Feeding Changes in Children With Trisomy 18: Longitudinal Data on Primary Feeding Method and Reflux Identification and Treatment

Liveborn children with trisomy 18: A scoping review

BACKGROUND

There have been an increasing number of publications related to trisomy 18 associated with a shift in the philosophy of care. The objective of this review is to understand the scope of contemporary literature informing the care of children born alive with trisomy 18.

METHODS

Included was peer-reviewed, primary literature in MEDLINE, Embase, CINAHL, Scopus, Web of Science, and Cochrane Library from 2012 to 2023 reporting outcomes of children born alive with trisomy 18. Data extraction involved descriptive statistics of the types of studies, and an inductive thematic analysis of the questions addressed by the studies.

RESULTS

Of 4628 records identified, 229 met inclusion criteria. Key themes were organized around the domains: What is trisomy 18? What are the chances of survival with trisomy 18? What can be done to improve the chances of survival with trisomy 18? How do children with trisomy 18 die? Do surgical interventions provide a benefit? Are there non-surgical options? What knowledge is informing medical management? How is life described for children with trisomy 18? What are children with trisomy 18 like as babies and as they get older? What is life like for families caring for children with trisomy 18?

CONCLUSIONS

A sizeable number of publications grouped trisomy 18 with other syndromes. Relatively few showed the longitudinal evolution of medical issues associated with trisomy 18, nor did they unfold the clinical heterogeneity of this population. This review shows the limited knowledge base guiding decision-making and care for children born alive with trisomy 18.

Oral health needs in individuals with trisomy 18 and trisomy 13: Implications for dental professionals

The purpose of this study was to examine oral health needs and dental care in individuals with trisomy 18 and trisomy 13 (full, mosaic, partial and other, mixed types). Primary feeding method was also examined. Data was collected from a parent-completed, mixed method survey (TRIS Survey). Mean age in months was 120.2 (range 38 to 394 months) and 133 (range 36 to 405 months), respectively, for trisomy 18 and trisomy 13 individuals. Results indicated the majority of individuals received routine dental care from their family dentist. Approximately 80% in both groups needed some form of specialized dental care. Close to 25% and 30% of trisomy 18 and trisomy 13 individuals, respectively, required hospital admission for specialized dental care. Responses indicated the presence of excessive plaque and tooth decay across the groups with a higher incidence for individuals with trisomy 13. Although not the primary form of intake, over half of the individuals received oral feedings. Implications for dental care and management are provided along with the need for additional research to confirm or disconfirm this study's findings.

Parent questionnaires measuring feeding disorders in preschool children: a systematic review

AIM

Preschool feeding disorders are common and debilitating and are associated with a range of developmental and medical issues. Parent report allows assessment of feeding in a naturalistic environment over time, with advantages over time-limited, clinic-based observations. However, little is understood about the limitations and advantages of current parent-report measures. We aimed to systematically review the psychometrics and clinometrics of parent-administered feeding questionnaires.

METHOD

Five search engines were used to identify questionnaires that met inclusion criteria, i.e. being norm-or criterion-referenced, child focused, appropriate for preschool children, and measured two or more feeding domains (e.g. dysphagia/oral motor delay, food refusal).

RESULTS

In total 3535 abstracts were identified and 215 full-text articles were evaluated. Five questionnaires met the criteria. The Behavioral Pediatrics Feeding Assessment Scale (BPFAS) was the most reliable questionnaire identified, with good test-retest reliability and internal consistency. More predictive and concurrent validity data was available for the BPFAS, the Mealtime Behavior Questionnaire, and the Montreal Children's Hospital Feeding Scale than for other measures.

INTERPRETATION

Further research is needed on the psychometric properties of feeding questionnaires used in research and clinical practice. To date, the BPFAS has the most comprehensive reliability and validity data of any parent-administered feeding questionnaire for preschool children.