Complementary feeding in infants born prematurely

Abstract

Purpose To investigate if there is difficulty in introducing complementary feeding in premature infants. Methods This is an exploratory, cross-sectional study performed in premature infants between six and twenty-four months of gestationally corrected age, using complementary feeding. Thirty-eight infants born prematurely were included. The feeding difficulties presented by the infants were investigated through an objective question followed by the application of a food behavior checklist for the last month. The children's clinical variables were investigated through a medical record review. An interview was conducted with those responsible for the child to identify the sociodemographic aspects and the type of breastfeeding before the corrected six months of age. Results Asked about the general perception, 50% of parents answered that their children did not present feeding difficulties in the last month. However, when a checklist was applied, 73.7% of the parents reported that their children had at least one defensive behavior at mealtime. Refusal to open their mouths (42.1%), food selectivity (28.9%), and feeding refusal (26.3%) were the most frequent defensive behaviors. The food refusal item (44.4%) had a greater association with formula feeding (p = 0.033). Conclusion The present study showed an association between the type of breastfeeding and the difficulties in complementary feeding, especially in premature infants with formula feeding, presenting food refusal during meals. We found the presence of different types of defensive behaviors at mealtime in the majority of premature infants investigated.

Disfunção motora oral e dificuldade alimentar durante a alimentação complementar em crianças nascidas pré-termo

“…The data from this research show that children exposed to exclusive breastfeeding (EB) up to the sixth month of life tend to refuse food less. This result, coupled with the greater chance of infants on artificial breastfeeding, have difficulties in complementary feeding (21) , supports the claim that the introduction of complementary foods is easier in breastfed children (22) .…”

Preterm’s Nutrition from Hospital to Solid Foods: Are We Still Navigating by Sight?

“…Preterm's eating difficulties may be related to their intrinsic immaturity, neurological deficits, and co-morbidities, or even have psychological roots caused by the multiple and unpleasant procedures undergone during hospitalization (e.g., tube feeding, intubation, etc.). Moreover, the involvement of emotional factors could play a significant role and need to be considered, especially in growth-restricted babies, whose growth rate is often a cause for concern for parents [48,49]. We can recognize two critical aspects, and we could hypothesize possible practical approaches.…”

Complementary Feeding in Preterm Infants: A Systematic Review

“…After examining the full texts of the 40 retrieved papers, 14 were excluded, as 9 did not actually deal with CF and 5 reported data only about term infants, leading to 26 suitable studies [ 5 , 6 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ]. Five additional papers were identified from the reference lists of included studies [ 33 , 34 , 35 , 36 , 37 ]; 31 studies were then included in the systematic review [ 5 , 6 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ,…”

“…Among these, there were six narrative reviews [5,14,15,22,27,32], one systematic review [13], two meta-analyses [11,33], one commentary [17], two recommendations [36,37] and one study protocol [31]. Among the remaining 18 trials, there were 14 observational studies [6,9,10,12,[18][19][20][21]24,[28][29][30]34,35], two randomized controlled trials (RCTs) [16,25] and two papers pooling data from different RCTs [23,26].…”

“…among the investigated 38 infants, 42% refused to open their mouth, 29% showed food selectivity and 26% experienced feeding refusal. A potential association between formula feeding and risk of feeding refusal was also suggested [30].…”