 'absent' or 'present'. The Pediatric version of the Eating Assessment Tool-10 (PEDI EAT-10) was used to determine dysphagia symptom severity, and the Turkish version of the Feeding/Swallowing Impact Survey (T-FS-IS) was used to measure the impact of swallowing disorders on caregivers. Mothers of DS reported higher rates of chewing disorders (n = 39, 40.6%), drooling (n = 30, 31.3%) and coughing during swallowing (n = 50, 41.7%) than mothers of TDC (p < 0.01). The mean PEDI-EAT-10 score of children with DS was higher than TDC (p = 0.006). There were significant differences between groups in terms of T-FS-IS. Moderate to strong correlations were detected between PEDI-EAT-10 and total and subscale scores from T-FS-IS (p < 0.001). This prospective study defines swallowing related problems of toddlers with DS. The study results highlight the importance of early investigation of (i) swallowing concerns in children with DS, and (ii) caregivers' quality of life to define swallowing problems and plan an appropriate swallowing related management program.
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Affiliation(s)
- Selen Serel Arslan
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, 06100 Altındağ, Ankara, Turkey
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Wood S, Clegg J. Asking parents/carers of young children with Down syndrome about specific eating behaviours and feeding practices could lead to more effective tailored support for feeding problems. Evid Based Nurs 2022; 25:ebnurs-2022-103520. [PMID: 35589372 DOI: 10.1136/ebnurs-2022-103520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Sian Wood
- Human Communication Sciences, The University of Sheffield, Sheffield, UK
- Intellectual and Developmental Disabilities, Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - Judy Clegg
- Human Communication Sciences, The University of Sheffield, Sheffield, UK
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Rogers SL, Smith B, Mengoni SE. Relationships between feeding problems, eating behaviours and parental feeding practices in children with Down syndrome: A cross-sectional study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 35:596-606. [PMID: 34913544 DOI: 10.1111/jar.12972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 11/16/2021] [Accepted: 11/29/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Research investigating feeding problems in children with Down syndrome is scarce. This study investigated feeding problems, eating behaviours and parental feeding practices in children with Down syndrome (n = 40), and typically developing (TD) children of the same age and sex (n = 40). METHOD Parents of children aged 6-months to 5-years in the UK completed questionnaires assessing their child's feeding problems and eating behaviours and parental feeding practices. RESULTS For children with Down syndrome, feeding problems were: significantly greater than for TD children; negatively associated with breast milk duration and appetite during exclusive milk feeding; and positively associated with drinking more slowly. For both groups, feeding problems were significantly correlated with more food avoidant eating behaviours. CONCLUSIONS This study provides new information about the relationships between feeding problems and eating behaviours in early development. Longitudinal research is needed to further investigate these relationships, so that effective support can be developed for families.
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Affiliation(s)
- Samantha L Rogers
- Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UK
| | - Bobbie Smith
- Department of Psychology and Sport Sciences, University of Hertfordshire, Hatfield, UK
| | - Silvana E Mengoni
- Centre for Health Services and Clinical Research, University of Hertfordshire, Hatfield, UK
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12
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Roccatello G, Cocchi G, Dimastromatteo RT, Cavallo A, Biserni GB, Selicati M, Forchielli ML. Eating and Lifestyle Habits in Youth With Down Syndrome Attending a Care Program: An Exploratory Lesson for Future Improvements. Front Nutr 2021; 8:641112. [PMID: 34568399 PMCID: PMC8455913 DOI: 10.3389/fnut.2021.641112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 08/04/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction: Children with Down Syndrome (DS) have nutritional problems with unknown implications besides increased potential for obesity. Their food habits are unknown. We aim to delineate eating and lifestyle habits of DS children attending a multispecialist program to identify the challenges they face and the potential improvements. Patients and Methods: We interacted with 34 DS children (22 males, 12 females, 2-16 years old) and their families. Food habits, medical conditions and treatments, degrees of development and physical activity, anthropometric and laboratory data were recorded over 6 months and analyzed. A 3-day food diary and a 24-h recall food frequency questionnaire were administered. Results: Twenty-nine (85%) children completed meals, only 11 (32%) received alternative food such as milk. Weaning regularly started in 25 (73%) children. Preschool children introduced adequate calories and nutrients. School children and adolescents did not reach recommendations. All age groups, as the general pediatric population, excessively ate protein and saturated fat, and preferred bread, pasta, fruit juices, meat and cold cuts. Peculiarly, pulses and fish were adequately assumed by preschool and school children, respectively. Five children (15%) were overweight/obese. Conclusions: Dietary excesses commonly found in the general pediatric population are also present in this DS group, proving a narrowing gap between the two. DS group performed better nutritionally in the early years and overweight/obesity occurrence seems contained. DS children may benefit from a practical yet professional care-program in which nutrition education may improve their growth, development and transition into adulthood.
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Affiliation(s)
| | - Guido Cocchi
- Pediatrics, University of Bologna, Bologna, Italy
| | | | | | | | | | - Maria Luisa Forchielli
- Pediatrics, University of Bologna, Bologna, Italy
- Health Science and Technologies Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy
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Ross CF, Surette VA, Bernhard CB, Smith-Simpson S, Lee J, Russell CG, Keast R. Development and application of specific questions to classify a child as food texture sensitive. J Texture Stud 2021; 53:3-17. [PMID: 34435671 DOI: 10.1111/jtxs.12627] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/30/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
Understanding food texture sensitivity in children is important in guiding food selection. The objective of this work was to develop a short questionnaire that could be completed by parents in nonclinical settings to provide a categorization for food texture sensitivity in children. This study evaluated the distribution of children as texture sensitive (TS) or non-texture sensitive (NTS) and the predictive validity of these questions to explain rejection of specific food textures. Three sets of survey data were examined, including data from a home-use test (HUT) in children with and without Down syndrome (DS), and lingual tactile sensitivity measured by grating orientation task (GOT). From three parent-completed surveys, the use of the questionnaire yielded a similar distribution of children in the TS category (16-22%) as previously reported. TS children (4-36 months) were more likely to reject specific food textures, including chewy, hard, lumpy, and "tough meat" (p < .05). A higher percentage of children with a diagnosis of DS were TS (36.9%). Children who were TS showed increased negative behaviors to foods and ate less than NTS children. In older children (5-12 years), TS children were fussier than NTS children (p < .001). Lingual tactile sensitivity was not significantly different by TS/NTS categorization (p = .458). This study demonstrated that the use of these five questions specific to food texture provides a useful tool in categorizing a child as TS/NTS, with this information being useful in selecting preferred food textures. Future studies involving these TS questions should perform psychometric assessments and measures of criterion validity using other questionnaires.
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Affiliation(s)
- Carolyn F Ross
- School of Food Science, Washington State University, Pullman, Washington, USA
| | - Victoria A Surette
- School of Food Science, Washington State University, Pullman, Washington, USA
| | - Charles B Bernhard
- School of Food Science, Washington State University, Pullman, Washington, USA
| | | | - Jookyeong Lee
- CASS Food Research Centre, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Catherine G Russell
- CASS Food Research Centre, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
| | - Russell Keast
- CASS Food Research Centre, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia
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[Research advances in assessment tools for feeding problems in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23. [PMID: 33840418 PMCID: PMC8050544 DOI: 10.7499/j.issn.1008-8830.2011061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
As one of the most important non-nutritional factors associated with children's growth and development, feeding problems in children are getting more and more attention from medical professionals and guardians. The evaluation of feeding problems has developed from the single-factor and descriptive research in the past to the multi-factor and analytical research at present, and thus a good quantitative analysis system is increasingly important for researchers. However, the development of localized quantitative analysis tools remains a weak link in this field. Therefore, it is a research hotspot to develop child feeding assessment scales and questionnaires with high reliability, validity, and operability in combination with China's cultural background and eating habits and provide effective assessment tools for feeding problems in Chinese children. Through classification based on research mode and screening, this article reviews the research findings in the field of child feeding, so as to provide a basis for future research.
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Pados BF, Hill RR, Yamasaki JT, Litt JS, Lee CS. Prevalence of problematic feeding in young children born prematurely: a meta-analysis. BMC Pediatr 2021; 21:110. [PMID: 33676453 PMCID: PMC7936467 DOI: 10.1186/s12887-021-02574-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 02/24/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Difficulties related to eating are often reported in children born preterm. The objective of this study was to quantitatively synthesize available data on the prevalence of problematic feeding in children under 4 years of age who were born preterm. METHODS Literature was identified from PubMed, CINAHL, and PsycInfo. The search was limited to English language and publication years 2000-2020. To be included in the meta-analysis, the article had to report the prevalence of problematic oral feeding within a population of children born prematurely (< 37 weeks' gestation), and the child age at the time of study had to be between full-term corrected age and 48 months. For studies meeting inclusion criteria, the following data were extracted: sample size and subsamples by gestational age and/or child age at time of study; definition of problematic feeding; measures used for assessment of feeding; gestational age at time of birth of sample; child age at time of study; exclusion criteria for the study; and prevalence of problematic feeding. Random-effects meta-analyses were performed to estimate the prevalence of problematic feeding across all studies, by gestational age at birth, and by child age at time of study. RESULTS There were 22 studies that met inclusion criteria. Overall prevalence of problematic feeding (N = 4381) was 42% (95% CI 33-51%). Prevalence was neither significantly different across categories of gestational age nor by child age at the time of study. Few studies used psychometrically-sound assessments of feeding. CONCLUSION Problematic feeding is highly prevalent in prematurely-born children in the first 4 years of life regardless of degree of prematurity. Healthcare providers of children born preterm should consider screening for problematic feeding throughout early childhood as a potential complication of preterm birth. SYSTEMATIC REVIEW REGISTRATION NUMBER Not applicable.
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Affiliation(s)
- Britt Frisk Pados
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Maloney Hall 268, Chestnut Hill, MA, 02467, USA.
| | - Rebecca R Hill
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Maloney Hall 268, Chestnut Hill, MA, 02467, USA
| | - Joy T Yamasaki
- CHA Hollywood Presbyterian Medical Center, Los Angeles, CA, USA
| | - Jonathan S Litt
- Beth Israel Deaconess Medical Center, Boston Children's Hospital, Harvard Medical School, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Christopher S Lee
- Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Maloney Hall 268, Chestnut Hill, MA, 02467, USA
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Diniz PB, Fagondes SC, Ramsay M. CROSS-CULTURAL ADAPTATION AND VALIDATION OF THE MONTREAL CHILDREN'S HOSPITAL FEEDING SCALE INTO BRAZILIAN PORTUGUESE. REVISTA PAULISTA DE PEDIATRIA 2021; 39:e2019377. [PMID: 33656142 PMCID: PMC7903413 DOI: 10.1590/1984-0462/2021/39/2019377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 04/07/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To cross-culturally adapt and validate the Montreal Children's Hospital Feeding Scale (MCH-FS) into Brazilian Portuguese. METHODS The MCH-FS, originally validated in Canada, was validated in Brazil as Escala Brasileira de Alimentação Infantil (EBAI) and developed according to the following steps: translation, production of the Brazilian Portuguese version, testing of the original and the Brazilian Portuguese versions, back-translation, analysis by experts and by the developer of the original questionnaire, and application of the final version. The EBAI was applied to 242 parents/caregivers responsible for feeding children from 6 months to 6 years and 11 months of age between February and May 2018, with 174 subjects in the control group and 68 ones in the case group. The psychometric properties evaluated were validity and reliability. RESULTS In the case group, 79% of children were reported to have feeding difficulties, against 13% in the control group. The EBAI had good internal consistency (Cronbach's alpha=0.79). Using the suggested cutoff point of 45, the raw score discriminated between cases and controls with a sensitivity of 79.4% and specificity of 86.8% (area under the ROC curve=0.87). CONCLUSIONS The results obtained in the validation process of the EBAI demonstrate that the questionnaire has adequate psychometric properties and, thus, can be used to identify feeding difficulties in Brazilian children from 6 months to 6 years and 11 months of age.
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Ren Z, Lan H, Szeto IMY, Yang C, Zhang J, Li P, Li J, Wang P, Zhang Y, Zhao A. Feeding Difficulty Among Chinese Toddlers Aged 1-3 Years and Its Association With Health and Development. Front Pediatr 2021; 9:758176. [PMID: 34888269 PMCID: PMC8650057 DOI: 10.3389/fped.2021.758176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022] Open
Abstract
Feeding problems are biopsychosocial in nature and have a great influence on children's growth. The aim of this study was to profile the status and possible influencing factors of feeding difficulty among normal Chinese toddlers, and to investigate its association with health and development. This study is a part of the Young Investigation (YI study) conducted in 10 cities in China. Data from 924 children aged 1-3 years were analyzed. Data on socio-demographic factors, feeding behaviors, self-reported diseases, and anthropometry parameters were collected. Blood samples were drawn to determine hemoglobin levels. Feeding difficulty was evaluated by the Montreal Children's Hospital Feeding Scale (MCH-FS). Ages and Stages Questionnaires, Third Edition (ASQ-3) were used to assess developmental progress. Multivariable analyses were performed to explore the potential associations. The mean total score of the MCH-FS was 35.21 ± 12.90 and the highest scored item was "acting up/making a big fuss during mealtimes." Feeding difficulty occurred more often among children with picky eating behavior or whose caregivers once used the strategy of pre-mastication. Children with feeding difficulty had lower intakes of cereals, vegetables, and fruits, and were more likely to suffer from diarrhea (OR, 2.04; 95%CI: 1.32, 3.11) or constipation (OR, 2.04; 95%CI: 1.27, 3.24), but not anemia. Feeding difficulty was also negatively associated with weight, height, head circumference and mid-upper-arm circumference-related Z-scores (P all < 0.05). In addition, it was related to poorer fine motor skills, personal and social skills, and total scores of ASQ-3 (β, -9.00; 95%CI: -15.11, -2.89). Feeding difficulty assessed by MCH-FS showed a negative association with children's health and development, supporting the need for early identification.
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Affiliation(s)
- Zhongxia Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Hanglian Lan
- Yili Maternal and Infant Nutrition Institute, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
| | - Ignatius Man-Yau Szeto
- Yili Maternal and Infant Nutrition Institute, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
| | - Chenlu Yang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jian Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Pin Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Jingwen Li
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Peiyu Wang
- Department of Social Science and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yumei Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
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Nutritional challenges in children and adolescents with Down syndrome. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 4:455-464. [DOI: 10.1016/s2352-4642(19)30400-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/15/2019] [Accepted: 11/27/2019] [Indexed: 12/14/2022]
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