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Management of severe feeding dysfunction in children with fetal alcohol syndrome
Insights
Children with fetal alcohol syndrome experienced severe feeding dysfunction, requiring prolonged tube feeding due to oral motor delays and fatigue. Complete oral feeding was achieved late, highlighting the challenges of nutritional support in these cases.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Pediatrics
Background:
- Maternal alcohol abuse during pregnancy can lead to Fetal Alcohol Syndrome (FAS).
- FAS is associated with a spectrum of physical and developmental challenges in children.
- Feeding dysfunction is a recognized complication in infants with FAS.
Observation:
- Three infants with severe feeding dysfunction requiring prolonged hospitalization were identified.
- All infants had a history of significant maternal alcohol abuse during pregnancy.
- Physical findings and dysmorphic features consistent with FAS were present in all subjects.
Findings:
- Feeding evaluations revealed significant delays in oral motor development.
- Limited suck patterns and easy tiring during feeding were consistently observed.
- All infants required prolonged gastrostomy and/or nasogastric tube feeding.
- Complete oral feeding was achieved between 14 and 18 months of age.
Implications:
- Early identification and intervention for feeding difficulties in infants with FAS are crucial.
- Understanding the specific feeding challenges, such as limited suck and fatigue, can guide therapeutic strategies.
- Multidisciplinary support is essential for managing nutritional and growth problems in infants with FAS.
- This highlights the long-term impact of prenatal alcohol exposure on infant development and feeding.
Abstract:
In the past three years, we have seen three children who required prolonged inpatient admissions for severe feeding dysfunction resulting in nutritional and growth problems. The pregnancies were significant for severe maternal alcohol abuse during the entire pregnancy. All of the subjects had multiple physical findings and dysmorphic features seen in children with mild to severe fetal alcohol syndrome. Feeding evaluations showed significant delays in oral motor development. Specific oral motor dysfunction was not a commonality and did not appear to be a major determinant in delays in feeding development. Continued assessment revealed that the babies had limited suck patterns and were consistently noted to tire easily. Each required feeding by either gastrostomy and/or nasogastric feeding for prolonged periods of time. They started initial feeding by mouth at about 8 to 10 months. The times for complete oral feeding were 14, 17 and 18 months.