Feeding problems in infancy and early childhood: evolutionary concept analysis

Abstract

A spectrum conceptualization of feeding problems is suggested for further development, with attributes that would be critical to have a feeding problem.

Age-based norm-reference values for the Pediatric Eating Assessment Tool

“…Physiologic symptoms are often the earliest indicators of problematic feeding, particularly symptoms of respiratory compromise, choking, gagging, symptoms of gastroesophageal reflux, and constipation. 9,[17][18][19][20] These data provide reference values that will allow clinicians to identify a child with concerning levels of physiologic symptoms and intervene early with targeted treatment, prior to the child developing strong negative associations with feeding. Prolonged negative associations with food and eating, especially in the early stages of introduction to different tastes and textures, may establish patterns that are more resistant to change and more difficult to treat.…”

“…3,4 Problematic eating is defined, for the purposes of this paper, as a child being unable or unwilling, despite availability of food, to eat and/or drink enough volume or variety of ageappropriate food to support appropriate growth, development, and hydration. 5,6 Parental concerns about nutrition, intake, and weight gain are common concerns brought to the pediatric primary care provider, particularly in the infant through preschool years. In many cases, these concerns resolve with time, but in about 3-10% of cases of children across diagnostic categories, including otherwise healthy children, problematic feeding becomes a chronic problem, 7 requiring long-term, expensive treatment that is burdensome on the family and the healthcare system.…”

Feeding and developmental outcomes of infants in a South African community

“…This is noteworthy as both are based on caregiver report (Ramsay et al, 2011;Van der Linde et al, 2015b). The discrepancy between caregiver report of feeding and developmental outcomes may be due to the nonspecificity and heterogeneity of red flags in early feeding development leading to misinterpretation by caregivers (Estrem et al, 2017). It was found that developmentally appropriate receptive language and self-help outcomes were significantly associated with infants who were breastfed (ø = 0.013; P = 0.010) and given both colostrum (ø = 0.022; P = 0.020) and breastmilk (ø = 0.009; P = 0.012).…”

“…Sensory over-reactions (such as gagging, spitting, or vomiting) occur as sensory tolerances emerge and align with the development of oral motor skills (Van den Engel- Hoek et al, 2014). The presence of such a maladaptive mealtime cycle may indicate transactional development between the caregiver and the infant, negatively impacting the infant's development (Guralnick, 2013;Estrem et al, 2017). Conversely, poor infant development such as delayed fine or gross motor skills may create a maladaptive mealtime cycle, continuing this negative pattern (Crapnell et al, 2015).…”

“…treated in Occupational Therapy, Speech-Language Pathology, and Psychology, but uncommon to the professions of medicine and nursing (Estrem et al, 2017). Healthcare professionals may have difficulty identifying feeding difficulties in infants due to the complex relationship between biopsychosocial factors involved during feeding (Berlin et al, 2009;Estrem, 2015).…”