• About Me
    • Disclosure and Disclaimer Policy
  • Blog
  • Shop Ebooks
  • Recommended Products

Pediatric Feeding News

Dedicated to up to date pediatric feeding and dysphagia information

Welcome!

Hi, I'm Krisi Brackett, PhD, CCC-SLP,C/NDT. This blog is dedicated to current information on pediatric feeding and swallowing issues. Email me at feedingnewsletter@gmail.com with questions.

Read More About Me Here...
  • Feeding Flock
    Research
  • For Parents
    & Caregivers
  • View The
    Resources
  • Pediatric Feeding
    & Dysphagia Newsletter
    • Volume 1
    • Volume 2
    • Volume 3
    • Volume 4
    • Volume 5
    • Volume 6
    • Volume 7
    • Volume 8
    • Volume 9
    • Volume 10
  • Workshops &
    Presentations
  • Work
    With Me
  • Links
    We Like

Research review

August 21, 2015 by Krisi Brackett 2 Comments

feed 24Tharner, A., Jansen, P., Kiefte-de Jong, J., Moll, H., Hofman, A., Jaddoe, V. , Tiemeier, H., and Franco, O. Bidirectional Associations between Fussy Eating and Functional Constipation in Preschool Children, J Pediatr 2015;166:91-6

  • picky eating affects constipation through poor diet quality, it also can be hypothesized that constipation and the related abdominal pain are involved in the development of fussy eating.
  • Up to 50% of preschool children are “fussy” or “picky” eaters
  • Fussy eaters consume less green vegetables and fruits, foods high in dietary fibers and vitamins and eat more unhealthy foods with high sugar, salt, and/or fat content (ready-to- eat-meals and snacks).
  • This poor eating pattern can lead to weight gain and essential nutrient deficiencies.

Childhood constipation

  • affects up to 30% of children in Western countries.
  • affects the quality of life of affected children/families (school attendance, peer group activities, and friendships.)
  • In the US, the annual cost of treatment of constipation in the general pediatric population is estimated at $3.9 billion.
  • The vast majority (90%-95%) of constipation etiology of functional likely multifactorial, involving genetic influences, behavioral factors such as physical activity, and dietary factors.

Taylor, C., Wernimont S., Northstone, K, Emmett, P. Picky/fussy eating in children: Review of definitions, assessment, prevalence and dietary intakes Appetite 95 (2015) 349e359

  • Picky eating and food neophobia (reluctance to eat or avoidance of new foods) can lead to concern about the nutrient composition of some children’s diets
  • The development of picky eating may be affected by multiple (pressure to eat, personality, and parental feeding styles)
  • Picky eating appears to affect girls and boys equally
  • There is no single widely accepted definition of picky eating, although most definitions include an element of restricted intake of familiar foods
  • Several studies have identified associations of picky eating with intakes of particular food groups. A strong association was found between the mother’s liked and disliked food items and those of the child, as well as the frequency of consumption of those items

 

Edwards, S., Davis, A., Bruce, A., Mousa, H., Lyman, B., Cocjin, J., Dean, K., MS, Ernst, L., Almadhoun, O., Hyman, P. Caring for Tube-Fed Children: A Review of Management, Tube Weaning, and Emotional Considerations. Journal of Parenteral and Enteral Nutrition Volume XX Number X Month 201X 1–7

  • Enteral feeding (delivering nutrition through a tube or other device) is necessary when children are unable or unwilling to ingest sufficient nutrition to maintain adequate body composition and growth, but there is no problem with digestion.
  • Approximately 4 in 100,000 children require enteral feeding
  • The multidisciplinary approach is recommended (pediatric gastroenterologist, psychologist, dietitian, occupational therapist, and speech-language pathologist)
  • Feeding treatment programs have used both bolus and continuous feeding schedules successfully.
  • Before tube weaning: many behavioral and physical characteristics must be present (ability of the child to sit at a table, accept a bite, and adhere to the concept of structured mealtimes)
  • Diagnosis and treatment of underlying chronic illness are an important part of assessing a child for readiness to wean off of tube feedings.
  • There may be a sensitive period of oral-motor feeding skill acquisition, during which it is very important that children are exposed to tasks requiring these skills. Age and degree of exposure to oral feeding experiences may affect prognosis for success with weaning of tube feeding.

Recommendations

  1. Tube-fed children should be treated with a multidisciplinary approach.
  2. Blenderized diets, ideally under supervision of a healthcare professional, should be considered for tube- fed children who have difficulty with formula.
  3. An overnight continuous tube-feeding schedule should be considered for children who eat orally and need to increase overall calorie consumption.
  4. A combination of caloric reduction of tube feedings and behavioral modification should be used to facilitate tube weaning.
  5. Assessment of the parent-child interaction should be a significant part of treating the tube-fed child.
  6. Treatment of pain should be considered as part of a comprehensive feeding program.
  7. Skills that teach chewing and promote oral intake should be initiated early to promote a shorter duration of tube feeding.

 

Van Tilburg, M., Hyman, P., Walker, L., Rouster, A., Palsson, O., Min Kim, S., , and Whitehead, W. Prevalence of Functional Gastrointestinal Disorders in Infants and Toddlers . Vol. 166, No. 3 March 2015

 

  • current findings suggest that FGIDs are common in US infants and toddlers group
  • associated with lower quality of life and increased medical consultation
  • most common FGIDs in infants were regurgitation and colic
  • most common FGIDs in toddlers (ages 2-3) are functional constipation and functional diarrhea.

 

Silverman, A. Interdisciplinary Care for Feeding Problems in Children. Nutrition in Clinical Practice , Volume 25 Number 2 April 2010 160-165

  • This article describes a biobehavioral approach for the assessment and treatment of feeding disorders.
  • Feeding problems disrupt the acquisition of age-appropriate feeding habits.
  • Feeding problems may include: food refusal, disruptive mealtime behavior, rigid food preferences, suboptimal growth, and failure to master self-feeding skills commensurate with the child’s developmental abilities.
  • Prevalence: 25%-45% of children in the general population, one-third of children with developmental disabilities, and in up to 80% of children with severe or profound mental retardation.
  • Generally, younger children have more feeding problems than do older children. However, the general trend is for early feeding problems to persist over time.
  • the prevalence of feeding disorders is expected to increase
  • Many children present with mixed causes that include behavioral, physiological, and developmental factors.
  • treatment may be provided by a variety of healthcare professionals from medicine, psychology, speech–language pathology, nutrition, and other specialties
  • few medical centers offer interdisciplinary clinics, frequently resulting in difficulties in coordination of care and potentially resulting in suboptimal treatment outcomes.
  • Even when a child’s medical status, oral motor status, and nutrition status have stabilized, feeding difficulties frequently continue.
  • Considerable evidence supports the use of behavioral approaches in the treatment of feeding disorders.
  • Behavioral treatment goals include decreasing behavioral problems at meals, decreasing parent stress at meals, increasing pleasurable parent– child interactions at meals, increasing oral intake or variety of oral foods, advancing texture (eg, moving from purees and smooth foods to chewable solids), and increasing the structure and routine of meals.
  • intensive treatment (day treatment or inpatient care) is warranted: when the feeding disorder is severe or complex (outpatient treatment not likely to be effective)

 

Najib, K., Moghtaderi3, M., Karamizadeh, Z., Fallahzadeh, E. Beneficial Effect of Cyproheptadine on Body Mass Index in Undernourished Children: A Randomized Controlled Trial, Iran J Pediatr; Vol 24 (No 6), Dec 2014

  • Cyproheptadine hydrochloride (CH) is a first-generation antihistamine which is used as an appetite stimulant.
  • cyproheptadine promotes increase in body mass index in children with mild to moderate undernutrition after four weeks treatment.
  • The probable mechanisms for appetite- stimulating effect of this drug including constant increased energy intake through more desire to eating and stimulation of grow hormone secretion by deep sleep induction .
  • The most frequent adverse reaction to protocol regimen was sleepiness

Dodrilla, P and Gosa, M. Pediatric Dysphagia: Physiology, Assessment, and Management. Ann Nutr Metab 2015;66(suppl 5):24–31

  • Swallowing difficulties can effect pulmonary health and nutritional intake.
  • It is estimated that swallowing difficulties occur in approximately 1% of children in the general population, though the incidence rate is much higher in some clinical populations.
  • Oropharyngeal dysphagia should be considered in the differential diagnosis of any young child who presents with unexplained respiratory complications.
  • given the high rates of silent aspiration in the pediatric population, several studies in the literature question a clinician’s accuracy for predicting airway compromise based on clinical observation alone
  • Common instrumental assessment for children suspected of dysphagia includes videofluoroscopic swallow study and fiberoptic endoscopic evaluation of swallow.
  • Common management strategies include the use of thickened fluids for children with demonstrated aspiration of thin fluids.
  • Significant improvements in both swallow function and sensory testing following GERD treatment have been shown in the literature (suggesting that GERD may result in decreased laryngopharyngeal sensitivity)
  • insufficient evidence to determine the effects of oral motor exercises on children with dysphagia.
  • review investigating therapy interventions for dysphagia in children with neurological impairment- show insufficient evidence regarding the effectiveness of any particular type of swallowing therapyLiterature review of using thicker liquids reveals that it can reduce the risk of laryngeal penetration and aspiration but also increase the risk of post-swallow residue in the pharynx
  • neurologically intact child, many clinicians advocate that an assessment of the upper airway should be performed to assess for structural malformations

 

 

 

 

 

 

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)

Related

Filed Under: Research

Comments

    Leave a Reply Cancel reply

    Your email address will not be published. Required fields are marked *

  1. Diane Bahr says

    August 22, 2015 at 12:23 pm

    Hi Krisi, This is an awesome review of some very important literature. It is just what I needed for one of my current pediatric patients. Thank you for all you do with the Pediatric Feeding News. di

    Reply
  2. Susan Spieker says

    August 25, 2015 at 3:49 pm

    Thanks for the great articles! Pediatric Feeding News has so much useful information.

    Reply

Work with Krisi

Professional Consulting
Individualized Professional Training
Caregiver/Family Coaching

Girl Image
Click here for more infomation

Cart

Products

  • When Your Child Can't Or Won't Eat When Your Child Can't Or Won't Eat $10.00

Recent Posts

  • A Gold Standard for Meals with Children Using NG Tubes
  • Feeding Matters – Get Curious!
  • Universal Aspects in Feeding Intervention
  • Handout Info- Feeding and Syndrome Info
  • New Research: The efficacy of 3-ounce water swallow test as a screening tool for dysphagic children: a study in a tertiary hospital. 

Recent Comments

  • Jamesheity on Working on Cup Drinking: The Benefits of Using an Open Cup
  • Aaronhoide on Working on Cup Drinking: The Benefits of Using an Open Cup
  • mob.genmens.ru on Working on Cup Drinking: The Benefits of Using an Open Cup
  • Mali on Know the flow, don’t go with the flow! by Britt Pados PhD(c), RN, NNP-BC, bpados@email.unc.edu.
  • Emma on Cyproheptadine (or periactin) to Boost Appetite

A Gold Standard for Meals with Children Using NG Tubes

Post by: Nick HopwoodTube feeding is becoming more common among children. Increasingly, tube feeding continues after families are discharged from hospital. So, it is important that parents and carers are confident and comfortable in feeding their child in a safe and enjoyable way – at home and in other places where mealtimes would normally happen.There are important medical and safety aspects of Keep Reading >>

Feeding Treatment

Universal Aspects in Feeding Intervention

Let's talk about universal aspects in feeding interventionThis is any idea I have been playing around with for awhile now. We all know that there are different strategies and philosophies in feeding treatment. This is a good thing- we need many Keep Reading >>

Understanding Parenting Styles in Feeding Therapy

As feeding therapists, we work closely with caregivers and parents. Perhaps our biggest success in feeding intervention is helping a parent be able to feed their child. One way we do this is to help caregivers understand their child's cues and how to Keep Reading >>

Involving Caregivers in Feeding Therapy

Feeding children is a dyad between the child and their caregiver who is responsible to buying, preparing, and presenting food. In all of my classes whether it be for professionals or graduate students, I talk about the importance and benefits of Keep Reading >>

Adapted Baby Led Weaning

Information from Jill Rabin CCC-SLP/L, IBCLCI wanted to share some resources for adapted baby led weaning from Jill Rabin. I was lucky enough to catch a free seminar last month from Jill which inspired me to add in some of these techniques to my Keep Reading >>

More This Way

Swallowing

Implementing FEES for Infants in CVICU & NICU

BackTable / ENT / Podcast / Episode #165Implementing FEES for Infants in CVICU & NICU with Olivia Brooks, SLPIn this episode, pediatric speech language pathologist (SLP) Olivia Brooks (University of Florida Shands Hospital) shares her experience Keep Reading >>

What is a MBSS- video for kids

I wanted to share a video we made to help children coming to UNC for a modified barium swallow study. Please share with your clients if you think it is helpful. It's also on our feeding team page Keep Reading >>

Swallowing Difficulties May Be Caused by Misfiring Neurons

in Genetic Engineering & Biotechnology News (GEN)Pediatric dysphagia (swallowing difficulties) is a frequent and serious clinical complication in a large number of clinically defined neurodevelopmental disorders including the genetic childhood Keep Reading >>

Swallow: A Documentary- Dysphagia

Nice Documentary on Dysphagia from the National Foundation of Swallowing Disorders. Keep Up the Good Work Everyone! Keep Reading >>

Oral-Motor and Sensory

Impact of Oral Motor Impairment in Infants with Poor Feeding Webinar

Impact of Oral Motor Impairment in Infants with Poor Feeding Presented by Debra Beckman, MS, CCC-SLP, https://www.beckmanoralmotor.com/A few weeks ago I had the pleasure of attending a wonderful free webinar presented by Debra Beckman, MS, Keep Reading >>

Musculus masseter pars coronidea

Scientists Just Identified a Brand New Muscle Layer in The Human Jaw DAVID NIELD23 DECEMBER 2021 It turns out there are still exciting new discoveries to be made in a field as well-studied as human anatomy: researchers have confirmed the existence of Keep Reading >>

Poster: Child Cain’t Chew

This poster from 2018 was shared with me by Sally Asquith who gave permission to post here. The objective of this study: REVIEW CURRENT LITERATURE PERTINENT TO THE ROLE OF ORAL-MOTOR DEVELOPMENT IN DX AND TX OF PFD. COMPLETE A RETROSPECTIVE CHART Keep Reading >>

The Sensory-Motor Approach to Modified Baby-Led Weaning for Babies with Feeding Challenges

by Jill Rabin & Lori Overland Baby-Led Weaning has become “all the rage” with many parents choosing this method of transitioning their little ones to solid foods. Everyone is jumping in, with speech pathologists, dietitians, occupational Keep Reading >>

More This Way

Case Studies

Challenging case with advice from Suzanne Evans Morris, PhD

In this post, I have described a challenging case  and solicited advice from Suzanne Evans Morris, PhD, one of the experts in our field. Suzanne graciously provided commentary and advice and challenged me to look differently at the feeding Keep Reading >>

Complex Case – Changing Therapy Strategies When Needed

Complex Case - Changing Therapy Strategies When Needed*I shared this case with Suzanne Evans Morris and she provided some   guidance and analysis at the end. Hope you enjoy John is a 6 year old male with a complex medical history:Downs Keep Reading >>

Feeding Harley

I am excited to share Harley’s story, written by his Mother about her journey to help her son wean from his g-tube and become an oral feeder. Thank you Liz for sharing and inspiring us all to continue looking for answers! I feel I do need post a Keep Reading >>

Cases From Clinic

Cases From Clinic This is my second post highlighting some of our kids and how we provide multidisciplinary intervention using a medical/nutritional/behavioral approach. I post this hoping it might give some treatment ideas to clinicians. There Keep Reading >>

More This Way

search

Categories

Recent Posts

  • A Gold Standard for Meals with Children Using NG Tubes
  • Feeding Matters – Get Curious!
  • Universal Aspects in Feeding Intervention
  • Handout Info- Feeding and Syndrome Info
  • New Research: The efficacy of 3-ounce water swallow test as a screening tool for dysphagic children: a study in a tertiary hospital. 

Recent Comments

  • Jamesheity on Working on Cup Drinking: The Benefits of Using an Open Cup
  • Aaronhoide on Working on Cup Drinking: The Benefits of Using an Open Cup
  • mob.genmens.ru on Working on Cup Drinking: The Benefits of Using an Open Cup
  • Mali on Know the flow, don’t go with the flow! by Britt Pados PhD(c), RN, NNP-BC, bpados@email.unc.edu.
  • Emma on Cyproheptadine (or periactin) to Boost Appetite

Archives

search

Categories

Archives

My Account | Shop | Shopping Cart
Copyright ©2025, Pediatric Feeding News. All Rights Reserved. Custom design by Pixel Me Designs
 

Loading Comments...