11 month-old twins with food avoidance.

Area of Science:

• Developmental-Behavioral Pediatrics
• Pediatric Gastroenterology
• Clinical Case Study

Background:

• Presents an 11-month-old set of twins with a lifelong history of significant feeding difficulties.
• Pregnancy was complicated by preterm labor, with delivery at 35 weeks gestation.
• One twin was small-for-gestational age and initially required NICU care with nasogastric tube feeding.

Purpose of the Study:

• To describe a clinical case of severe feeding difficulties in otherwise developmentally appropriate twins.
• To review the diagnostic process and interventions attempted for persistent pediatric feeding problems.

Main Methods:

• Detailed history of pregnancy, birth, and feeding behaviors.
• Gastroenterology evaluation including upper GI series, pH probe, and endoscopy with biopsies.
• Review of growth charts and developmental assessments.

Main Results:

• Twins exhibited extreme difficulty initiating and sustaining oral feeding, requiring over an hour per feeding.
• Despite behavioral resistance and need for intermittent nasogastric tube feeding, weight remained between the 10-25th percentiles.
• Gastrointestinal evaluations were normal, and trials of omeprazole, metoclopramide, and thickened feeds were ineffective.

Conclusions:

• The twins' feeding difficulties persisted despite a comprehensive workup and medical interventions.
• The case underscores the complex nature of pediatric feeding disorders and their significant impact on families.
• Further investigation may be warranted to explore underlying etiologies beyond typical gastrointestinal issues.