P2B.18: Feeding difficulties in children with Intestinal Failure

Abstract

Introduction: Children with intestinal failure (IF) may be at risk for developing feeding difficulties given the negative stimuli associated with feeding, chronic illness and prolonged hospitalization. There is no literature on the prevalence of feeding difficulties in the IF population, its associated factors or intervention strategies. As a first step, we sought to screen for the frequency of the feeding difficulties and eating behaviours in children and herein provide the results of a preliminary sample. Methods:Children who were greater than 1 year of age with IF and on home PN for > 3 months were included from two centres: Alberta Children’s Hospital (ACH), Canada and Hôpital Necker-Enfants Malades, France. The validated MCH-Feeding Scale was used to screen for mild, moderate and severe feeding difficulty. The validated parent-rated Child Eating Behaviour Questionnaire (CEBQ) was used to screen for eating styles and food avoidant behaviours. Results: Preliminary data was gathered for n=34 subjects, median age 6 years with diagnoses of short bowel syndrome (n=22), chronic intestinal pseudo-obstruction (n=4), or other (n=8). Analysis of the MCH-Feeding Scale indicated that 24% of the subjects had no feeding difficulty, while 29%, 18%, and 29% reported mild, moderate and severe difficulty respectively. The subset of n=21 completing the CEBQ rated very high on food fussiness, very high on food enjoyment and very low for emotional over-eating relative to the UK reference sample (Fig 1). In particular, the ACH children scored very high on satiety responsiveness. Conclusions: Preliminary data indicate that approximately half of children with IF have moderate to severe eating difficulties. Interestingly, both food fussiness and enjoyment of food are more commonly featured eating behaviours in this sample. It is unclear whether the feeding difficulties of children with IF are related to the impact of the disease etiology and severity, early feeding history, degree of gastrointestinal symptomatology and/or attempts to assert some control. Future work will examine how IF specific factors including the use of tube feeds are associated with feeding difficulties.