Pediatric Outpatient Feeding Clinic: If You Build It, Who Will Come?

Feeding disorders occur commonly in the pediatric population and vary in severity from picky eating to extreme food selectivity. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases, 10th Revision provide more inclusive diagnostic criteria for feeding disorders, but little is known about the actual referral population to an outpatient feeding clinic. In this investigation, the nutrition status, reason for referral, and related exploratory questions of outpatient referrals are detailed.

Children aged 1-18 years were eligible for enrollment. Survey data collected included demographics, prior diagnoses, parental/caretaker complaint, mealtime duration, referral source, and food repertoire. Exploratory questions examined the impact of the feeding disorder on immediate family.

Ten percent of participants had a weight-for-height z score or body mass index score of ≤-2. The most common parental/caretaker chief complaint were poor nutrition, food refusals, and poor weight gain. The food repertoire included 15 or fewer items (7%), between 15 and 25 items (18%), or greater than 25 items (75%). The most positive responses to exploratory questions were mealtime frustration, lack of understanding by other family members, lack of access to appropriate treatment in a timely fashion, and inability to meet the child's feeding needs.

Most referred infants and children were not undernourished. Despite this finding, most parents/caretakers were concerned about inadequate nutrition status and poor weight gain. Feeding disorders have an adverse effect on immediately family members. Revised diagnostic criteria should facilitate better identification of the broad spectrum of feeding disorders.