Infant Feeding Problems Research Articles

A Survey of Expressive Communication Skills in Children With Angelman Syndrome

Angelman syndrome (AS) results from partial deletion of the 15th chromosome (Knoll et al., 1989) and occurs in approximately 1 per 10,000 live births (Petersen, Brondum-Nielsen, Hansen, & Wulff, 1995). Individuals with AS exhibit a pattern of developmental delays that include feeding problems in infancy, delays in motor development, ataxic movements, seizures, severe to profound mental retardation, and a lack of expressive speech (Williams, Zori, et al., 1995). The purposes of this article are to summarize clinical research on AS, to provide a description of the communication skills of individuals with AS, and to identify strategies and resources for communication intervention. It begins by reviewing the existing literature on the clinical characteristics of individuals with AS, with an emphasis on communication skills. The second part of the article presents results obtained from a survey of 20 families of children with AS on the children's expressive communication skills. The implications of the findings of the survey are discussed relative to the existing literature.

Feeding problems in infancy and early childhood: Identification and management

The purpose of this paper is to present a structured method to assess and manage feeding problems in children under three years of age and a newly developed instrument to assist in the assessment and monitoring of these feeding problems. Simple management strategies and practical suggestions are described, derived from clinical experience and a pertinent review of the literature. Because feeding problems are so prevalent (affecting up to 35% of infants), the use of structured parent questionnaires, interviews and observation scales is important when assessing and managing these problems.

Factors of early life as predictors of headache in children at school entry.

To study the main predictors of childhood preschool headache, 1443 families expecting their first child were followed from the onset of pregnancy to the child's sixth year of life. Subject selection was based on stratified randomized cluster sampling. Of the children, 14.9% (144) suffered from headache disturbing daily activities at the age of 6 years. The mother's assessment of the infant's poor health (OR 2.5, 95% CI 1.1 to 5.8) and feeding problems (OR 1.9, 95% CI 1.1 to 3.2) at the age of 9 months predicted later occurrence of headache. At 3 years, depression and sleeping difficulties (according to Achenbach's psychological test) and recurrent difficulties in falling asleep (OR 3.2, 95% CI 1.5 to 7.2) were strong predictors. Headache in other family members (OR 3.5, 95% CI 2.0 to 5.9), especially in the mother (OR 1.7, 95% CI 1.2 to 2.4), predicted preschool headache in a child. At the age of 5 years, travel sickness (OR 2.8, 95% CI 1.5 to 5.1), nocturnal enuresis (OR 1.8, 95% CI 1.1 to 3.0), and the presence of long-term disease (OR 1.8, 95% CI 1.1 to 3.0) were strong predictors of later headache. At the same age, concentration difficulties (OR 2.3, 95% CI 1.3 to 4.2), behavioral problems (OR 2.7, 95% CI 1.1 to 6.4), unusual tiredness (OR 3.8, 95% CI 1.0 to 13.5), and, conversely, high sociability (OR 1.5, 95% CI 1.0 to 2.2) predicted headache. The three last-mentioned psychological factors seemed to be associated with concentration difficulties at the age of 5, which was found to be the strongest predictor. The parents of child headache sufferers often became aware of the child's problems long before the emergence of headache.

Feeding problems in infants and young children with chronic lung disease

Aim: To determine the frequency and nature of feeding problems in infants with oxygen dependent chronic lung disease (CLD).Methods: A questionnaire regarding the feeding history of the infant was administered to parents of infants with CLD and a control group.Results: Forty‐seven infants with CLD and 35 control infants were studied. Fewer infants in the CLD group fed well once established on milk feeds compared to the control group (49% vs. 77%; P<0.05) and a greater number had significant vomiting under the age of 6 months when compared to controls (66% vs. 37%; P<0.05). The CLD group had a significantly higher incidence of feeding problems compared to the controls, including recurrent spitting out of food (34% vs. 3%), refusal of food (38% vs. 26%) or gagging on food (47% vs. 6%). Twenty‐three per cent of infants in the CLD group required enteral feeding beyond 3 months of age, and 19% had a second episode of enteral feeding.Conclusion: The incidence of feeding problems in infants with CLD is high. Strategies aimed at reducing these problems need to be identified and evaluated.

Maternal sensitivity, infant temperament, and the development of early feeding problems

Early feeding problems, assessed in maternal reports about general problems and refusal behaviors, were investigated in a normal sample (n = 115) at the ages of 10 months and 2 years. In a longitudinal design, stability of feeding problems was studied. A model for development of nonorganic failure to thrive proposed by Chatoor (1989: Chatoor & Egan, 1983) was used as a guide in selection of potential antecedents to early feeding problems. The predictive value of parent-rated infant temperament and directly observed maternal sensitivity for explaining variance in feeding problems was explored. The results showed moderate stability for feeding problems. Feeding problems at both ages were predicted by interactions between infant temperament and maternal sensitivity. At 10 months feeding problems were marginally associated with an interaction between sensitivity and infant manageability (degree of negative emotionality); less sensitive mothers with less manageable infants reported more refusal behaviors. At the age of 2 years irregular infants were reported to have more problems if their mothers were less sensitive to their signals. The results are discussed in relation to studies of more severe feeding problems in infancy, and the Chatoor model was found to contribute to an understanding of the development of everyday infant feeding problems in a normal sample. © 1997 Michigan Association for Infant Mental Health

Infant and Toddler Feeding Patterns and Problems

To fill information gaps, predominantly non-Hispanic white parents in five Chicago-area pediatric offices were surveyed concerning infant (n = 130) and toddler (n = 151) feeding times and behaviors. Feeding time distributions did not differ by age. Percentiles (in minutes) were: 10th, 9.4; 50th, 17.7; and 90th, 29.3. The most common infant problematic feeding behavior (PFB) was "not always hungry at mealtime" (33%). Toddler PFB included "not always hungry at mealtime" (52%), "trying to end meals after a few bites" (42%), "picky eating" (35%), and strong food preferences (33%). Toddler picky eaters ate more slowly (means 23.3 vs 19.7 minutes, p < .04). Toddlers with recalled PFB at 6 and 12 months ate most slowly (mean 37.5 minutes). We conclude that: (1) infants and toddlers who take >30 minutes to feed are slow feeders; (2) reports of behavioral feeding problems are common in toddlers and are related to slow feeding; (3) and these data can guide clinical care and future studies.

Temporal characteristics of non-oral feedings and chronic feeding problems in premature infants.

1Assistant Professor Department of Family Health Care Nursing School of Nursing University of California at San Francisco San Francisco, California 2Professor Department of Psychology Brown University Providence, Rhode Island

Early feeding problems in a normal population

The prevalence of parentally experienced infant feeding problems was explored in two samples (N = 841 and N = 567) of infants, aged between 30 and 71 weeks. Correlates to specific problem types were sought. One-fourth of the parents had experienced feeding problems during the infant's first 6 months and more than 10% reported ongoing problems. Colic was the most commonly reported early appearing problem, while refusal of solids, poor appetite, and general refusal to eat were the most common problems after the first 6 months. Maternal health factors, severe and longlasting breastfeeding problems, and problematic mealtime behaviors were associated with colic, while vomiting was only related to breastfeeding problems. The refusal-to-eat group presented the largest number of correlates including family feeding problems, problematic meal behaviors, and health problems. The only aspects distinguishing all problem groups from controls were parental anxiety about infant health and sibling feeding problems.

Development Of Co‐Ordination Of Sucking, Swallowing And Breathing: Ultrasound Study Of Term And Preterm Infants

Fourteen newborn babies of different gestational ages (33 to 40 weeks) but similar postnatal age (four to 19 days) were studied during bottle-feeding using real-time ultrasonography, combined with respiratory monitoring. Previously undescribed tongue movements and graded changes in the temporal relationships between tongue movements, swallowing and breathing were observed among infants of differing maturity. These were most marked in the least mature infants, but were occasionally seen in term infants. The results suggest that adequate neuromuscular co-ordination is more a function of gestational maturity than of postnatal sucking experience. The pattern of intraoral events for infants of differing maturity described in this study provides a framework for the study of feeding problems of term and preterm infants.

Feeding disorders and gastroesophageal reflux in infants with chronic renal failure.

Twenty-two infants (mean age 7.5 months) with chronic renal failure (CRF) were studied for their nutrition, growth, and upper gastrointestinal function. Most infants had a history of poor caloric intake and 7 had received supplemental feeding (SF) prior to the investigation. All infants were undergrown, underweight, and malnourished. The infants were characterized as having only a fair interest in food, refusing feedings, and vomiting excessively. Sixteen of 22 infants (73%) had significant gastroesophageal (GE) reflux demonstrated by 24-h esophageal pH monitoring. Gastroesophageal scintiscans were less sensitive and specific in detecting the reflux. Infants with GE reflux were significantly younger and more often required SF than those without GE reflux. There were no significant differences in the degree of renal failure, growth failure, caloric intake, protein intake, or nutritional status between the infants with and without GE reflux. From these studies we conclude that GE reflux should be considered as one of the factors contributing to the feeding problems of infants with CRF.

Infants with and without feeding difficulties: Maternal experiences

This study aimed at describing parental emotions and experiences mainly related to the feeding situation during infancy. Two groups were compared, one group of families (n = 42) with infants exhibiting severe feeding problems, and a matched control group without such problems. Subjective maternal reports were obtained in a structured interview covering aspects such as child behavior at mealtimes, amount of problem experience, maternal emotions, and social relations as well as facts about the feeding situation (frequency of feeds, length of meal, period of breastfeeding, etc). In the large majority of comparisons, there were significant group differences, with problem parents reporting more negative experiences and emotions, more social isolation, and more irritable child behavior coupled to more prolonged and frequent feedings. The feeding difficulties appeared to have influenced the total situation in the problem families. It was concluded that such negative experiences could not be regarded as “normal” stress reactions following the birth of a child. The relevance of parental experiences for clinical work with infant feeding problems was discussed.

Preventing Common Feeding Problems in Infants and Young Children

Feeding is one of many important ways that parents nurture their infants and children. When parents are overly concerned about feeding, they can exacerbate temporary feeding difficulties and misbehaviors by their inappropriate responses to the child's behavior. Child health supervision visits provide opportunities for the early detection of feeding problems, for education about early feeding experiences and typical child behavior at mealtimes, and for suggestions about the prevention of feeding problems. Handouts and printed materials can provide useful guidelines for introducing solid foods and for managing children's mealtime behavior. Early detection might reduce the likelihood that minor feeding disturbances will develop into severe feeding problems. Behavior management strategies and a pleasant social context for mealtimes can improve children's eating and mealtime behavior. Impairments in the parent-infant relationship may lead to serious feeding problems and referrals to appropriate support services are necessary. Prevention and early treatment of feeding problems can be facilitated by health education about early food experiences and the common developmental behaviors that occur as children grow and develop.

Terminal and interstitial deletions of the long arm of chromosome 7: A review with five new cases

Sixteen cases of terminal deletions and 17 cases of interstitial deletions of the long arm of chromosome 7 have been reported to date. We present two new cases of the former and three of the latter. The somatic changes in these patients are tabulated and an update on the anomalies associated with the various cytogenetic entities is presented. Changes found in over one-third of patients with 7q terminal deletion syndrome include: developmental delay, pre- and postnatal growth retardation, generalized hypotonia, abnormal electroencephalograms with or without seizures, feeding problems in infancy, microcephaly, prominent forehead, ocular hypertelorism, eye defects, broad nasal bridge, bulbous nasal tip, auricular malformations, micrognathia, chest abnormalities, genital malformations in males, and abnormal palmar and plantar creases. Evidence for the localization of the Kidd blood group gene on chromosome 7 distal to band q32, as suggested by previous reports, is reviewed; we conclude that the evidence does not warrant placement of the gene in this region of the genome.

The problem of infant feeding: the Australian experience from the mid-nineteenth century to the 1920s.

Journal Article The Problem of Infant Feeding: The Australian Experience from the Mid-Nineteenth Century to the 1920s Get access MILTON LEWIS MILTON LEWIS Canberra, Australia Search for other works by this author on: Oxford Academic PubMed Google Scholar Journal of the History of Medicine and Allied Sciences, Volume XXXV, Issue 2, April 1980, Pages 174–187, https://doi.org/10.1093/jhmas/XXXV.2.174 Published: 01 April 1980

Simplified Feeder for Infants With Cleft Palate

Standard pediatric texts accord scant attention to feeding problems in infants with cleft palate, dismissing them as mild and easily managed. Quite a different impression, however, is conveyed by retrospective accounts of parents' experience, which characterize the feeding process in such infants as laborious, time consuming, and anxiety provoking, with ingested volume often inadequate. Since actual studies of feeding and weight gain in infants with cleft palate have not been reported, the dimensions and implications of the problem remain uncertain. When first seen at this Center, most infants under 1 year of age with cleft palate are undergrown. Weight gain has often averaged less than 500 gm monthly during the first few months of life, and histories of difficult feedings—often prolonged to an hour or more in duration—are the rule. See image in the PDF file See image in the PDF file See image in the PDF file

Coffin-Siris syndrome. Two new cases.

Two additional cases of a recently delineated pattern of malformation, the Coffin-Siris syndrome, bring the number of reported cases to six. The features of the disorder variably include growth and mental deficiency; a coarse appearing facies with low nasal bridge, wide nose and/or mouth, and thick lips; hypoplastic nails, especially those of the fifth finger and toes; hirsutism and sparse scalp hair; and lax joints and/or hypotonia. These patients tend to have feeding problems in infancy and frequent respiratory infections. The disorder has been a sporadic one in each family. No chromosomal abnormality has been detected, and the cause remains undetermined.

The critical or sensitive period, with special reference to certain feeding problems in infants and children

Children should be given solids to chew at a time when they are developmentally ready: in an average child this age is 6 to 7 months. If they are not given solids then (as distinct from thickened feedings, which can be given any time after birth), they are very apt to be difficult about taking them later, failing to chew, refusing the solids, or vomiting. Failure to give solids may be due to mismanagement in normal children, including overanxiety about their choking. It is common in defective children and occurs under certain circumstances in incompletely repaired esophageal atresia. It is suggested that the chewing difficulty is related to the sensitive or critical period described in animals. Children should be given solids to chew at a time when they are developmentally ready: in an average child this age is 6 to 7 months. If they are not given solids then (as distinct from thickened feedings, which can be given any time after birth), they are very apt to be difficult about taking them later, failing to chew, refusing the solids, or vomiting. Failure to give solids may be due to mismanagement in normal children, including overanxiety about their choking. It is common in defective children and occurs under certain circumstances in incompletely repaired esophageal atresia. It is suggested that the chewing difficulty is related to the sensitive or critical period described in animals.

Basic aspects of infant nutrition.

New discoveries, overemphasis on specific dietary factors, and lack of a definite guide for minimal dietary requirements may confuse the problem of infant feeding. However, certain nutritional needs must be fulfilled if the infant is to develop normally. The authors discuss the basic aspects of infants' nutritional requirements, dividing them into the categories of water and electrolytes, calories, proteins and amino acids, carbohydrates, fat and linoleic acid, minerals, and vitamins.

Emotional Problems of Childhood.

Two of the physician's most challenging problems are the recognition of when behavior leaves the fringe of normal and becomes abnormal and the early management best suited to the condition. The collection of lectures comprising this book serves this area well. Basic information and dynamics are presented with clear examples and interpretations aiding greatly the understanding and beginning management of, for example, feeding problems in infancy, speech problems in children, common problems in adolescence, and the problems of the physically handicapped child. This book is highly recommended for the pediatrician, the general practitioner, and the internist who is physician to the adolescent.

Studies on lactation in poor Indian communities.

A group of lactating Indian women were studied to obtain information about 1)the extent to which breast milk contributes to the infants nutrition 2)whether improvement in quality and quantity of breast milk was possible and 3)the effects of prolonged breastfeeding on the mothers nutrition. Infant growth was adequate during the first 6 months of total breast milk diet but when rice gruel was supplemented after the sixth month growth became progressively inadequate. Breast milk gave 35% of the infants protein intake after 12 months. An increase in the mothers dietary protein by 30 gm daily increased milk output however protein content of the milk decreased. Nitrogen retention increased as protein intake increased and nitrogen balance studies showed that the women needed .15 gm nitrogen/kg body weight/day requiring 1.5 gm protein/kg body weight/day. The problem of infant feeding in poor communities is to ensure adequate improvement of the maternal diet to maintain lactation at the current level but without maternal protein depletion.