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Nutrients 2019, 11(3), 529;

How Does Feeding Development and Progression onto Solid Foods in PKU Compare with Non-PKU Children During Weaning?

Birmingham Women’s and Children’s Hospital NHS Foundation Trust, Birmingham B4 6NH, UK
Bradford Teaching Hospitals NHS Trust, Bradford BD9 6RJ, UK
Royal Hospital for Children Glasgow G51 4TF, UK
Danone Early Life Nutrition, Macquarie Park, New South Wales 2113, Australia
Author to whom correspondence should be addressed.
Received: 21 December 2018 / Revised: 25 February 2019 / Accepted: 26 February 2019 / Published: 28 February 2019
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Weaning is complex for children with phenylketonuria (PKU). Breastmilk/infant formula and phenylalanine (Phe)-free infant protein-substitute (PS) are gradually replaced with equivalent amounts of Phe-containing food, a semi-solid/spoonable weaning PS and special low-protein foods. In PKU, feeding patterns/practices during weaning in PKU have not been formally evaluated. In this longitudinal, prospective, case-control study (n = 20) infants with PKU transitioning to a second-stage PS, were recruited at weaning (4–6 months) for a comparison of feeding practices and development with non-PKU infants. Subjects were monitored monthly to 12 months and at age 15 months, 18 months and 24 months for: feeding progression; food textures; motor skill development and self-feeding; feeding environment; gastrointestinal symptoms; and negative feeding behaviours. Children with PKU had comparable weaning progression to non-PKU infants including texture acceptance, infant formula volume and self-feeding skills. However, children with PKU had more prolonged Phe-free infant formula bottle-feeding and parental spoon feeding than controls; fewer meals/snacks per day; and experienced more flatulence (p = 0.0005), burping (p = 0.001), retching (p = 0.03); and less regurgitation (p = 0.003). Negative behaviours associated with PS at age 10–18 months, coincided with the age of teething. Use of semi-solid PS in PKU supports normal weaning development/progression but parents require support to manage the complexity of feeding and to normalise the social inclusivity of their child’s family food environment. Further study regarding parental anxiety associated with mealtimes is required. View Full-Text
Keywords: Phenylketonuria; protein substitute; weaning; feeding development Phenylketonuria; protein substitute; weaning; feeding development

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Evans, S.; Daly, A.; Wildgoose, J.; Cochrane, B.; Chahal, S.; Ashmore, C.; Loveridge, N.; MacDonald, A. How Does Feeding Development and Progression onto Solid Foods in PKU Compare with Non-PKU Children During Weaning? Nutrients 2019, 11, 529.

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