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Symptoms of Feeding Problems in Preterm-born Children at 6 Months to 7 Years Old
Jinhee Park1, Suzanne M Thoyre2, Britt F Pados1
1Boston College, William F. Connell School of Nursing, Chestnut Hill, MA.
Insights
Children born preterm experience more feeding problems than full-term infants. Medical risk factors significantly increase these feeding challenges, requiring ongoing monitoring.
Area of Science:
- Pediatric Nutrition
- Neonatal Development
- Child Health Outcomes
Background:
- Feeding problems are common in children, but prevalence and severity may differ based on gestational age at birth.
- Preterm birth, defined as birth before 37 weeks gestation, encompasses a spectrum from very preterm (<32 weeks) to moderate/late preterm (32-37 weeks).
- Understanding the specific feeding challenges and associated risk factors in preterm populations is crucial for early intervention and improved outcomes.
Purpose of the Study:
- To compare the symptoms of feeding problems in children born very preterm, moderate to late preterm, and full-term.
- To investigate the contribution of various medical risk factors to the development of feeding problems in preterm children.
Main Methods:
- A cohort of children aged 6 months to 7 years, including very preterm (n=57), moderate to late preterm (n=199), and full-term (n=979) born individuals, was assessed.
- The Pediatric Eating Assessment Tool (PEAT) was used to evaluate feeding problem symptoms, with comparisons made between gestational age groups.
- Eleven specific medical factors were analyzed for their association with feeding problems in the preterm subgroup.
Main Results:
- Both very preterm and moderate to late preterm children exhibited significantly higher PEAT scores compared to full-term controls.
- Very preterm children presented with more severe feeding issues, particularly in physiologic symptoms and selective/restrictive eating.
- All 11 investigated medical factors were significantly associated with an increased likelihood of feeding problems in preterm children.
Conclusions:
- Preterm-born children, irrespective of current age, demonstrate a higher prevalence of feeding problems compared to their full-term counterparts.
- These findings underscore the need for sustained and vigilant monitoring of feeding development throughout childhood for individuals born preterm.
- Identifying and addressing medical risk factors is essential for managing feeding difficulties in the preterm population.
Objectives:
Describe symptoms of feeding problems in children born very preterm (<32 weeks gestation) and moderate to late preterm (32-37 weeks gestation) compared to children born full-term; explore the contribution of medical risk factors to problematic feeding symptoms.
Methods:
The sample included 57 very preterm, 199 moderate to late preterm, and 979 full-term born children ages 6 months to 7 years. Symptoms of feeding problems were assessed using the Pediatric Eating Assessment Tool and compared between groups after accounting for the child's age and/or sex. With the sample of preterm children, we further analyzed 11 medical factors as potential risk factors affecting a child's feeding symptoms: feeding problems in early infancy and conditions of oxygen requirement past 40 weeks of postmenstrual age, congenital heart disease, structural anomaly, genetic disorder, cerebral palsy, developmental delay, speech-language delay, sensory processing disorder, vision impairment, or symptoms of gastroesophageal reflux.
Results:
Compared to children born full-term, both very preterm and moderate to late preterm born children had significantly higher scores on the Pediatric Eating Assessment Tool total scale and all 4 subscales. More severe symptoms were noted in very preterm children, particularly in the areas of Physiologic Symptoms and Selective/Restrictive Eating. Among preterm children, all 11 medical factors were found to be associated significantly with increased symptoms of feeding problems.
Conclusion:
Compared to children born full-term, preterm born children demonstrated greater symptoms of feeding problems regardless of their current age, suggesting children born preterm may require more careful monitoring of feeding throughout childhood.
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