How Does Feeding Development and Progression onto Solid Foods in PKU Compare with Non-PKU Children During Weaning?

Area of Science:

• Pediatric Nutrition
• Metabolic Disorders
• Developmental Pediatrics

Background:

• Weaning is a critical developmental stage for infants, particularly those with phenylketonuria (PKU).
• Feeding practices and developmental outcomes during weaning in PKU have not been extensively studied.
• Phenylketonuria requires a specialized diet involving protein substitutes (PS) and low-phenylalanine foods.

Purpose of the Study:

• To evaluate and compare feeding patterns, practices, and developmental progression in infants with PKU versus non-PKU infants during the weaning period.
• To identify specific challenges and differences in gastrointestinal symptoms and feeding behaviors in infants with PKU.

Main Methods:

• A longitudinal, prospective case-control study involving 20 infants with PKU and a control group.
• Monthly monitoring from 4-6 months to 24 months, assessing feeding progression, texture acceptance, motor skills, self-feeding, feeding environment, GI symptoms, and negative feeding behaviors.
• Comparison of weaning progression, including formula intake and self-feeding skills.

Main Results:

• Infants with PKU demonstrated comparable weaning progression, texture acceptance, and self-feeding skills to controls.
• Children with PKU exhibited prolonged bottle-feeding with Phe-free formula and parental spoon-feeding, fewer meals/snacks, and increased flatulence, burping, and retching.
• Negative feeding behaviors in PKU infants often coincided with teething (10-18 months).

Conclusions:

• Semi-solid protein substitutes support normal weaning development in PKU.
• Parents of children with PKU require enhanced support for managing complex feeding and integrating children into family mealtimes.
• Further research into parental anxiety surrounding mealtimes for children with PKU is warranted.