Abstract
Delays in gross motor development, sensory processing issues, and organic and behavioral problems are known to interfere in the development of feeding skills (FS); and-therefore-in the success of the process of feeding a child. Children with feeding difficulties (FD) commonly present inadequacy of FS. Assessment of five FS in Brazilian children with FD, and search of associations with types of FD. Cross-sectional study with 70 children below 10 years old. Data were obtained from medical records: age, gender, age at texture transitions, feeding phase (breastfeeding, weaning to solids or full solids) at first complaint; characteristics of the meal (duration, environment, and shared meals with adults), self-feeding practices, use of feeding equipment and bottle, mouthing, feeding position and FD diagnosis. Skills were categorized according to standards for age. Chi-Square, Anova Test (or non-parametric equivalent) and Multinomial logistic regression tests were used, with a significance level of 5%. There was no difference in FS (p > 0.05) or in the number of FS inadequateness (p = 0.84) according to FD diagnosis. The majority (94%) of children presented at least one delayed development of FS; 1/3 presented delays in more than half of the FS. The most prevalent inadequacies in FS were inadequate feeding position (73.5%), prolonged bottle feeding (56.9%), and inadequate self-feeding practices (37.9%). Feeding complaints first appeared at 10.9 ± 11.4 months, and picky eating was the most prevalent type of FD (37.1%). Most children were fed in inadequate environments (55.2%), without the company of adults (78%). Transition to solid foods occurred at 16 ± 5.6 months. Multinomial logistic regression showed no difference in likelihood of presenting any type of FD compared to picky eating, according to FS. Age at texture transition both from breastfeeding to complementary feeding (p = 0.95), and from complementary feeding to solid foods (p = 0.43) did not vary according to FD diagnosis. FS development or number of FS inadequateness did not vary according to FD diagnosis. Identification of these inadequacies could help the discussion for multi-professional treatment of patients with FD.
Highlights
It is well established that oral feeding processes depend on both motor skills and reflexes that work in synergy [1], and which maintain close relationship with brain development and its functions
Children followed at the center below 12 months of age started with complaints during breastfeeding/formula feeding periods; children between 1 and 6 years old started complaints mostly during complementary feeding; while older children started complaints around 3 years old
The use of feeding equipment was associated to different types of feeding difficulties (FD): children who were diagnosed as misinterpretation of parents were related to inadequate use of feeding equipment (p = 0.014)
Summary
It is well established that oral feeding processes depend on both motor skills and reflexes that work in synergy [1], and which maintain close relationship with brain development and its functions. Sensory processing issues may contribute to this individual variation [1, 3, 4]. Delays in gross motor development, sensory processing issues, and organic and behavioral problems are known to interfere in the development of FS; and——in the success of the whole process of feeding a child [1, 3]. Delays in gross motor development, sensory processing issues, and organic and behavioral problems are known to interfere in the development of feeding skills (FS); and——in the success of the process of feeding a child. Children with feeding difficulties (FD) commonly present inadequacy of FS
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