Feeding Problems in Typically Developing Young Children, a Population-Based Study

Association between parental feeding styles, body mass index, and consumption of fruits, vegetables and processed foods with mothers´ perceptions of feeding difficulties in children

BACKGROUND

Feeding difficulties (FDs) are complex phenomena influenced by parental factors, feeding behaviour, and cultural factors. However, studies of the influences of these factors on FDs incidence are scarce. Thus, this study aimed to identify the associations between mothers' perceptions of FDs in children and parental feeding styles, body mass index, and the consumption of fruits, vegetables and processed foods.

METHOD

Two hundred and fifty-seven mothers of children aged 1 to 6 years and 11 months participated in this cross-sectional study and self-completed electronic questionnaires on sociographic variables, parental feeding styles, the consumption of fruits, vegetables and processed foods and FDs. Nutritional status was classified by body mass index (kg/m2).

RESULTS

The prevalence of FDs in children was 48.2%, and the mean age was 43.8 (± 17.6) months. The indulgent parental feeding style was the most common (40.1%), followed by the authoritative (31.1%), authoritarian (23.7%), and uninvolved (5.1%) styles. An indulgent parental feeding style (OR: 4.66; 95% CI: 2.20-9.85), a high body mass index (OR: 1.35; 95% CI: 1.09-1.68), and the consumption of processed foods (OR: 5.21; 95% CI: 2.85-9.53) were positively associated with increased odds of the absence of FDs in children. The associations of authoritarian and uninvolved parental feeding styles and the consumption of fruits and vegetables with FDs in children were not significant.

CONCLUSION

This study identified multiple factors that are possibly associated with feeding behaviours in young children. However, further studies need to be undertaken to evaluate how such behaviours affect FDs.

Mother-child pairs' eating and feeding behaviours in two different nutritional status from two distinct provinces

Nutrition plays a crucial role for the bio-psycho-social growth and development of children. Mother-child pairs' eating-feeding problems can be hypothesized to relate to the child's nutritional status and living area. Our focus was to assess maternal attitudes and children's eating habits in thin and normal-weight children across two cities characterized by distinct socioeconomic and demographic profiles: Ankara and Şanlıurfa. This double case-control study included the mothers whose children are aged between 2 and 7 years old in both cities. Figure Rating Scale, Child Feeding Questionnaire and Behavioral Pediatrics Feeding Assessment Scale were filled by mothers of children. The mothers of thin children were concerned more about the weight of their children, felt more responsible for feeding their children, and use of pressured them to eat more frequently compared to normal-weight children's mothers in both cities. In Ankara, the duration of breastfeeding is longer, using formula is rarer and starting complementary food on time is more common, mother had higher scores on perceived responsibility, perceived child weight, and concern about child weight subscales; lower score on the restriction subscale compared to Şanlıurfa. Mothers of both thin and normal weight children in Şanlıurfa rated their children as weaker compared to those in Ankara. In conclusion, child eating behaviors and parental feeding practices were associated with the weight of children depending on demographic and sociocultural differences. Implementing customized, location-specific preventive educational initiatives on child feeding will not only foster behavioral changes but also yield valuable insights for shaping future interventions.

Long-term changes in oral feeding behaviors of growing rats

Oral feeding is critical for survival in both humans and animals. However, few studies have reported quantitative behavioral measures associated with the development of oral feeding behaviors. Therefore, the present study investigated developmental changes in the oral feeding behaviors of rats by quantitatively assessing pasta eating and licking behaviors. In the pasta eating test, the time to finish pasta sticks of three different thicknesses (Φ = 0.9, 1.4, and 1.9 mm, 4 cm long) was recorded between postnatal day 29 (P29) and P49, because all rats were able to finish eating these pasta sticks on P29. A developmental decrease in the time to finish pasta sticks of all thicknesses was observed during the initial period of recordings and plateaued before P35. The extent of this decrease was dependent on the thickness of pasta sticks. In the licking test, the number of licks per 10 s and the total intake volume during the test were recorded between P19 and P49, because all rats were able to access and lick the solution on P19. The time courses of developmental increases in the number of licks and the total intake volume were similar to the results obtained in the pasta eating test. Collectively, these results suggest that developmental changes in pasta eating and licking behaviors markedly differed between the weanling and periadolescent periods. The present study also demonstrated the applicability of the pasta eating and licking tests to the quantification of developmental changes in the oral feeding behaviors of rats.

Impact of diet on sensory processing in early childhood: summary of an interactive webconference / expert roundtable discussion

Pediatric feeding disorders can be seen in up to 45% of normally developing children aged under 5 years old, mainly during the first three years of life when the child has inadequate food intake and/or difficulty maintaining adequate growth, and/or lack of age-appropriate eating habit. This article describes the opinion of a group of experts on children eating patterns and how to manage pediatric feeding disorders, with the aim to improve the quality of life of children and their caregivers.

[Feeding and growth patterns in preterm children at 3-4 years of age]

AIM

to describe the feeding and growth patterns of preterm-born children at preschool age, considering feeding problems based on behaviours and skills, diet quality and parental feeding practices.

METHODS

a cross-sectional study was performed on preterm children born in Asturias (Spain) in 2016 (n = 94). When preterm-born children reached 3-4 years of age their families were asked to complete the Behavioral Pediatrics Feeding Assessment Scale and a food frequency questionnaire to identify possible feeding problems and assess diet quality (KIDMED index), respectively. Self-reported anthropometric data were also collected to assess weight growth. Electronic health records were reviewed to gather gestational and neonatal clinical data.

RESULTS

feeding problems were found in 7.4 % of children and 20.2 % of parents. According to the KIDMED index, 25.5 % of children had a high-quality diet. Feeding problems were higher in children born before 32 weeks of gestation, and decreased in frequency as the gestational age increased (p = 0.030). No differences were found in parental feeding practices (p = 0.455) or diet quality according to gestational age (p = 0.399), but body weight at 3-4 years was lower in preterm-born children (p = 0.015).

CONCLUSIONS

feeding patterns of preterm-born children were suitable at the age of 3-4 years, but diet quality was moderate to poor in the majority of children. Follow-up of very preterm children beyond 3-4 years of age becomes necessary as they displayed more feeding problems and lower body weight.

Assessment of Feeding Behaviors and Parents' Frustrations of Children with Autism Spectrum Disorder in Lebanon: A Case-Control Study

Children with autism spectrum disorder (ASD) exhibit restrictive and repetitive behaviors that affect their eating habits. The purpose of this study is to identify the behavioral feeding problems and eating habits among ASD children compared to typically developed (TD) children age/gender-matched controls, along with their parents'/caregivers' strategies for dealing with them. It included 43 ASD children and 43 TD children aged two to eleven years. The analysis was performed based on two valid questionnaires: the Behavior Pediatrics Feeding Assessment Scale (BPFA) and "My Child Eating Habits" (MCEH). The BPFA and MCEH scores conceded three manifestations that fall into food selectivity and problematic mealtime behavior in both groups of children. Compared to TD children, children with ASD exhibited higher BPFA scores, which indicated food-related behavioral and skill-based problems (p = 0.004). Children with ASD were less likely to consume fruits, vegetables, and milk than TD children, which may lead to nutritional deficiencies (p = 0.003, p = 0.003, and p = 0.010, respectively). Parents of ASD children were concerned about their behavioral problems and expressed their intention of an early intervention. These findings highlight the importance of nutritional clinical routines that incorporate the evaluation of the nutritional status and feeding behaviors of ASD children.

Factors associated with the early emergence of atypical feeding behaviours in infants and young children: A scoping review

BACKGROUND

Atypical feeding behaviours such as significantly limited food preferences, hypersensitivity to food textures or temperatures and pocketing food without swallowing are common concerns in child health. Current reports indicate an inter-relationship between early growth, feeding problems and developmental disorders, yet little is known about how these behaviours develop in early childhood. There is also a lack of consensus about clinical definitions for atypical feeding behaviours, diagnostic thresholds and the associated precursors. To date, there has been no synthesis of the extant literature about factors associated with the early onset of atypical feeding behaviours in young children.

OBJECTIVE

This scoping review aimed to characterize the factors associated with the early emergence of atypical feeding behaviours in typically developing young children.

METHODS

CINAHL, MEDLINE, PsycINFO and Scopus databases were searched. Studies published in the last 5 years were included if they examined factors associated with the development of atypical eating behaviours in infants and young children. Of the 2137 records obtained after the search strategy was applied, 202 full-text articles were retrieved for a more detailed examination and to ensure they met the inclusion criteria. This resulted in 54 studies being included in this scoping review.

RESULTS

Of the 54 studies, three studies analysed precursors responsible for atypical feeding behaviours, and 51 studies discussed the factors associated with the early emergence of feeding difficulties. Multiple factors, including genetic factors, breastfeeding, late introduction of solids and lumpy foods, complementary feeding techniques, parental mental health, prematurity and child factors including temperament, were identified. There is inconsistent evidence for the associations between breastfeeding exposure and feeding difficulties.

CONCLUSIONS

This study identified multiple factors potentially associated with the early onset of atypical feeding behaviours in young children; however, there is insufficient evidence at this time to support specific recommendations for early feeding practices in young children. More methodologically rigorous studies are needed to extend these findings.

The Polish Version of the Avoidant/Restrictive Food Intake Disorder Questionnaire—Parents Report (ARFID-Q-PR) and the Nine Items Avoidant/Restrictive Food Intake Disorder Screen—Parents Report (NIAS-PR): Maternal Perspective

The aim of the present study was to develop and validate the Avoidant/Restrictive Food Intake Disorder Questionnaire—Parents Report (ARFID-Q-PR), a new tool to diagnose ARFID, based on a report submitted by Polish mothers of children aged 2 to 10 years. In total, 167 mothers of boys and girls aged 2 to 10 participated in the study. We used the ARFID-Q-PR and the Nine Items Avoidant/Restrictive Food Intake Disorder Screen—Parents Report (NIAS-PR). In addition, all mothers were asked to provide information on age, sex, height and weight, chronic somatic diseases, neurodevelopmental and mental disorders as well as intellectual disability of their children. Results of the reliability analysis demonstrated that the ARFID-Q-PR had adequate internal consistency (Cronbach’s alpha of 0.84). The stability of the ARFID-Q-PR factorial structure was confirmed. It is composed of three subscales: (1) attitudes to food; (2) justification for restrictions; (3) somatic symptoms. Our findings demonstrated that the ARFID-Q-PR total score was positively associated with the NIAS-PR total score. In addition, children with developmental and mental disorders substantially demonstrated more ARFID symptoms than did the children in the general population. The Polish version ARFID-Q-PR can be used to recognize the ARFID symptoms in young children by the main feeder in the family—mother or father.

Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases

Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.