Feeding behaivour problems in infants born preterm: a psychological perspective. Preliminary report

The study was aimed at exploring feeding behaviour problems reported by parents of premature infants during the first 12 months corrected age.

A subsample of families enrolled in a larger, prospective project on psychological and biological predictors of self-regulation in preterm children participated in the study. The material consisted of data collected from 40 families of preterm infants in the first and fourth and then at six and twelve months corrected age. The children were divided into two groups according to their gestational age: group 1 - 22 children born before 29th week (mean gestational age 26 Hbd and mean birth weight 905 g) and group 2 - 18 children born between 29th and 34th week (mean gestational age 31 Hbd and mean birth weight 1531 g). Semi-structured interviews and daily activity diaries were used. Qualitative, exploratory analysis of parental descriptions of child's feeding behaviour was performed.

No feeding behaviour problems were reported in 31.8% infants in group 1 and 44.4% in group 2, whereas chronic feeding behaviour problems - in the case of 5 infants in group 1 (22.7%) and just in one child in group 2 (5.6%). There was a significant association between "gastrointestinal complications of prematurity" and parental reports of feeding behaviour problems at two and more evaluation times. No relationship was found with such variables as: group, child's gender, method of feeding, mother's postnatal depression, or other complications of prematurity. Six major categories of feeding problems were identified: 1) early regulatory problems, 2) pain and/ or excessive spitting, 3) insufficient weight gain, 4) poor eater, 5) difficulties introducing new taste or consistency, and 6) difficulties with introducing self-feeding. These categories occurred with varying frequencies depending on the child's gestational age and the assessment time.

The results point to an interesting diversity and dynamics of feeding behaviour difficulties in babies born preterm. It was shown that extremely low gestational age as well as gastrointestinal complications of prematurity may contribute to increased parental reports of feeding behaviour difficulties. Further research is needed to disentangle divergent underlying mechanisms of different feeding behaviour problems and describe possible challenges they may imply to the child, parents and their relationship.