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Background: The mechanisms behind brain and spinal cord injuries in hypoxic-ischemic encephalopathy (HIE) and associated feeding difficulties are unclear, with previous magnetic resonance imaging (MRI) attempts yielding inconclusive results. Objective: We aim to evaluate an MRI radiomics model for predicting feeding difficulties in HIE infants. Additionally, we investigate changes in predictive capability after incorporating the duration of mechanical ventilation and the timing of MRI examination. Materials and methods: Retrospective study with 151 HIE infants (January 2013 to December 2021), randomly divided into training and validation sets. Radiomics features extracted from basal ganglia-thalamus and brainstem in T1-weighted and T2-weighted MRI. Established single-modality, single-site, and multimodality/multisite models. Receiver operating characteristic analysis and area under the curve evaluated models. Decision curve analysis assessed changes in predictive capability. Results: The combined radiomics model of the basal ganglia-thalamus and brainstem regions on the T2-weighted imaging demonstrated superior performance (area under the curve: 0.958 and 0.875 for training and validation, respectively). Combining scores with duration of mechanical ventilation and MRI examination time in a calibration plot model improved and stabilized performance, showing high fitting and clinical utility. Decision curve analysis favored the combined calibration plot model. Conclusion: The MRI-based radiomics model predicts feeding difficulties in HIE infants, with basal ganglia-thalamus and brainstem as relevant factors. The combined calibration plot model exhibits the highest clinical predictive efficacy. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study identified bottle-feeding techniques for infants with feeding difficulties. Methods: Between December 2021 and April 2022, a survey was distributed to nurses with at least 5 years of experience in caring for infants at 1109 hospitals in Japan. The questionnaire included open-ended questions regarding preparation before bottle-feeding, methods of nipple insertion, methods of assisting with sucking, and criteria for continuing bottle-feeding. The responses were classified according to semantic similarity. Results: In total, 514 valid responses were received. The respondents had an average of 19.16 years of experience as a nurse or midwife. The most frequently used nipples for infants with feeding difficulties were the Combi Breastfeeding Model, Pigeon Weak Sucking Nipple, and Bean Stalk Nipple. Preparation before bottle-feeding consisted of six categories, including determining the timing of feeding and stimulation to promote wakeup. Nipple insertion methods consisted of four categories, such as assisted opening of the mouth, nipple insertion, and nipple insertion depth. Methods of assisting with sucking were divided into four categories, including encouraging sucking ability from around the mouth and matching the infant's sucking pace. The criteria for continuing bottle-feeding spanned three categories, including willingness to suck and ensuring necessary nutrition. Conclusions: The variety of survey responses describes the current state of bottle-feeding technologies. A combination of several techniques indicated that feeding strategies may lead to effective and appropriate feeding. The nurses continued feeding based on an assessment of the infant's acceptance. Future studies regarding bottle-feeding techniques must consider the individuality of each infant. [ABSTRACT FROM AUTHOR]

Background: Amongst children presenting to an interdisciplinary clinic with complaints of picky eating, we aim to identify the proportion who have underlying selective feeding and to describe its implications on growth and nutrition, as well as parental coping responses. Methods: We conducted a retrospective chart review of first-visit consults from January 2020 to July 2022. Caregiver and child mealtime behaviours were assessed using the standardised Caregiver's Feeding Styles Questionnaire (CFSQ) and by direct observation. Caloric intake and oromotor skills were assessed by dietitians and speech therapists, respectively. Medical concerns were addressed by the doctor. Results: Out of 152 children referred for concerns of "picky eating", 128 (84.2%) were diagnosed as having selective eating, while the rest were diagnosed with delayed oromotor skills, poor appetite, oral aversion and 4 were deemed to have normal feeding behaviour for their age. Of the 128 selective eaters, 67 (52%) children had comorbidities such as autism spectrum disorder (ASD) (n = 59), attention-deficit/hyperactivity (ADHD) (n = 2) and underlying medical conditions (n = 6). The remaining 61 children were "otherwise well". Of the "otherwise well" children, 47.5% had inadequate caloric intake and 31% had failure to thrive. The commonest feeding style among caregivers of "otherwise well" picky eaters was authoritarian (36%). The majority (80%) of these caregivers also experienced helplessness. Conclusions: We conclude that picky eating in young children is a symptom with several possible underlying aetiologies. It is associated with nutritional consequences for the child and significant stress on caregivers. Being able to recognise those who need referral for specialist intervention and multidisciplinary management (such as selective feeding and delayed oromotor skills) would be important. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the frequency and clinical features of the late preterm infants with feeding intolerance. MATERIASL AND METHODS: Medical records of 426 infants with gestational age of 340/7- 366/7 weeks were retrospectively reviewed for the study. Clinical and demographic features of late preterm infants and episodes of feeding intolerance were recorded. RESULTS: A total of 54 late preterm infants with feeding intolerance were evaluated and compared with 178 infants without feeding intolerance. Baseline demographics were similar between groups. Mean duration of intolerance period was 2.3 ± 1.2 days. Time to full enteral feeding was significantly longer in late preterm infants with feeding intolerance when compared with infants without feeding intolerance (8 ± 2.3 vs 5.2 ± 1.7 days, respectively, p<0.001). Breastfeeding rates were similar between the groups. Rate of prokinetic use in the feeding intolerance group was 37%. There were no differences between the time to full enteral feeding and the duration of parenteral nutrition between prokinetic users and non-users. CONCLUSIONS: Although the gestational ages of late preterm infants are close to term and their size is relatively large, they are not like term infants. These infants should be followed closely in terms of feeding problems as well as many morbidities. [ABSTRACT FROM AUTHOR]

Food neophobia, defined as fear or aversion to eating new or unfamiliar foods, is a significant challenge, especially in the context of preschool children. In the scientific literature, this phenomenon is often described as a natural developmental stage, but its severity and impact on preferences and eating patterns still raise many questions. The purpose of the present study was to assess the prevalence of food neophobia in children aged 1 to 6 years and to analyze its relationship with eating habits, preferences, and eating patterns. The study was conducted using a proprietary questionnaire and validated research tools such as the Child Feeding Scale (MCH-FS) and Food Neophobia Scale (FNS). The study included 345 children, of whom 59.1% were observed to be at significant risk for food neophobia. The results of the study suggest that food neophobia is not a common phenomenon in children aged 1–2 years but becomes more pronounced later in childhood. Another important finding was that food neophobia shows a stronger association with established eating patterns than with individual taste preferences. Considering these results, this phenomenon should be considered not only as a natural part of child development, but also as a potential indicator of eating disorders that may require intervention. These findings underscore the need for further research that could deepen the understanding of the mechanisms governing food neophobia and its long-term consequences for child health. [ABSTRACT FROM AUTHOR]

Ensuring proper early feeding for young children is crucial, as encountering feeding difficulties (FD) during this stage can give rise to a cascade of health problems, the repercussions of which may endure into late childhood and adolescence. Children raised by transgender parents may be at risk of encountering FD, however, there is no research conducted on Chinese transgender families. We designed a cross-sectional survey in which the rate of FD and its influencing factors were investigated among transgender parents in China. A total of 446 Chinese transgender parents (average age 30.39 years) were included in the analysis. Logistic regression models were applied to investigate the influencing factors of FD among children of transgender parents. We also established structural equation modeling (SEM) to explore the possible pathways among these factors and FD. The rate of FD in children of Chinese transgender parents is 55.4%, with 34.5% having severe FD. Coming out after having a child (AOR = 2.26, 95%CI = 1.33 ∼ 3.91), family violence (AOR = 1.06, 95%CI = 1.04 ∼ 1.09), partner violence (AOR = 1.11, 95%CI = 1.08 ∼ 1.15), no feeding education (accepting feeding education: AOR = 0.43, 95%CI = 0.25 ∼ 0.74), being discriminated during seeking of childbearing health care (AOR = 1.99, 95%CI = 1.3 ∼ 3.05), and poor relationship with partner (fair: AOR = 0.09, 95%CI = 0.03 ∼ 0.22; good: AOR = 0.06, 95%CI = 0.02 ∼ 0.15) are significantly associated with higher FD. Furthermore, through the pathway analysis, the indirect effects of education level (β=−0.151), feeding education (β = 0.145), and relationship with partner (β=-0.196) on FD are observed. Children of Chinese transgender parents showed a high FD rate. It is crucial to help build a better family and social environment for transgender families to reduce the FD and improve children's and adolescents' health. [ABSTRACT FROM AUTHOR]

Guidance on indications for, and types of, feeding tubes recommended in Prader‐Willi syndrome (PWS) is needed. A Global PWS Registry survey was developed to investigate nasogastric (NG) and gastrostomy (G) tube use and associated complications. Of 346 participants, 242 (69.9%) had NG‐tubes, 17 (4.9%) had G‐tubes, and 87 (25.1%) had both NG‐ and G‐tubes. Primary indication for placement was "feeding difficulties and/or poor weight gain" for both NG‐ (90.2%) and G‐tubes (71.2%), while "aspiration/breathing difficulties" was the procedural indication for 6.4% of NG‐tubes and 23.1% of G‐tubes. NG‐tubes were generally removed by age 6 months (NG Only: 82.9%; NG/G: 98.8%), while G‐tubes were often removed by age 2 years (G Only: 85.7%; NG/G: 70.5%). The severe complication rate from G‐tubes was 31.7% and from NG‐tubes was 1.2%. Overall, caregivers indicated the presence of an NG‐ or G‐tube had a positive effect on quality of life. Feeding difficulties in PWS are largely managed by NG‐tube alone. The severe complication rate from G‐tubes was about 25 times higher than from NG‐tubes; yet, G‐tube placement rates have generally increased. G‐tube placement puts individuals with PWS at risk for anesthesia and surgery‐related complications and should be considered judiciously by a multidisciplinary team. [ABSTRACT FROM AUTHOR]

Many guidelines have been published to help diagnose food allergies, which have included feeding difficulties as a presenting symptom (particularly for non-IgE-mediated gastrointestinal allergies). This study aimed to investigate the prevalence of feeding difficulties in children with non-IgE-mediated gastrointestinal allergies and the association of such difficulties with symptoms and food elimination. An observational study was performed at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Children aged 4 weeks to 16 years without non-allergic co-morbidities who improved on an elimination diet using a previously published Likert scale symptom score were included. This study recruited 131 children, and 114 (87%) parents completed the questionnaire on feeding difficulties. Feeding difficulties were present in 61 (53.5%) of the 114 children. The most common feeding difficulties were regular meal refusals (26.9%), extended mealtimes (26.7%), and problems with gagging on textured foods (26.5%). Most children (40/61) had ≥2 reported feeding difficulties, and eight had ≥4. Children with feeding difficulties had higher rates of constipation and vomiting: 60.7% (37/61) vs. 35.8% (19/53), p = 0.008 and 63.9% (39/61) vs. 41.5% (22/53), p = 0.017, respectively. Logistic regression analysis demonstrated an association between having feeding difficulties, the age of the child, and the initial symptom score. Gender and the number of foods excluded in the elimination diet were not significantly associated with feeding difficulties. This study found that feeding difficulties are common in children with non-IgE-mediated gastrointestinal allergies, but there is a paucity of food allergy specific tools for establishing feeding difficulties, which requires further research in the long-term and consensus in the short term amongst healthcare professions as to which tool is the best for food allergic children. [ABSTRACT FROM AUTHOR]

The term "feeding difficulties" refers to a spectrum of phenotypes characterized by suboptimal intake of food and/or lack of age‐appropriate eating habits. While it is evident that feeding difficulties are prevalent within healthy children, no consensus has been reached for those with food allergies. The aim of this study was to systematically review all the available literature reporting the prevalence of feeding difficulties within food allergic children. We searched eight international electronic databases for all published studies until June 2022. International experts in the field were also contacted for unpublished and ongoing studies. All publications were screened against pre‐defined eligibility criteria and critically appraised by established instruments. The substantial heterogeneity of included studies precluded meta‐analyses, so narrative synthesis of quantitative data was performed. A total of 2059 abstracts were assessed, out of which 21 underwent full‐text screening and 10 studies met the study criteria. In these, 12 different terms to define feeding difficulties and 11 diagnostic tools were used. Five papers included data of feeding difficulty prevalence in children with food allergies, ranging from 13.6% to 40%. Higher prevalence was associated with multiple food allergies. The current literature suggests that feeding difficulties are prevalent within food allergic children, particularly those with multiple food allergies. However, the heterogeneity of terminologies and diagnostic tools makes drawing conclusions challenging. Consensus guidelines for the diagnosis and management of feeding difficulties within food allergic children and further research on the development and perpetuation of feeding difficulties are needed to appropriately manage such patients. [ABSTRACT FROM AUTHOR]

In general, premature babies are discharged home when they reach full self-feeding. We established a discharge management protocol which allows for discharging late preterm babies with a feeding tube if necessary. This retrospective study included 108 preterm infants (34+ weeks) born in 2019 and 2020. The preterm infants discharged with a feeding tube (n = 32) were born at 35.23 weeks' gestation (±0.884), with a birth weight of 2423 g (±375.1), and were discharged at 7.22 days (±3.63) and had a weight of 3466 g (±591.3) at the first outpatient visit around the expected birth date. The preterm infants discharged without a feeding tube were born at 35.97 weeks' gestation (±0.702) with a birth weight of 2589 g (±424.84), discharged home at 6.82 days (±7.11) and a weight of 3784 g (±621.8) at the first outpatient visit. The gestational week and birth weight were statistically significantly different between the groups, with a p-value of <0.001 for each, and the length of hospital stay (p = 0.762) and weight at follow-up (p = 0.064) did not significantly differ. No infant required tube-feeding at the time of the first outpatient visit, i.e., the time of expected birth. Therefore, with well-thought-out management, it is possible and safe to discharge preterm infants home with a feeding tube. [ABSTRACT FROM AUTHOR]

Background: Identifying the factors influencing mental health of mothers at critical stages of childrearing is significant for the implementation of effective promotion policies and counselling activities. Objective: This study aimed to investigate the relationships between children's feeding difficulties, marital quality, parenting quality and maternal mental health risks amidst Chinese mothers with high and low social support using a multi-group structural equation modelling approach. Participants: A cross-sectional study was conducted in Wenzhou, China and a total of 772 mothers with children aged 0–3 were surveyed by using purposive sampling. Findings: Results showed that of the 772 participants, 23.6 % reported anxiety, 50.1 % reported depression, 91.2 % reported insomnia, and 24 % reported feeding difficulties. The joint occurrence of multiple forms of mental problems is the most commonly reported features of mental health risks among mothers. The positive association between feeding difficulties of children and mental health risks of mothers was mediated by marital quality and parenting quality. In addition, feeding difficulties were not related to mental health risks in high social support group but all the relationships were significant in low social support group. Conclusions: These findings highlight the importance of the specific interventions to enhance social support, marital quality and parenting quality for improving mental health of mothers of children with feeding difficulties.

Abstract Background Feeding difficulties (FDs) are complex phenomena influenced by parental factors, feeding behaviour, and cultural factors. However, studies of the influences of these factors on FDs incidence are scarce. Thus, this study aimed to identify the associations between mothers’ perceptions of FDs in children and parental feeding styles, body mass index, and the consumption of fruits, vegetables and processed foods. Method Two hundred and fifty-seven mothers of children aged 1 to 6 years and 11 months participated in this cross-sectional study and self-completed electronic questionnaires on sociographic variables, parental feeding styles, the consumption of fruits, vegetables and processed foods and FDs. Nutritional status was classified by body mass index (kg/m2). Results The prevalence of FDs in children was 48.2%, and the mean age was 43.8 (± 17.6) months. The indulgent parental feeding style was the most common (40.1%), followed by the authoritative (31.1%), authoritarian (23.7%), and uninvolved (5.1%) styles. An indulgent parental feeding style (OR: 4.66; 95% CI: 2.20–9.85), a high body mass index (OR: 1.35; 95% CI: 1.09–1.68), and the consumption of processed foods (OR: 5.21; 95% CI: 2.85–9.53) were positively associated with increased odds of the absence of FDs in children. The associations of authoritarian and uninvolved parental feeding styles and the consumption of fruits and vegetables with FDs in children were not significant. Conclusion This study identified multiple factors that are possibly associated with feeding behaviours in young children. However, further studies need to be undertaken to evaluate how such behaviours affect FDs.

Oropharyngocutaneous fistula following deep neck space infections is a rare entity. Patients can present with feeding difficulty and food leakage through the wound. The fistula is suspected to have formed not only due to the infectious process but also due to the combination of transoral and transcervical approach. Infection eradication, aggressive wound care, control of risk factors, and strict NPO with NGT feeding are all important parts of management. [ABSTRACT FROM AUTHOR]

Background: Feeding difficulties (FDs) are complex phenomena influenced by parental factors, feeding behaviour, and cultural factors. However, studies of the influences of these factors on FDs incidence are scarce. Thus, this study aimed to identify the associations between mothers' perceptions of FDs in children and parental feeding styles, body mass index, and the consumption of fruits, vegetables and processed foods. Method: Two hundred and fifty-seven mothers of children aged 1 to 6 years and 11 months participated in this cross-sectional study and self-completed electronic questionnaires on sociographic variables, parental feeding styles, the consumption of fruits, vegetables and processed foods and FDs. Nutritional status was classified by body mass index (kg/m2). Results: The prevalence of FDs in children was 48.2%, and the mean age was 43.8 (± 17.6) months. The indulgent parental feeding style was the most common (40.1%), followed by the authoritative (31.1%), authoritarian (23.7%), and uninvolved (5.1%) styles. An indulgent parental feeding style (OR: 4.66; 95% CI: 2.20–9.85), a high body mass index (OR: 1.35; 95% CI: 1.09–1.68), and the consumption of processed foods (OR: 5.21; 95% CI: 2.85–9.53) were positively associated with increased odds of the absence of FDs in children. The associations of authoritarian and uninvolved parental feeding styles and the consumption of fruits and vegetables with FDs in children were not significant. Conclusion: This study identified multiple factors that are possibly associated with feeding behaviours in young children. However, further studies need to be undertaken to evaluate how such behaviours affect FDs. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the influence of children's autism characteristics, sensory profiles and feeding difficulties on caregiver‐reported impact at mealtimes. Background: Caregivers of children (5–12 years) with a diagnosis of Autism Spectrum Disorder completed an online survey examining (a) demographic characteristics, (b) children's autism characteristics (Social Communication Questionnaire), (c) sensory profiles (Sensory Profile 2–short form), (d) feeding difficulties (Behavioural Paediatrics Feeding Assessment Scale, BPFAS) and (c) caregiver‐reported impact of feeding difficulties (Feeding‐Swallowing Impact Survey, FS‐IS). Results: Seventy‐eight caregivers completed surveys for 80 children. Children with clinically significant feeding difficulties on the BPFAS (n = 55, 68.8%) had higher levels of caregiver‐reported impact on daily activities, worry and feeding difficulties compared to children without clinically significant feeding difficulties (FS‐IS; U = 257.000, z = −4.471, p < 0.01). Spearman's rank correlation showed a statistically significant, moderate correlation between BPFAS total frequency score and FS‐IS Daily activities score, rs (98) = 0.56, p < 0.01, indicating that as the frequency of feeding difficulties increased, the impact of these feeding difficulties on caregivers also increased. Using multiple regression, a model comprising of the three factors was statistically significant (F[1, 78] = 87.75, p < 0.001, adj. R2 = 0.52), with children's frequency of feeding difficulties the strongest predictor of caregiver‐reported impact with a moderate effect size (r = 0.49). Conclusion: Autistic children's feeding difficulties had a greater impact on caregivers than autism or sensory profiles, with the frequency of feeding difficulties and the caregiver impact of these feeding difficulties positively correlated. The findings demonstrate that efforts to understand and address feeding difficulties in autistic children must extend beyond the children to include their families. [ABSTRACT FROM AUTHOR]

Current clinical guidelines provide information about the diagnostic workup of children with growth failure. This mini-review focuses on the nutritional assessment, which has received relatively little attention in such guidelines. The past medical history, in particular a low birth size and early feeding problems, can provide information that can increase the likelihood of nutritional deficits or several genetic causes. The current medical history should include a dietary history and can thereby reveal a poorly planned or severely restricted diet, which can be associated with nutritional deficiencies. Children on a vegan diet should receive various nutritional supplements, but insufficient compliance has been reported in one-third of cases. While proper use of nutritional supplements in children consuming a vegan diet appears to be associated with normal growth and development, insufficient intake of supplements may impede growth and bone formation. Physical examination and analysis of height and weight over time can help differentiating between endocrine causes, gastrointestinal disorders, psychosocial problems, or underlying genetic conditions that prevent adequate nutritional intake. Laboratory screening should be part of the workup in every child with short stature, and further laboratory tests can be indicated if warranted by the dietary history, especially in children on a poorly planned vegan diet. [ABSTRACT FROM AUTHOR]

Introduction: The main aim of the study was to identify the prevalence of food neophobia using the standardised food neophobia of children scale (FNSC) questionnaire in a group of Polish children attending nurseries and kindergartens. Material and methods: The study was carried out using a survey method. The questionnaire was distributed to randomly selected nurseries and kindergartens. The period in which we conducted the above survey was January -- March 2023. A total of 585 pairs of mothers and their children participated in the survey. A standardised questionnaire assessing food neophobia among children was used to assess food neophobia FNSC. A score below 27 indicated a low risk of neophobia, 28--40 an intermediate risk, and a score above 41 was a high risk. Results: In the study group, 171 children (29.23%) had a low risk of food neophobia, 182 children (31.11%) had a medium risk, and 232 children (39.66%) had a high risk. There were no differences in the risk of food neophobia between girls and boys (p = 0.907), between children's weight (p = 0.776), or between place of residence (p = 0.095). There was a statistically significant difference between age and in the risk of food neophobia (p = 0.0002). Conclusions: In the study group, 40% of the children had a high risk of food neophobia. Food neophobia was highest among 4-year-olds and 5-year-olds. There were no differences between girls and boys and the prevalence of food neophobia. Among children with a higher risk of food neophobia, feeding problems such as playing while eating meals, fussing at meals, and picky eating were more common. [ABSTRACT FROM AUTHOR]

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In general, premature babies are discharged home when they reach full self-feeding. We established a discharge management protocol which allows for discharging late preterm babies with a feeding tube if necessary. This retrospective study included 108 preterm infants (34+ weeks) born in 2019 and 2020. The preterm infants discharged with a feeding tube (n = 32) were born at 35.23 weeks’ gestation (±0.884), with a birth weight of 2423 g (±375.1), and were discharged at 7.22 days (±3.63) and had a weight of 3466 g (±591.3) at the first outpatient visit around the expected birth date. The preterm infants discharged without a feeding tube were born at 35.97 weeks’ gestation (±0.702) with a birth weight of 2589 g (±424.84), discharged home at 6.82 days (±7.11) and a weight of 3784 g (±621.8) at the first outpatient visit. The gestational week and birth weight were statistically significantly different between the groups, with a p-value of p = 0.762) and weight at follow-up (p = 0.064) did not significantly differ. No infant required tube-feeding at the time of the first outpatient visit, i.e., the time of expected birth. Therefore, with well-thought-out management, it is possible and safe to discharge preterm infants home with a feeding tube.

Feeding difficulties are commonly reported in autistic children. However, there is limited data on the presentation, severity, and impact of feeding difficulties in autistic children in Asia. To describe the dietary patterns, growth and nutritional status of autistic children with pediatric feeding disorder (PFD), and identify factors associated with more severe feeding difficulties. A retrospective review of electronic medical records. Autistic children (aged between 0 and 18 years) with PFD, who attended a multidisciplinary feeding clinic between August 2013 and December 2022. The children's parents provided a 3-day food diary, which was verified by the dietitian and analyzed for their nutritional content using Foodworks 10 Professional. Food selectivity was classified as mild, moderate or severe, based on the number of food groups accepted and the absolute number of foods accepted in each group. Information regarding demographics, height, weight, medical information, developmental history (autism diagnosis, cognition, adaptive skills) and relevant nutritional bloodwork were collected. Parents also completed two validated questionnaires (the Behavioral Pediatrics Feeding Assessment Scale (BPFAS), which assessed childhood mealtime behaviors; and the Caregiver Feeding Style Questionnaire (CFSQ), which determined caregiver/ parental feeding styles). Factors associated with higher BPFAS total frequency scores (TFS) (representing more severe feeding difficulties) and food selectivity were analyzed. There were a total of 98 patients (82 males), with mean ± SD (range) age of 59.2 ± 27.5 (17–169) months. They had mild (19.4 %), moderate (22.4 %) and severe (58.2 %) food selectivity, respectively. While the majority had normal weight (84.7 %) and height (88.8 %) for age, 69.4 % had diets deficient in calories, macronutrients or micronutrients (iron, calcium). Comparison between groups according to parental feeding style found that there was a significant difference in BFPAS TFS between different parental feeding styles (p < 0.001). Post-hoc testing revealed that parents who reported an authoritarian parental feeding style on the CFSQ were significantly more likely to report higher frequencies of difficult feeding behaviors on the BPFAS (98.3 ± 15.8), while an uninvolved parental feeding style was associated with the lowest BPFAS TFS (80.9 ± 11.0), Bonferroni-adjusted p < 0.001; indulgent (p = 0.012) and authoritative (p = 0.096). Intellectual impairment and Malay ethnicity were associated with more severe food selectivity [adjusted odds ratio 123.7 (95 % CI 3.09–4945.4, p = 0.01) and 38.0 (95 % CI 1.35–1074.18, p = 0.03)], respectively. In this retrospective cohort, autistic children with PFD were at significant nutritional risk despite demonstrating normal growth patterns, with specific patient profiles being associated with more severe feeding difficulties. • Many autistic children with pediatric feeding disorder had significant nutritional risk despite normal growth patterns. • Intellectual impairment and Malay ethnicity were associated with more food selectivity. • Authoritarian feeding style was associated with more severe presentations of pediatric feeding disorder. [ABSTRACT FROM AUTHOR]

Background/objectives: This study aimed to identify the P-bottle feeding techniques systematically organized by Ms. Kumagai, an expert in nursing care for children with a cleft lip and/or palate (CLP), which were developed as she gained expertise in feeding affected children., Methods: We recruited three nurses who had mastered the Kumagai method for feeding with a P-bottle. Through analysis of participants' voices and videos during interviews, we focused on aspects such as dealing with a closed mouth, inserting the nipple in cases of unilateral and bilateral CLP, dealing with the child's movements after insertion, and key considerations when squeezing the bottle., Results: The interview analyses revealed numerous techniques used by nurses to manage the difficulties encountered while feeding children, ensuring successful provision of nourishment. Specifically, the nurses employed techniques such as placing the nipple along the midline of the child's tongue and varying the application of force on the nipple depending on the cleft type. The nurses reported that the objectives of these techniques were to prevent ulcer formation and encourage the use of the tongue, simulating original feeding movements., Conclusions: We explored feeding techniques and the management of associated challenges. Our results suggest that the "Kumagai Method" could be valuable in improving feeding practices.

Objective: The objective of this study was to describe feeding practices and weight status in a cohort of children with congenital Zika syndrome (CZS) in northeastern Brazil., Methods: This longitudinal study of children with CZS (N = 156) included data collection on child feeding practices and weight status at five timepoints between 2018 and 2022. The average age of the children was 32.1 months at enrollment and 76.6 months at the fifth assessment. Multilevel models, with repeated observations nested within children, were used to estimate time-related differences in each outcome., Results: Use of enteral feeding, such as gastrostomy, increased from 19.2% to 33.3% over 4 years (p < .001). Among children who did not exclusively use an enteral feeding method, the percentage experiencing at least one dysphagia-associated behavior, such as coughing or gagging, increased from 73.9% to 85.3% (p = .030) while consuming liquids and from 36.2% to 73.5% (p = .001) while consuming solids. Based on weight-for-age z-scores, the percentage of children who were moderately or severely underweight increased from 42.5% to 46.1% over the 4 years but was not statistically significant. Children exclusively using an enteral feeding method had significantly decreased odds of being underweight at assessments 3, 4, and 5., Conclusions: These data highlight the ongoing and increasing challenges of feeding young children with CZS. Our findings elucidate the physiological reasons children with CZS may be underweight and point to intervention targets, such as enteral feeding, to improve their feeding practices., (© 2024 European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Patients with non-eosinophilic esophagitis eosinophilic gastrointestinal diseases (non-EoE EGIDs) are prone to nutritional deficiencies due to food-avoidant behaviors, malabsorption, and high nutrition impact symptoms. Nutrient deficiencies correspond to the segment, depth, and extent of the gastrointestinal tract involved and can impact organs distant from the gut. Patients with non-EoE EGIDs are often atopic, and some appear to respond to dietary avoidance of specific food allergens. Tests to identify food triggers other than response to elimination diets are lacking. Dietary restriction therapy should be considered in such patients and is best implemented through a multidisciplinary approach to avoid nutritional complications., Competing Interests: Disclosure M. Chehade is currently serving or has served as consultant for Regeneron, Adare/Ellodi, AstraZeneca, Sanofi, Bristol Myers Squibb, Recludix Pharma, Nexstone Immunology, Allakos, Shire/Takeda, and Phathom, and is currently receiving or has received research funding from Regeneron, United States, Allakos, Shire/Takeda, AstraZeneca, United Kingdom, Adare/Ellodi, Bristol-Myers Squibb, United States, Danone, v. B. Doerfler has served on speakers bureaus for Nutricia North America, on advisory boards for Trellus Health LLC, and received honoraria from PRIMED CME and ACHL Healthcare. D. Atkins has nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction and Objectives: Food allergy has several negative nutritional consequences and may persist beyond the first year of lives. This study aimed to assess the role of a complete oral amino acid-based supplement in the diet of children on cow's milk protein elimination diet because of food allergy., Materials and Methods: This study included two groups of children aged 1-5 years paired by age and socioeconomic status: (1) study group, on cow's milk protein elimination diet plus an oral amino acid-based supplement, and (2) control group, on cow's milk protein elimination diet. Sociodemographic, clinical, anthropometric, and dietary data were obtained through online interviews. Two 24-h dietary recalls were collected on nonconsecutive days. Both groups comprised mostly boys., Results: The study group presented lower values of body mass index. The frequency of feeding difficulties was similar between groups. The study group had a higher intake of energy, protein, carbohydrates, calcium, iron, zinc, phosphorus, magnesium, copper, selenium, vitamins D, E, B1, B2, B6, and B12, niacin, and folic acid compared to the control group. A higher proportion of children in the study group had adequate intake according to the recommendations made for energy, carbohydrates, iron, phosphorus, selenium, vitamins A, D, E, B1, B2, and B6, and folic acid., Conclusions: The use of a complete oral amino acid-based supplement has a positive effect on the diet quality of preschoolers on cow's milk elimination diet because of food allergy, promoting higher intake of energy, calcium, vitamin D, and other essential nutrients., Competing Interests: Adriana Sanudo, Vanessa Cristina de Castro Rodrigues, and Mauro Batista de Morais received personal fees to develop this study. Thaysa Maués Cezar works the Medical Affairs Division of Danone Nutricia Brazil, and Camila Leonel Mendes de Abreu was working in the Medical Affairs Division of Danone Nutricia Brazil when this study was developed.

Objectives: Feeding difficulties after congenital heart surgery are a common concern for caregivers of children with CHD. Insight into the intricacies of their experience is lacking. With a better understanding, healthcare providers can continue to optimize the approach and support mechanisms for these families. This study will explore the psychosocial impacts on caregivers, define barriers to care, and identify areas to improve their care., Study Design: This mixed-methods study combined semi-structured interviews with surveys. Purposive sampling targeted caregivers of a child who underwent heart surgery and was discharged with alternative enteral feeding access. A hybrid inductive-deductive methodology was used to analyse interview transcripts. Survey scores were compared to interview content for concordance., Results: Fifteen interviews were conducted with socio-demographically diverse caregivers. Feeding difficulties were often identified as their greatest challenge, with the laborious feeding schedule, sleep deprivation, and tube management being common contributors. Most caregivers described feeling overwhelmed and worried. Time-intensive feeding schedules and lack of appropriate childcare options precluded caregivers' ability to work. Barriers to care included imperfect feeding education, proximity of specialist clinics, and issues with medical supply companies. Caregiver proposals for improved care addressed easing the transition home, improving emotional support mechanisms, and intensifying feeding therapy for expedited tube removal., Conclusion: This study describes the psychosocial toll on the caregiver, typical barriers to care, and ideas for improved provision of care. These themes and ideas can be used to advance the family-centered approach to feeding difficulties after heart surgery.

Purpose: The aim of the present study was to investigate whether term infants with feeding difficulties who received either a 5-minute premature infant oral motor intervention (PIOMI) or a 15-minute Fucile treatment had different outcomes, compared to term infants in a nontreatment group., Method: Stable term infants ( N  = 51) born between 37-41 weeks of gestational age with feeding difficulties were randomly assigned into one of two intervention groups and a control group. One intervention group received PIOMI and the other group received Fucile treatment once a day for seven consecutive days; the control group received usual care only. The volume of milk intake, the amount of weight gain, and the length of hospital stay were compared across all groups., Result: Findings indicated that the volume of milk intake and weight gain showed significant improvement in all three groups. However, pairwise comparison revealed that infants in the Fucile group had significantly higher volume of milk intake and weight gain compared to infants in both the control and PIOMI groups. Length of hospital stay was not significantly different amongst all groups., Conclusion: The effects of Fucile treatment were more considerable than for usual care or PIOMI. This finding raises the possibility that prolonged exercise may facilitate improvement in feeding skills for term infants with feeding difficulties.