Parental concern of feeding difficulty predicts poor growth status in their child

Abstract

Background: Parents often express concerns about feeding difficulties in their child. We hypothesized that these parental concerns were associated with adverse growth status in early childhood. We aimed to determine the prevalence of such concerns and whether these concerns were associated with adverse growth status in early childhood. Methods: We performed a cross-sectional study among healthy children aged 12e36 months attending three well-baby clinics in three urban areas in Malaysia and Singapore between December 2016 and February 2017. Parents were interviewed for concerns about their child's feeding and presence of behavioral and organic red flags for feeding difficulties. We defined growth faltering as weight-forage < 3rd centile and short stature as height-forage < 3rd centile according to World Health Organization Growth Standards. Results: Of the 303 children studied (boys Z 160, 52.8%; mean [AE SD] chronological age at interview 21.3 [AE 4.0] months), 13% (n Z 38/292) had growth faltering and 19.5% (n Z 50/ 256) had short stature. Overall, 36.3% (n Z 110) of parents expressed concerns about their child's feeding behavior. Sixty-eight percent (n Z 206) of parents reported presence of at least one behavioral and 18.5% (n Z 56) had at least one organic red flag for feeding difficulties, respectively. 9.9% (n Z 30) had both behavioral and organic red flags for feeding difficulties. Growth faltering was significantly associated with parental concern about feeding (odds ratio [OR] 3.049, p < 0.001), food refusal (OR 4.047, p < 0.001) and presence of at least one organic red flag (OR 2.625, p Z 0.012).

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

“…Of the 54 studies included in the synthesis, four utilized an RCT design (da Costa et al, 2017; Mallan et al, 2016; Sanchez et al, 2018; Tauman et al, 2017) and eight were reviews (Dunn & Lessen, 2017; Gibson & Cooke, 2017; Nicklaus, 2016; Taylor & Emmett, 2019; Verhage et al, 2018; Walton et al, 2017; Watson et al, 2018; Wolstenholme et al, 2020). All other included studies were of observational design (19 cohort studies: Harris et al, 2016; Maslin et al, 2016; Monnery‐Patris et al, 2015; Smith et al, 2017; Specht et al, 2018; Amarger et al, 2015; Cardona Cano et al, 2015; Cole et al, 2018; Cole, Wang, et al, 2017; de Barse et al, 2017; de Barse et al, 2016; Emmett et al, 2018; Fildes et al, 2016; Hollis et al, 2016; Johnson et al, 2016; Oliveira et al, 2015; Pang et al, 2020; Reis et al, 2015; Tharner et al, 2015; 16 cross‐sectional studies: Bell et al, 2018; Coulthard & Sahota, 2016; Finnane et al, 2017; Fu et al, 2018; Helland et al, 2017; Holley et al, 2020; Kaar et al, 2016; Marlina et al, 2020; Maslin et al, 2015; Nederkoorn et al, 2015; Podlesak et al, 2017; Rahill et al, 2019; Ramos et al, 2017; Sandvik et al, 2018; van der Horst et al, 2016; Lee et al, 2019; five longitudinal studies: Bilgin & Wolke, 2017; Boots et al, 2019; Costantini et al, 2019; Micali et al, 2016; Steinsbekk et al, 2017; one correlational study: Griffith et al, 2018,...…”

“…Five studies analysed sensory preferences (Coulthard & Sahota, 2016 ; Monnery‐Patris et al, 2015 ; Nederkoorn et al, 2015 ; Steinsbekk et al, 2017 ; Tauman et al, 2017 ), four on effects of prematurity (Bilgin & Wolke, 2017 ; Griffith et al, 2018 ; Johnson et al, 2016 ; Sanchez et al, 2018 ) and two on effects of cow's milk exclusion (Maslin et al, 2015 ; Maslin et al, 2016 ). The remaining studies focused on a combination of these factors (Cardona Cano et al, 2015 ; Cole et al, 2018 ; da Costa et al, 2017 ; Gibson & Cooke, 2017 ; Helland et al, 2017 ; Hollis et al, 2016 ; Lee et al, 2019 ; Marlina et al, 2020 ; Nicklaus, 2016 ; Oliveira et al, 2015 ; Rahill et al, 2019 ; Ramos et al, 2017 ; Reis et al, 2015 ; Sandvik et al, 2018 ; Smith et al, 2017 ; Tharner et al, 2015 ; van der Horst et al, 2016 ; Verhage et al, 2018 ; Werthmann et al, 2015 ).…”

“…High Wolstenholme et al, 2020). All other included studies were of observational design (19 cohort studies: Maslin et al, 2016;Monnery-Patris et al, 2015;Smith et al, 2017;Specht et al, 2018;Amarger et al, 2015;Cardona Cano et al, 2015;Cole et al, 2018;Cole, Wang, et al, 2017;de Barse et al, 2017;de Barse et al, 2016;Emmett et al, 2018;Fildes et al, 2016;Hollis et al, 2016;Johnson et al, 2016;Oliveira et al, 2015;Pang et al, 2020;Reis et al, 2015;Tharner et al, 2015;16 cross-sectional studies: Bell et al, 2018;Coulthard & Sahota, 2016;Finnane et al, 2017;Fu et al, 2018;Helland et al, 2017;Holley et al, 2020;Kaar et al, 2016;Marlina et al, 2020;Maslin et al, 2015;Nederkoorn et al, 2015;Podlesak et al, 2017;Rahill et al, 2019;Ramos et al, 2017;Sandvik et al, 2018;van der Horst et al, 2016;Lee et al, 2019; five longitudinal studies: Bilgin & Wolke, 2017;Boots et al, 2019;Costantini et al, 2019;Micali et al, 2016;…”

Prevalence of undernutrition and associated factors in young children in Malaysia: A nationwide survey

“…However, we did not analyse whether having just one or both factors affected the child's height status as number of children reported to have both factors were small. A study of healthy children (12–36 months) by Lee et al showed that children who had food refusal were more likely to have growth faltering, while children with limited variety of food intake were less likely to have short stature ( 31 ).…”

Maternal perception of child weight and concern about child overweight mediates the relationship between child weight and non-responsive feeding practices

“…They thus may be less concerned about child overweight than mothers in other countries. Moreover, monitoring or restricting unhealthy food intake may be associated with maternal concern about pediatric health problems, resulting in a decreased/lack of appetite or chronic diseases, such as obesity [49,55,56].…”