Mitigating Feeding Disorders and Malnutrition in Children with Developmental Disabilities: A Narrative Review

Pediatric feeding disorder (PFD) is characterized by age-inappropriate oral intake associated with dysfunction in feeding skills, medical, nutritional, or psychosocial domains. Children with developmental disabilities (DD), such as cerebral palsy (CP), often meet the criteria for PFD due to underlying neurological, motor, and sensory impairments, compounded by psychosocial stressors. These challenges contribute to undernutrition, poor growth, and adverse developmental outcomes, but remain undiagnosed. This review evaluates the burden and spectrum of feeding problems in children with developmental disabilities and aims to bridge gaps in clinical awareness, assessment, and intervention. Evidence acquisition A literature search was conducted using PubMed, Scopus, and Google Scholar for studies published between January 2015 and January 2025. Keywords included: "children" OR "childhood" AND "feeding problems" OR "feeding disorders" OR "malnutrition" OR "dysphagia" OR "drooling" OR "food aversion" OR "oral sensory processing disorders" AND "cerebral palsy" OR "developmental disabilities" OR "neurological impairment."

Forty studies were included wherein feeding disorders were observed in 33-80% of these children. Physical anomalies, swallowing dysfunction, restricted diets, and socio-cultural factors were observed to be responsible for feeding difficulties which ranged from dysphagia, swallowing dysfunction, gastroesophageal reflux disease, constipation, sensory issues and food aversions. A systematic approach-objective assessment of nutritional status, calculating dietary needs, evaluating safety and efficiency of oral feeding, optimizing intake, considering enteral nutrition when indicated-can improve outcomes.

Feeding disorders are a significant yet modifiable source of morbidity in children with DD. Early recognition and multidisciplinary, evidence-based approach are critical to improving their quality of life.