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The prevalence of feeding problems in children formerly treated in a neonatal intensive care unit

Journal of Perinatology volume 37, pages 578–584 (2017)Cite this article

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Abstract

Objective:

To determine the prevalence of oral feeding problems in neonatal intensive care unit (NICU) graduates at 1 to 2 years, and to identify clinical risk factors during NICU admission.

Study Design:

Observational cohort study of 378 children, who received level III/IV NICU care for 4 days or more in 2011 to 2012, chromosomal abnormalities excluded. We detected feeding problems in four gestational age (GA) groups (<28, 28 to 31, 32 to 36 weeks, and term-borns) using the Dutch standardized Screeningslijst Eetgedrag Peuters, and collected clinical factors for logistic regression analyses.

Results:

The prevalence of feeding problems was higher in NICU (20.4%) than in reference (15.0%) population (P=0.024), but similar for all GA groups (P=0.468). Prolonged tube feeding, that is, >30 days (odds ratio (OR) 2.50, confidence interval (CI) 1.13 to 5.56) and being born small for GA (OR 4.79, CI 1.64 to 14.03) were the most prevalent risk factors in children with GA ⩾32 and GA <32 weeks, respectively.

Conclusion:

Feeding problems are more prevalent in NICU graduates, with prolonged tube feeding as most important risk factor.

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References

  1. da Costa SP, van der Schans CP, Boelema SR, van der Meij E, Boerman MA, Bos AF . Sucking patterns in fullterm infants between birth and 10 weeks of age. Infant Behav Dev 2010; 33 (1): 61–67.

    Article  Google Scholar 

  2. Sakalidis VS, Kent JC, Garbin CP, Hepworth AR, Hartmann PE, Geddes DT . Longitudinal changes in suck-swallow-breathe, oxygen saturation, and heart rate patterns in term breastfeeding infants. J Hum Lact 2013; 29 (2): 236–245.

    Article  Google Scholar 

  3. Lau C, Alagugurusamy R, Schanler RJ, Smith EO, Shulman RJ . Characterization of the developmental stages of sucking in preterm infants during bottle feeding. Acta Paediatr 2000; 89 (7): 846–852.

    Article  CAS  Google Scholar 

  4. Carruth BR, Skinner JD . Feeding behaviors and other motor development in healthy children (2-24 months). J Am Coll Nutr 2002; 21 (2): 88–96.

    Article  Google Scholar 

  5. Gahagan S . Development of eating behavior: biology and context. J Dev Behav Pediatr 2012; 33 (3): 261–271.

    Article  Google Scholar 

  6. van Dijk M, Hunnius S, van Geert P . The dynamics of feeding during the introduction to solid food. Infant Behav Dev 2012; 35 (2): 226–239.

    Article  Google Scholar 

  7. Pearcey SM, De castro JM . Food intake and meal patterns of one year old infants. Appetite 1997; 29 (2): 201–212.

    Article  CAS  Google Scholar 

  8. Rommel N, De Meyer AM, Feenstra L, Veereman-Wauters G . The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. J Pediatr Gastroenterol Nutr 2003; 37 (1): 75–84.

    Article  Google Scholar 

  9. Blaymore Bier J, Ferguson A, Cho C, Oh W, Vohr BR . The oral motor development of low-birth-weight infants who underwent orotracheal intubation during the neonatal period. Am J Dis Child 1993; 147 (8): 858–862.

    Google Scholar 

  10. Burklow KA, McGrath AM, Valerius KS, Rudolph C . Relationship between feeding difficulties, medical complexity, and gestational age. Nutr Clin Pract 2002; 17 (6): 373–378.

    Article  Google Scholar 

  11. Miller CK . Updates on pediatric feeding and swallowing problems. Curr Opin Otolaryngol Head Neck Surg 2009; 17 (3): 194–199.

    PubMed  Google Scholar 

  12. Wood NS, Costeloe K, Gibson AT, Hennessy EM, Marlow N, Wilkinson AR et al. The EPICure study: growth and associated problems in children born at 25 weeks of gestational age or less. Arch Dis Child Fetal Neonatal Ed 2003; 88 (6): F492–F500.

    Article  CAS  Google Scholar 

  13. Crapnell T, Rogers C, Neil J, Inder T, Woodward L, Pineda R . Factors associated with feeding difficulties in the very preterm infant. Acta Paediatr 2013; 102 (12): e539–e545.

    Article  CAS  Google Scholar 

  14. Burklow KA, Phelps AN, Schultz JR, McConnell K, Rudolph C . Classifying complex pediatric feeding disorders. J Pediatr Gastroenterol Nutr 1998; 27 (2): 143–147.

    Article  CAS  Google Scholar 

  15. Crapnell TL, Woodward LJ, Rogers CE, Inder TE, Pineda RG . Neurodevelopmental profile, growth, and psychosocial environment of preterm infants with difficult feeding behavior at age 2 years. J Pediatr 2015; 167 (6): 1347–1353.

    Article  Google Scholar 

  16. Thoyre SM . Feeding outcomes of extremely premature infants after neonatal care. J Obstet Gynecol Neonatal Nurs 2007; 36 (4):366–375.

    Article  Google Scholar 

  17. Field D, Garland M, Williams K . Correlates of specific childhood feeding problems. J Paediatr Child Health 2003; 39 (4): 299–304.

    Article  CAS  Google Scholar 

  18. Ross ES, Browne JV . Developmental progression of feeding skills: an approach to supporting feeding in preterm infants. Semin Neonatol 2002; 7 (6): 469–475.

    Article  Google Scholar 

  19. Ramsay M, Martel C, Porporino M, Zygmuntowicz C . The Montreal Children's Hospital Feeding Scale: a brief bilingual screening tool for identifying feeding problems. Paediatr Child Health 2011; 16 (3): 147–151.

    Article  Google Scholar 

  20. van Dijk M, Timmerman ME, Martel C, Ramsay M . Towards the development of a dutch screening instrument for the detection of feeding problems in young children. Netherlands J Psychol 2011; 66 (1): 112–119.

    Google Scholar 

  21. Dodrill P, McMahon S, Ward E, Weir K, Donovan T, Riddle B . Long-term oral sensitivity and feeding skills of low-risk pre-term infants. Early Hum Dev 2004; 76 (1): 23–37.

    Article  Google Scholar 

  22. Marino A, Assin E, Carbone M, Hiatt I, Hegyi T, Graff M . The incidence of gastroesophageal reflux in preterm infants. J Perinatol 1995; 15 (5): 169–171.

    Google Scholar 

  23. Mathisen B, Worrall L, Masel J, Wall C, Shepherd RW . Feeding problems in infants with gastro-oesophageal reflux disease: a controlled study. J Paediatr Child Health 1999; 35 (2): 163–169.

    Article  CAS  Google Scholar 

  24. da Costa SP, van der Schans CP, Zweens MJ, Boelema SR, van der Meij E, Boerman MA et al. The development of sucking patterns in preterm, small-for-gestational age infants. J Pediatr 2010; 157 (4): 603–609.

    Article  Google Scholar 

  25. Jonsson M, van Doorn J, van den Berg J . Parents' perceptions of eating skills of pre-term vs full-term infants from birth to 3 years. Int J Speech Lang Pathol 2013; 15 (6): 604–612.

    Article  Google Scholar 

  26. Kloosterman G . On intrauterine growth, the significance of prenatal care. Int J Gynaecol Obstet 1970; 8: 895–912.

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Neonatology, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    M Hoogewerf, H J ter Horst, T Nieuwenhuis & A F Bos

  2. Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    H Groen

  3. Heymans Institute of Psychological Research, University of Groningen, Groningen, The Netherlands

    M W G van Dijk

Authors
  1. M Hoogewerf
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  2. H J ter Horst
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  3. H Groen
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  4. T Nieuwenhuis
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  5. A F Bos
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  6. M W G van Dijk
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Correspondence to M Hoogewerf.

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The authors declare no conflict of interest.

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Hoogewerf, M., ter Horst, H., Groen, H. et al. The prevalence of feeding problems in children formerly treated in a neonatal intensive care unit. J Perinatol 37, 578–584 (2017). https://doi.org/10.1038/jp.2016.256

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  • DOI: https://doi.org/10.1038/jp.2016.256

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