Feeding difficulties: etiology and growth parameters

In the first year of life it is crucial to maintain a well-balanced diet. It ensures optimal growth and development of the child. Feeding difficulties experienced by a child might lead to impairment of the nutritional status. Despite the importance of the subject, we did not find much recent published information. The aim of the study was to assess the etiology and growth parameters in children with feeding difficulties.

Children with feeding difficulties admitted to the Department of Pediatrics (September 2013 - April 2019) were recruited. Feeding difficulties were diagnosed by a minimum of two specialists. Based on medical records and clinical evaluation they were categorized as: organic, nonorganic or mixed (both medical and behavioral). To assess nutritional status weight, length/height, and body mass index (BMI) were obtained and compared with WHO reference standards.

Four hundred twenty-two children with mean age of 35 months (range: 3 to 156 months) were recruited. Fifty-three percent of feeding difficulties were nonorganic (behavioral), whereas the remaining 47% were caused by mixed factors. Organic factors were mostly related to gastroenterological disorders, food allergy or coexistence of more than one medical problem. Underweight (weight < -2 z-score) was observed in 18% of patients, stunted growth (length/height < -2 z-score) in 11%, wasting (BMI < -2 z-score) in 15%, and overweight (BMI > + 2 z-score) in 1%.

Our study showed that organic feeding difficulties coexisted with a behavioral component. The observed nutritional impairments in children with feeding difficulties indicate that there is a need for quick detection of these difficulties in order to provide appropriate support and help as soon as possible.