Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Measures
2.2.1. Demographic and Anthropometric Data
2.2.2. The Child’s Medical History
2.2.3. Behavioral Pediatrics Feeding Assessment Scale (BPFAS)
2.2.4. Set of Questions Developed to Assess Parental Feeding Practices
2.2.5. Set of Questions Developed to Assess Mealtime Environment
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Manikam, R.; Perman, J.A. Pediatric feeding disorders. J. Clin. Gastroenterol. 2000, 30, 34–46. [Google Scholar] [CrossRef] [PubMed]
- Roig-Quilis, M.; Pennington, L. Oromotor Disorders in Childhood; Viguera: La Rioja, Spain, 2011. [Google Scholar]
- Sdravou, K.; Emmanouilidou-Fotoulaki, E.; Mitakidou, M.R.; Printza, A.; Evangeliou, A.; Fotoulaki, M. Children with diseases of the upper gastrointestinal tract are more likely to develop feeding problems. Ann. Gastroenterol. 2019, 32, 217. [Google Scholar] [CrossRef]
- Equit, M.; Pälmke, M.; Becker, N.; Moritz, A.M.; Becker, S.; von Gontard, A. Eating problems in young children—A population-based study. Acta Paediatr. 2013, 102, 149–155. [Google Scholar] [CrossRef]
- Estrem, H.H.; Pados, B.F.; Park, J.; Knafl, K.A.; Thoyre, S.M. Feeding problems in infancy and early childhood: Evolutionary concept analysis. J. Adv. Nurs. 2017, 73, 56–70. [Google Scholar] [CrossRef]
- Aldridge, V. Characterisation of Paediatric Feeding Disorders and the Underlying Factors Implicated in Their Development and Maintenance. Ph.D. Thesis, Loughborough University, Loughborough, UK, 2012. [Google Scholar]
- Burklow, K.A.; Phelps, A.N.; Schultz, J.R.; McConnell, K.; Rudolph, C. Classifying complex pediatric feeding disorders. J. Pediatr. Gastroenterol. Nutr. 1998, 27, 143–147. [Google Scholar] [CrossRef] [PubMed]
- Van Dijk, M. A complex dynamical systems approach to the development of feeding problems in early childhood. Appetite 2020, 157, 104982. [Google Scholar] [CrossRef] [PubMed]
- Powell, F.; Farrow, C.; Meyer, C.; Haycraft, E. The importance of mealtime structure for reducing child food fussiness. Matern. Child. Nutr. 2017, 13, e12296. [Google Scholar] [CrossRef] [Green Version]
- Milano, K.; Chatoor, I.; Kerzner, B. A functional approach to feeding difficulties in children. Curr. Gastroenterol. Rep. 2019, 21, 51. [Google Scholar] [CrossRef]
- Finnane, J.M.; Jansen, E.; Mallan, K.M.; Daniels, L.A. Mealtime structure and responsive feeding practices are associated with less food fussiness and more food enjoyment in Children. J. Nutr. Educ. Behav. 2017, 49, 11–18.e1. [Google Scholar] [CrossRef] [Green Version]
- Nicklaus, S.; Schwartz, C. Early influencing factors on the development of sensory and food preferences. Curr. Opin. Clin. Nutr. Metab. Care 2019, 22, 230–235. [Google Scholar] [CrossRef]
- Warkentin, S.; Mais, L.A.; de Oliveira Latorre, M.D.R.D.; Carnell, S.; de Aguiar CarrazedoTaddei, J.A. Relationships between parent feeding behaviors and parent and child characteristics in Brazilian preschoolers: A cross-sectional study. BMC Public Health 2018, 18, 704. [Google Scholar] [CrossRef]
- Jansen, P.W.; Roza, S.J.; Jaddoe, V.W.; Mackenbach, J.D.; Raat, H.; Hofman, A.; Verhulst, F.C.; Tiemeier, H. Children’s eating behavior, feeding practices of parents and weight problems in early childhood: Results from the population-based generation R study. Int. J. Behav. Nutr. Phys. Act. 2012, 9, 130. [Google Scholar] [CrossRef] [Green Version]
- Lucendo, A.J.; Molina-Infante, J.; Arias, Á.; von Arnim, U.; Bredenoord, A.J.; Bussmann, C.; Amil Dias, J.; Bove, M.; González-Cervera, J.; Larsson, H.; et al. Guidelines on eosinophilic esophagitis: Evidence-based statements and recommendations for diagnosis and management in children and adults. United Eur. Gastroenterol. J. 2017, 5, 335–358. [Google Scholar] [CrossRef] [Green Version]
- Rosen, R.; Vandenplas, Y.; Singendonk, M.; Cabana, M.; DiLorenzo, C.; Gottrand, F.; Gupta, S.; Langendam, M.; Staiano, A.; Thapar, N.; et al. Pediatric gastroesophageal reflux clinical practice guidelines: Joint recommendations of the north american society for pediatric gastroenterology, hepatology, and nutrition and the european society for pediatric gastroenterology, hepatology, and nutrition. J. Pediatr. Gastroenterol. Nutr. 2018, 66, 516–554. [Google Scholar] [CrossRef] [PubMed]
- Sdravou, K.; Emmanouilidou-Fotoulaki, E.; Printza, A.; Andreoulakis, E.; Evangeliou, A.; Fotoulaki, M. Mealtime environment and control of food intake in healthy children and in children with gastrointestinal diseases. Children 2021, 8, 77. [Google Scholar] [CrossRef] [PubMed]
- Sdravou, K.; Printza, A.; Andreoulakis, E.; Sotiriadou, F.; Evangeliou, A.; Fotoulaki, M. Parental feeding practices data in healthy children and children with gastrointestinal diseases. Data Brief 2020, 31, 106036. [Google Scholar] [CrossRef] [PubMed]
- Goday, P.S.; Huh, S.Y.; Silverman, A.; Lukens, C.T.; Dodrill, P.; Cohen, S.S.; Delaney, A.L.; Feuling, M.B.; Noel, R.J.; Gisel, E.; et al. Pediatric feeding disorder: Consensus definition and conceptual framework. J. Pediatr. Gastroenterol. Nutr. 2019, 68, 124–129. [Google Scholar] [CrossRef]
- Crist, W.; Napier-Phillips, A. Mealtime behaviors of young children: A comparison of normative and clinical data. J. Dev. Behav. Pediatr. 2001, 22, 279–286. [Google Scholar] [CrossRef] [PubMed]
- Sanchez, K.; Spittle, A.J.; Allinson, L.; Morgan, A. Parent questionnaires measuring feeding disorders in preschool children: A systematic review. Dev. Med. Child. Neurol. 2015, 57, 798–807. [Google Scholar] [CrossRef] [Green Version]
- Wu, Y.P.; Franciosi, J.P.; Rothenberg, M.E.; Hommel, K.A. Behavioral feeding problems and parenting stress in eosinophilic gastrointestinal disorders in children. Pediatr. Allergy Immunol. 2012, 23, 730–735. [Google Scholar] [CrossRef] [PubMed]
- Mehta, P.; Furuta, G.T.; Brennan, T.; Michelle, L.H.; Maune, N.C.; Sundaram, S.S.; Menard-Katcher, C.; Atkins, D.; Takurukura, F.; Giffen, S.; et al. Nutritional state and feeding behaviors of children with eosinophilic esophagitis and gastroesophageal reflux disease. J. Pediatr. Gastroenterol. Nutr. 2018, 66, 603–608. [Google Scholar] [CrossRef] [PubMed]
- Chehade, M.; Meyer, R.; Beauregard, A. Feeding difficulties in children with non–IgE-mediated food allergic gastrointestinal disorders. Ann. Allergy Asthma Immunol. 2019, 122, 603–609. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Field, D.; Garland, M.; Williams, K. Correlates of specific childhood feeding problems. J. Paediatr. Child Health 2003, 39, 299–304. [Google Scholar] [CrossRef]
- Haas, A.M. Feeding disorders in food allergic children. Curr. Allergy Asthma Rep. 2010, 10, 258–264. [Google Scholar] [CrossRef]
- Mehta, H.; Groetch, M.; Wang, J. Growth and nutritional concerns in children with food allergy. Curr. Opin. Allergy Clin. Immunol. 2013, 13, 275–279. [Google Scholar] [CrossRef] [Green Version]
- Meyer, R.; Rommel, N.; Van Oudenhove, L.; Fleming, C.; Dziubak, R.; Shah, N. Feeding difficulties in children with food protein-induced gastrointestinal allergies. J. Gastroenterol. Hepatol. 2014, 29, 1764–1769. [Google Scholar] [CrossRef]
- WHO. WHO Anthro for Personal Computers, Software for Assessing Growth and Development of the World’s Children, Version 3.2.2, 2011; WHO: Geneva, Switzerland, 2010; Available online: http://www.who.int/childgrowth/software/en/ (accessed on 22 February 2020).
- WHO. WHO AnthroPlus for Personal Computers Manual: Software for Assessing Growth of the World’s Children and Adolescents; WHO: Geneva, Switzerland, 2009; Available online: http://www.who.int/growthref/tools/en/ (accessed on 22 February 2020).
- Crist, W.; McDonnell, P.; Beck, M.; Gillespie, C.T.; Barrett, P.; Mathews, J. Behavior at mealtimes and the young child with cystic fibrosis. J. Dev. Behav. Pediatr. 1994, 15, 157–161. [Google Scholar] [CrossRef]
- Mitchell, M.J.; Powers, S.W.; Byars, K.C.; Dickstein, S.; Stark, L.J. Family functioning in young children with cystic fibrosis: Observations of interactions at mealtime. J. Dev. Behav. Pediatr. 2004, 25, 335–346. [Google Scholar] [CrossRef]
- Marshall, J.; Raatz, M.; Ward, E.C.; Dodrill, P. Use of parent report to screen for feeding difficulties in young children. J. Paediatr. Child Health 2015, 51, 307–313. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dovey, T.M.; Martin, C.I. A parent-led contingent reward desensitisation intervention for children with a feeding problem resulting from sensory defensiveness. Infant Child Adolesc. Nutr. 2012, 4, 384–393. [Google Scholar] [CrossRef]
- Dovey, T.M.; Martin, C.I. A quantitative psychometric evaluation of an intervention for poor dietary variety in children with a feeding problem of clinical significance. Infant Ment. Health J. 2012, 33, 148–162. [Google Scholar] [CrossRef] [PubMed]
- Allen, S.L.; Smith, I.M.; Duku, E.; Vaillancourt, T.; Szatmari, P.; Bryson, S.; Fombonne, E.; Volden, J.; Waddell, C.; Zwaigenbaum, L.; et al. Behavioral pediatrics feeding assessment scale in young children with autism spectrum disorder: Psychometrics and associations with child and parent variables. J. Pediatr. Psychol. 2015, 40, 581–590. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sdravou, K.; Evangeliou, A.; Tentzidou, K.; Sotiriadou, F.; Stasinou, E.; Fotoulaki, M. The behavioural paediatrics feeding assessment scale is a reliable and valid tool for Greek children. Acta Paediatr. 2018, 107, 1653–1654. [Google Scholar] [CrossRef] [PubMed]
- Sdravou, K.; Andreoulakis, E.; Printza, A.; Sotiriadou, F.; Evangeliou, A.; Fotoulaki, M. Parental management of feeding problems in young children-a population-based study. Int. J. Pediatr. Otorhinolaryngol. 2020, 136, 110162. [Google Scholar] [CrossRef] [PubMed]
- Sdravou, K.; Fotoulaki, M.; Emmanouilidou-Fotoulaki, E.; Andreoulakis, E.; Makris, G.; Sotiriadou, F.; Printza, A. Feeding Problems in Typically Developing Young Children, a Population-Based Study. Children 2021, 8, 388. [Google Scholar] [CrossRef]
- Printza, A.; Goutsikas, C.; Triaridis, S.; Kyrgidis, A.; Haidopoulou, K.; Constantinidis, J.; Pavlou, E. Dysphagia diagnosis with questionnaire, tongue strength measurement, and FEES in patients with childhood-onset muscular dystrophy. Int J. Pediatr. Otorhinolaryngol. 2019, 117, 198–203. [Google Scholar] [CrossRef]
- Mathisen, B.; Worrall, L.; Masel, J.; Wall, C.; Shepherd, R. Feeding problems in infants with gastro-oesophageal reflux disease: A controlled study. J. Paediatr. Child Health 1999, 35, 163–169. [Google Scholar] [CrossRef]
- Drent, L.V.; Pinto, E.A. Feeding Disorders In Children With Gastro-esophageal reflux disease (original title: Problemas de alimentaçãoemcrianças com doença do refluxogastroesofágico). Pró-FonoR Atual. Cient. 2007, 19, 59–66. [Google Scholar] [CrossRef] [Green Version]
- Kerzner, B.; Milano, K.; MacLean, W.C.; Berall, G.; Stuart, S.; Chatoor, I. A practical approach to classifying and managing feeding difficulties. Pediatrics 2015, 135, 344–345. [Google Scholar] [CrossRef] [Green Version]
- Benjasuwantep, B.; Chaithirayanon, S.; Eiamudomkan, M. Feeding problems in healthy young children: Prevalence, related factors and feeding practices. Pediatr. Rep. 2013, 5, 38–42. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Arvedson, J. Assessment of pediatric dysphagia and feeding disorders: Clinical and instrumental approaches. Dev. Disabil. Res. Rev. 2008, 14, 118–127. [Google Scholar] [CrossRef]
- Ibañez, V.F.; Peterson, K.M.; Crowley, J.G.; Haney, S.D.; Andersen, A.S.; Piazza, C.C. Pediatric prevention: Feeding disorders. Pediatr. Clin. N. Am. 2020, 67, 451–467. [Google Scholar] [CrossRef] [PubMed]
- Dovey, T.M.; Jordan, C.; Aldridge, V.K.; Martin, C.I. Screening for feeding disorders. Creating critical values using the behavioral pediatrics feeding assessment scale. Appetite 2013, 69, 108–113. [Google Scholar] [CrossRef]
- Birch, L.L. Development of food preferences. Annu. Rev. Nutr. 1999, 19, 41–62. [Google Scholar] [CrossRef] [Green Version]
- Birch, L.L. Effects of peer models’ food choices and eating behaviors on preschoolers’ food preferences. Child. Dev. 1980, 51, 489–496. [Google Scholar] [CrossRef]
- Berlin, K.; Davies, W.; Lobato, D.; Silverman, A. A biopsychosocial model of normative and problematic pediatric feeding. J. Child. Health Care 2009, 38, 263–282. [Google Scholar] [CrossRef]
- Ammaniti, M.; Lucarelli, L.; Cimino, S.; D’Olimpio, F.; Chatoor, I. Maternal psychopathology and child risk factors in infantile anorexia. Int J. Eat. Disord. 2010, 43, 233–240. [Google Scholar] [CrossRef] [PubMed]
- Burklow, K.; McGrath, A.; Kaul, A. Management and prevention of feeding problems in young children with prematurity and very low birth weight. Infants Young Child. 2002, 14, 19–30. [Google Scholar] [CrossRef]
- Brinksma, A.; Sulkers, E.; IJpma, I.; Burgerhof, J.G.M.; Tissing, W.J.E. Eating and feeding problems in children with cancer: Prevalence, related factors, and consequences. Clin. Nutr. 2020, 39, 3072–3079. [Google Scholar] [CrossRef]
- Powers, S.W.; Patton, S.R.; Byars, K.C.; Mitchell, M.J.; Jelalian, E.; Mulvihill, M.M.; Hovell, M.F.; Stark, L.J. Caloric intake and eating behavior in infants and toddlers with cystic fibrosis. Pediatrics 2002, 109, E75. [Google Scholar] [CrossRef] [Green Version]
- Sanchez, K.; Boyce, J.O.; Morgan, A.T.; Spittle, A.J. Feeding behavior in three-year-old children born <30 weeks and term-born peers. Appetite 2018, 130, 117–122. [Google Scholar] [CrossRef]
- Levine, A.; Bachar, L.; Tsangen, Z.; Mizrachi, A.; Levy, A.; Dalal, I.; Kornfeld, L.; Levy, Y.; Zadik, Z.; Turner, D.; et al. Screening criteria for diagnosis of infantile feeding disorders as a cause of poor feeding or food refusal. J. Pediatr. Gastroenterol. Nutr. 2011, 52, 563–568. [Google Scholar] [CrossRef]
- Cooper, P.J.; Whelan, E.; Woolgar, M.; Morrell, J.; Murray, L. Association between childhood feeding problems and maternal eating disorder: Role of the family environment. Br. J. Psychiatry 2004, 184, 210–215. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Collings, P.J.; Kelly, B.; West, J.; Wright, J. Associations of TV Viewing Duration, Meals and Snacks Eaten When Watching TV, and a TV in the Bedroom with Child Adiposity. Obesity (Silver Spring) 2018, 26, 1619–1628. [Google Scholar] [CrossRef]
- Trofholz, A.C.; Tate, A.; Loth, K.; Neumark-Sztainer, D.; Berge, J.M. Watching television while eating: Associations with dietary intake and weight status among a diverse sample of young children. J. Acad. Nutr. Diet. 2019, 119, 1462–1469. [Google Scholar] [CrossRef] [PubMed]
- Dubois, L.; Farmer, A.; Girard, M.; Peterson, K. Social factors and television use during meals and snacks is associated with higher BMI among pre-school children. Public Health Nutr. 2008, 11, 1267–1279. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Galloway, A.T.; Fiorito, L.M.; Francis, L.A.; Birch, L.L. ‘Finish your soup’: Counterproductive effects of pressuring children to eat on intake and affect. Appetite 2006, 46, 318–323. [Google Scholar] [CrossRef] [Green Version]
- Loth, K.A.; Friend, S.; Horning, M.L.; Neumark-Sztainer, D.; Fulkerson, J.A. Directive and non-directive food-related parenting practices: Associations between an expanded conceptualization of food-related parenting practices and child dietary intake and weight outcomes. Appetite 2016, 107, 188–195. [Google Scholar] [CrossRef] [Green Version]
- Larsen, J.K.; Hermans, R.C.; Sleddens, E.F.; Engels, R.C.; Fisher, J.O.; Kremers, S.P. How parental dietary behavior and food parenting practices affect children’s dietary behavior. Interacting sources of influence? Appetite 2015, 89, 246–257. [Google Scholar] [CrossRef]
- Batsell, W.R., Jr.; Brown, A.S.; Ansfield, M.E.; Paschall, G.Y. “You will eat all of that!”: A retrospective analysis of forced consumption episodes. Appetite 2002, 38, 211–219. [Google Scholar] [CrossRef] [PubMed]
- Dovey, T.M.; Staples, P.A.; Gibson, E.L.; Halford, J.C. Food neophobia and ‘picky/fussy’ eating in children: A review. Appetite 2008, 50, 181–193. [Google Scholar] [CrossRef]
- Powell, F.C.; Farrow, C.V.; Meyer, C. Food avoidance in children. The influence of maternal feeding practices and behaviours. Appetite 2011, 57, 683–692. [Google Scholar] [CrossRef] [Green Version]
- Lansigan, R.K.; Emond, J.A.; Gilbert-Diamond, D. Understanding eating in the absence of hunger among young children: A systematic review of existing studies. Appetite 2015, 85, 36–47. [Google Scholar] [CrossRef] [Green Version]
- Sánchez, S.; Castillo-Durán, C. Eating behavior disorders in Chilean infants. Int J. Eat. Disord. 2004, 36, 348–355. [Google Scholar] [CrossRef]
- Searle, B.E.; Harris, H.A.; Thorpe, K.; Jansen, E. What children bring to the table: The association of temperament and child fussy eating with maternal and paternal mealtime structure. Appetite 2020, 151, 104680. [Google Scholar] [CrossRef] [PubMed]
- Verhage, C.L.; Gillebaart, M.; van der Veek, S.M.C.; Vereijken, C.M.J.L. The relation between family meals and health of infants and toddlers: A review. Appetite 2018, 127, 97–109. [Google Scholar] [CrossRef]
- Taylor, R.W.; Williams, S.M.; Fangupo, L.J.; Wheeler, B.J.; Taylor, B.J.; Daniels, L.; Fleming, E.A.; McArthur, J.; Morison, B.; Erickson, L.W.; et al. Effect of a Baby-Led Approach to Complementary Feeding on Infant Growth and Overweight: A Randomized Clinical Trial. JAMA Pediatr. 2017, 171, 838–846. [Google Scholar] [CrossRef] [PubMed]
- Satter, E. The feeding relationship: Problems and interventions. J. Pediatr. 1990, 117 Pt 2, S181–S189. [Google Scholar] [CrossRef]
- Jansen, E.; Mallan, K.M.; Nicholson, J.M.; Daniels, L.A. The feeding practices and structure questionnaire: Construction and initial validation in a sample of Australian first-time mothers and their 2-year olds. Int. J. Behav. Nutr. Phys. Act. 2014, 11, 72. [Google Scholar] [CrossRef] [Green Version]
- Eneli, I.U.; Crum, P.A.; Tylka, T.L. The trust model: A different feeding paradigm for managing childhood obesity. Obesity (Silver Spring) 2008, 16, 2197–2204. [Google Scholar] [CrossRef] [PubMed]
Diagnosis | Frequency (Percentage) |
---|---|
Food allergy enteropathy | 67 (47.5%) |
Food protein-induced Gastroesophageal Reflux Disease (GERD) | 30 (21.3%) |
Food protein-induced Enterocolitis Syndrome (FPIES) | 27 (19.1%) |
Gastroesophageal Reflux Disease (GERD) | 14 (9.9%) |
Celiac disease | 3 (2.1%) |
N (%) | ||
---|---|---|
Child sex | Male | 77 (54.6) |
Child age group | >5 yrs | 99 (70.2) |
Only child | yes | 46 (32.6) |
Firstborn | yes | 91 (64.5) |
Parental sex | Female | 136 (96.5) |
Parental age group | <40 yrs | 109 (77.3) |
Parental education | >12 yrs | 92 (65.2) |
Working parent | yes | 84 (59.6) |
TFS score by cut-off | >84 | 24 (18.6) |
TPS score by cut-off | >9 | 47 (39.5) |
Child’s age (years) | Mean ± sd Median (Q1, Q3) | 4.2 ± 1.3 4.42 (3.33, 5.17) |
BMI z-score (current) | Mean ± sd Median (Q1, Q3) | −0.2 ± 1.3 −0.29 (−1.08, 0.82) |
Birth weight (grams) | Mean ± sd Median (Q1, Q3) | 3212.1 ± 414.5 3160 (2960, 3500) |
TFS score | Mean ± sd Median (Q1, Q3) | 70 ± 17.9 67 (56, 79) |
TPS score | Mean ± sd Median (Q1, Q3) | 8.9 ± 6.75 8 (3, 14) |
TFS | TPS | |||||
---|---|---|---|---|---|---|
1 (Never) | 2 | 3 | 4 | 5 (Always) | Perceived as Problem | |
1. Eats fruits | 5.7 | 19.1 | 19.1 | 10.6 | 45.4 | 25.9 |
2. Has problems chewing food | 70 | 17.1 | 4.3 | 5.7 | 2.9 | 14.4 |
3. Enjoys eating | 0.7 | 10.7 | 20.7 | 40 | 27.9 | 24.8 |
4. Chokes or gags at mealtimes | 78.4 | 15.8 | 4.3 | 1.4 | 0 | 13.9 |
5. Will try new foods | 10 | 28.6 | 22.1 | 18.6 | 20.7 | 42.3 |
6. Eats meat and/or fish | 5.9 | 7.4 | 13.2 | 13.2 | 60.3 | 22.2 |
7. Takes longer than 20 min to finish a meal | 22.6 | 17.5 | 21.9 | 19 | 19 | 29.1 |
8. Drinks milk | 19.3 | 7.9 | 13.6 | 10.7 | 48.6 | 20.3 |
9. Comes readily to mealtime | 5 | 7.1 | 18.6 | 33.6 | 35.7 | 26.5 |
10. Eats junky snack foods but will not eat at mealtime | 40 | 29.3 | 17.1 | 8.6 | 5 | 32.4 |
11. Vomits just before, at, or just after mealtime | 95 | 4.3 | 0 | 0.7 | 0 | 2.9 |
12. Eats only ground, strained or soft food | 73.6 | 7.9 | 4.3 | 6.4 | 7.9 | 12.4 |
13. Gets up from table during meal | 27.1 | 30 | 20.7 | 14.3 | 7.9 | 41 |
14. Lets food sit in mouth and does not swallow it | 60 | 24.3 | 9.3 | 5 | 1.4 | 26.6 |
15. Whines or cries at feeding time | 52.1 | 27.1 | 13.6 | 4.3 | 2.9 | 30.7 |
16. Eats vegetables | 9.3 | 14.3 | 20 | 27.9 | 28.6 | 35.1 |
17. Tantrums at mealtimes | 45.3 | 36 | 14.4 | 2.9 | 1.4 | 26.7 |
18. Eats starches (for example potato noodles) | 2.9 | 2.9 | 17.1 | 24.3 | 52.9 | 16.2 |
19. Has a poor appetite | 32.1 | 30 | 13.6 | 14.3 | 10 | 38 |
20. Spits out food | 57.9 | 30 | 7.9 | 2.1 | 2.1 | 18.8 |
21. Delays eating by talking | 23.9 | 34.8 | 21.7 | 12.3 | 7.2 | 28.8 |
22. Would rather drink than eat | 42.6 | 25.7 | 12.5 | 11 | 8.1 | 24.2 |
23. Refuses to eat meal, but requests food immediately after | 57.9 | 22.9 | 12.1 | 4.3 | 2.9 | 24.1 |
24. Tries to negotiate what will or won’t eat | 15 | 35 | 23.6 | 19.3 | 7.1 | 40.7 |
25. Has required supplemental tube feeds to maintain proper nutritional status | 98.6 | 0 | 0.7 | 0.7 | 0 | 0 |
26. I get frustrated and/or anxious when feeding my child | 49.6 | 18 | 12.9 | 12.9 | 6.5 | 41.6 |
27. I coax my child to get him/her to take a bite | 35.7 | 26.4 | 12.1 | 17.9 | 7.9 | 34.8 |
28. I use threats to get my child to eat | 55.7 | 25.7 | 11.4 | 7.1 | 0 | 27.9 |
29. I feel confident my child gets enough to eat | 12.9 | 17.9 | 13.6 | 27.9 | 27.9 | 33.3 |
30. I feel confident in my ability to manage my child’s behavior at mealtime | 7.1 | 12.1 | 19.3 | 22.9 | 38.6 | 28.7 |
31. If my child does not like what is being served, I make something else | 33.6 | 34.3 | 10 | 13.6 | 8.6 | 35.6 |
32. When my child has refused to eat, I have put the food in his/her mouth by force If necessary | 77.1 | 15.7 | 2.1 | 3.6 | 1.4 | 18.8 |
33. I disagree with other adults about how to feed my child | 43.6 | 23.6 | 19.3 | 9.3 | 4.3 | 31.4 |
34. I feel that my child’s pattern hurts his/her general health | 60.7 | 18.6 | 11.4 | 5 | 4.3 | 25.9 |
35. I get so angry with my child at mealtimes that it takes me a while to calm down after the meal | 68.6 | 20 | 5.7 | 1.4 | 4.3 | 22.5 |
TFS | TPS | |
---|---|---|
Demographic and anthropometric characteristics | ||
Child’s age | [−] ** | [−] ** |
Child’s age > 5 | [−] * | NA |
Child’s zBMI | [−] * | [−] * |
Birth weight | [−] * | [−] * |
Only child | [+] * | NA |
Poor weight gain | [+] *** | [+] ** |
Mealtime Environment | ||
We eat at the table | [−] *** | [−] * |
We eat at least one meal a day all of us together (or almost all of us together) | [−] ** | NA |
My child eats the same food with the rest of the family | [−] *** | [−] * |
My child eats at almost the same time every day | [−] ** | NA |
My child eats autonomously (without an adult’s help) | [−] *** | [−] *** |
My child sits at the table during the meal | [−] *** | [−] ** |
My child brings toys (books, tablets, etc.) at the table during the meal | [+] ** | [+] *** |
My child informs me or conveys to me that he/she is hungry | [−] *** | [−] ** |
I allow my child to sit up from the table during the meal if he/she wishes to | [+] ** | NA |
Parental feeding Practices | ||
I accept that he/she may not be hungry, and I take the food away. | NA | [−] * |
I urge the child to eat with prompts such as: “eat at least a little”, “please try to eat”, etc. | [+] *** | [+] *** |
I ask my family or other people to encourage the child to eat. | [+] *** | [+] *** |
I say to my child that I or someone else in the family is eating | [+] *** | [+] *** |
I feed my child myself to make him/her eat his/her food. | [+] *** | [+] * |
I help my child eat the food. | [+] *** | [+] * |
I move to a different feeding area | [+] *** | [+] * |
I customize the environment so that the child can eat. | [+] *** | [+] *** |
I say to the child “if you don’t eat, I’ll be sad”. | NA | [+] * |
I offer in exchange for the food a game or activity | [+] *** | [+] ** |
I offer some other food in exchange for the meal. | NA | [+] * |
I say something to show my displeasure when the child is not eating. | [+] *** | [+] * |
I have to make a physical effort to make the child eat. | [+] *** | [+] * |
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Sdravou, K.; Emmanouilidou-Fotoulaki, E.; Printza, A.; Andreoulakis, E.; Beropouli, S.; Makris, G.; Fotoulaki, M. Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases. Healthcare 2021, 9, 741. https://doi.org/10.3390/healthcare9060741
Sdravou K, Emmanouilidou-Fotoulaki E, Printza A, Andreoulakis E, Beropouli S, Makris G, Fotoulaki M. Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases. Healthcare. 2021; 9(6):741. https://doi.org/10.3390/healthcare9060741
Chicago/Turabian StyleSdravou, Katerina, Elpida Emmanouilidou-Fotoulaki, Athanasia Printza, Elias Andreoulakis, Stavroula Beropouli, Giorgos Makris, and Maria Fotoulaki. 2021. "Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases" Healthcare 9, no. 6: 741. https://doi.org/10.3390/healthcare9060741