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Children with early refusal to eat: follow-up during primary school
M Dahl1, A M Rydell, C Sundelin
1Department of Paediatrics, University Hospital, Uppsala, Sweden.
Insights
Children who refused to eat in infancy continue to experience feeding problems in primary school. This longitudinal study found persistent eating difficulties at home and school, impacting **pediatric feeding behavior**.
Area of Science:
- Pediatric Nutrition
- Child Psychology
- Longitudinal Studies
Background:
- Early childhood feeding refusal without medical cause can be a concern for parents and caregivers.
- Prospective follow-up is essential to understand the long-term trajectory of such feeding behaviors.
- Understanding the persistence of feeding issues is crucial for timely intervention.
Purpose of the Study:
- To prospectively investigate the long-term feeding characteristics and behavior of children who previously refused to eat.
- To compare the eating behavior and general development of these children with their peers during primary school.
Main Methods:
- Longitudinal follow-up of 18 children initially assessed between 3-12 months for feeding refusal.
- Comparison with 240 age-matched classmates.
- Data collection via school health records and parent/teacher questionnaires on eating and general behavior.
Main Results:
- Children with a history of early feeding refusal exhibited significantly more eating problems at home (p < 0.01) and school (p < 0.01).
- No significant differences were observed in general behavior, somatic health, or growth compared to controls.
- Problematic eating behavior persisted into the primary school years.
Conclusions:
- Early-onset feeding refusal is associated with persistent eating difficulties throughout childhood.
- These eating challenges manifest in both home and school environments.
- Further research into interventions for persistent pediatric feeding disorders is warranted.
Abstract:
Twenty-five children, previously investigated at 3-12 months of age for refusal to eat for at least four weeks with no apparent medical cause, have been followed-up prospectively with respect to feeding characteristics, general behaviour, somatic health and growth. In the present study, 18 of these children, still resident in Uppsala, were reinvestigated during the primary school period. Comparisons were made with 240 classmates. Information was obtained from school health records and from questionnaires completed by teachers and parents concerning the children's current eating behaviour and general behaviour. Compared with the controls, the children who refused to eat at an early age presented more eating problems both at home (p < 0.01) and at school (p < 0.01), but were not different with respect to general behaviour, somatic health or growth. We conclude that children with previous periods of refusal to eat continue to show problematic eating behaviour, not only at home but also at school.