Feeding disorders in preschoolers: a short-term outcome study in an Italian Family Care Program

Abstract

Purpose To provide a description about a cohort of preschoolers with feeding disorders (FD) recruited from the therapeutic nursery "Cerco Asilo" of a tertiary care University Hospital, and to evaluate the short-term clinical outcome after 6 months of multidisciplinary treatment. Methods The present inception cohort study was based on an observational longitudinal research design comparing families who underwent the multidisciplinary treatment and those who did not. 42 children (47.6% female; 52.4% males-mean age 36.7 months, SD 17.2, range 2.3-65 months) underwent FD assessment according to the DC-0-3R diagnostic criteria (T0). At the end of the assessment, 62% of families with FD children agreed to be included in the family-based treatment. Both treated and untreated children with FD underwent a follow-up clinical evaluation after 6 months (T1) from baseline. Comparison of clinical features at T0 between groups of subjects resolving or not the FD was performed. To evaluate baseline factors associated with FD resolution, principal components analysis (PCA) was used to identify new synthetic variables that were then used in a logistics analysis. Moreover, clinical differences between T1 and T0 were compared with a t test. Results Two third of the cases (66.7%) resolved the FD, while one third (33.3%) did not. Children who had the FD resolved displayed at T0 significant differences in clinical features with respect to those who did not. Specifically, the FD subtype Feeding Disorder of Caregiver-Infant Reciprocity was strongly associated with resolution, while the subtype Infantile Anorexia was not. In addition, the component depicting "Anxious-Depressed", "Mood" and "Isolation" problems was independently associated with a significantly higher probability of resolution, similar to children having FD other than anorexia. Conclusions FD in preschoolers are associated with problems in emotional development and in the relationship with parents. These difficulties tend to accentuate if the disorder persists. The study suggests the need to investigate the maintaining factors of FD in preschool age. Level of evidence Level IV: Evidence obtained from multiple time series with and without the intervention.

‘it was that … specialist … that finally listened to us … that's probably a weird answer to what you were expecting’: Clinician and carer perspectives on brilliant feeding care

“…It can isolate the child and their family from social interactions; compromise the child's well‐being; generate carer anxiety, family strain, and relationship issues; as well as warrant greater access to (mental) health services, adding to rising healthcare costs. 4 , 13 , 19 , 20 , 21 , 22 , 23 Furthermore, feeding difficulties and the management of tube‐feeding among children are not always readily ‘fixed’ by health services. This is due to myriad reasons, including poor clinician recognition of carer concerns.…”

“…Regardless of why a child requires tube‐feeding or the specialities involved in their care, PFD‐T can have personal, social, and economic implications. It can isolate the child and their family from social interactions; compromise the child's well‐being; generate carer anxiety, family strain, and relationship issues; as well as warrant greater access to (mental) health services, adding to rising healthcare costs 4,13,19–23 . Furthermore, feeding difficulties and the management of tube‐feeding among children are not always readily ‘fixed’ by health services.…”