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Prevalence of problematic feeding in young children born prematurely: a meta-analysis
Britt Frisk Pados1, Rebecca R Hill2, Joy T Yamasaki3
1Boston College William F. Connell School of Nursing, 140 Commonwealth Avenue, Maloney Hall 268, Chestnut Hill, MA, 02467, USA. britt.pados@bc.edu.
Insights
Problematic feeding affects 42% of children born preterm within their first four years. This high prevalence occurs regardless of prematurity level, highlighting the need for early screening.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Psychology
Background:
- Eating difficulties are common in preterm infants.
- Preterm birth can impact long-term child development, including feeding skills.
Purpose of the Study:
- To quantitatively synthesize data on the prevalence of problematic feeding in children under 4 years old born preterm.
- To assess if prevalence varies by gestational age or child age.
Main Methods:
- A meta-analysis of 22 studies (4381 children) published between 2000-2020.
- Included studies reported prevalence of problematic oral feeding in preterm children (born <37 weeks gestation).
- Analyzed data by gestational age at birth and child age up to 48 months.
Main Results:
- Overall prevalence of problematic feeding was 42% (95% CI 33-51%).
- Prevalence did not significantly differ based on gestational age or child age.
- Few studies utilized validated, psychometrically sound feeding assessments.
Conclusions:
- Problematic feeding is highly prevalent in children born preterm during early childhood.
- Healthcare providers should screen preterm-born children for feeding issues throughout early life.
- Feeding difficulties are a significant complication of preterm birth requiring ongoing attention.
Background:
Difficulties related to eating are often reported in children born preterm. The objective of this study was to quantitatively synthesize available data on the prevalence of problematic feeding in children under 4 years of age who were born preterm.
Methods:
Literature was identified from PubMed, CINAHL, and PsycInfo. The search was limited to English language and publication years 2000-2020. To be included in the meta-analysis, the article had to report the prevalence of problematic oral feeding within a population of children born prematurely (< 37 weeks' gestation), and the child age at the time of study had to be between full-term corrected age and 48 months. For studies meeting inclusion criteria, the following data were extracted: sample size and subsamples by gestational age and/or child age at time of study; definition of problematic feeding; measures used for assessment of feeding; gestational age at time of birth of sample; child age at time of study; exclusion criteria for the study; and prevalence of problematic feeding. Random-effects meta-analyses were performed to estimate the prevalence of problematic feeding across all studies, by gestational age at birth, and by child age at time of study.
Results:
There were 22 studies that met inclusion criteria. Overall prevalence of problematic feeding (N = 4381) was 42% (95% CI 33-51%). Prevalence was neither significantly different across categories of gestational age nor by child age at the time of study. Few studies used psychometrically-sound assessments of feeding.
Conclusion:
Problematic feeding is highly prevalent in prematurely-born children in the first 4 years of life regardless of degree of prematurity. Healthcare providers of children born preterm should consider screening for problematic feeding throughout early childhood as a potential complication of preterm birth.
Systematic Review Registration Number:
Not applicable.
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