Rommel Nathalie, De Meyer Anne-Marie, Feenstra Louw, Veereman-Wauters Gigi
Department of Ear-Nose-Throat, Head and Neck Surgery, University Hospitals, Leuven, Belgium.
J Pediatr Gastroenterol Nutr. 2003 Jul;37(1):75-84. doi: 10.1097/00005176-200307000-00014.
Feeding problems are common in infants and young children. A multidisciplinary team approach contributes to better patient care. However, few quantitative data on multidisciplinary feeding assessment of children have been published. OBJECTIVES The first aim of this study was to characterize the etiology of feeding difficulties in 700 children referred for assessment of severe feeding difficulty. The authors differentiated medical, oral, and behavioral categories. The second aim was to assess the prevalence of prematurity and dysmaturity in the patients and their relationship to the type of feeding problem.
Clinical data from 700 children aged less than 10 years who were examined for severe feeding problems were analyzed.
Close to 50% of the children had a combined medical and oral condition underlying their feeding difficulties. More than half of the children were examined for gastrointestinal conditions, particularly gastroesophageal reflux disease. Behavioral problems were more frequently seen in children aged more than 2 years. The results indicate that oral sensory-based feeding problems are related to past medical intervention. Children with feeding disorders had a significantly lower birthweight for gestational age. Preterm babies were overrepresented in this population.
A multidisciplinary team approach is essential for assessment and management because combined medical and oral problems are the most frequent cause of pediatric feeding problems. A significant relationship was found between the type of feeding problem and age. Infants born preterm and/or with a birthweight below the tenth percentile for gestational age are at greater risk for developing feeding disorders.
喂养问题在婴幼儿中很常见。多学科团队方法有助于更好地照顾患者。然而，关于儿童多学科喂养评估的定量数据很少被发表。目的：本研究的首要目的是描述700名因严重喂养困难接受评估的儿童喂养困难的病因。作者区分了医学、口腔和行为类别。第二个目的是评估患者中早产和发育不成熟的患病率及其与喂养问题类型的关系。
分析了700名年龄小于10岁因严重喂养问题接受检查的儿童的临床数据。
近50%的儿童在喂养困难背后存在医学和口腔合并问题。超过一半的儿童因胃肠道疾病接受检查，尤其是胃食管反流病。行为问题在2岁以上儿童中更常见。结果表明，基于口腔感觉的喂养问题与过去的医学干预有关。患有喂养障碍的儿童出生体重低于孕周对应的正常水平。早产婴儿在这一人群中占比过高。
多学科团队方法对于评估和管理至关重要，因为医学和口腔合并问题是儿童喂养问题最常见的原因。发现喂养问题类型与年龄之间存在显著关系。早产和/或出生体重低于孕周对应第十百分位数的婴儿发生喂养障碍的风险更高。
