Feeding difficulties in childhood: A narrative review and proposal for an interdisciplinary approach

V Hernández-Rosiles1, A Carias-Domínguez2, G Baules de Arrocha3

  • 1Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.

Insights

Pediatric feeding difficulties (PFDs) are common and require an interdisciplinary approach. This study reviews definitions, risk factors, and proposes a clinical algorithm for better diagnosis and treatment of PFDs.

Area of Science:

  • Pediatric Gastroenterology
  • Clinical Nutrition
  • Child Development

Background:

  • Feeding difficulties (FDs) in children are prevalent, often leading to fragmented clinical care.
  • The Pediatric Feeding Disorder (PFD) model offers a comprehensive, multidimensional framework.
  • Existing approaches lack standardization, hindering effective diagnosis and treatment.

Purpose of the Study:

  • To define pediatric feeding difficulties (PFDs).
  • To identify risk factors and classifications for PFDs.
  • To propose an interdisciplinary clinical algorithm for PFD diagnosis and management.

Main Methods:

  • A narrative review of literature from January 2000 to April 2025.
  • Searches conducted in PubMed, Scopus, SciELO, and LILACS databases.
  • Analysis performed by the Feeding Difficulties Working Group of LASPGHAN.

Main Results:

  • Three classification systems identified: sensory-based, medical/nutritional, and functional.
  • Key risk factors include prematurity, GI/neuromotor diseases, negative feeding experiences, and psychosocial factors.
  • A comprehensive, interdisciplinary clinical algorithm was developed.

Conclusions:

  • Pediatric FDs necessitate an interdisciplinary, family-centered approach tailored to the Latin American context.
  • Standardizing terminology and harmonizing clinical criteria are crucial for improving PFD diagnosis, treatment, and research.
  • The developed clinical algorithm serves as a foundational step towards optimizing care for PFDs in the region.
Abstract

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