PURPOSE OF THE STUDY.
Feeding dysfunction (FD) is a symptom complex commonly associated with neurologic diseases, developmental delays, and, occasionally, gastroesophageal reflux disease. Symptoms might range from abnormal feeding behavior and immature diet preferences to sensory and motor skill deficits. The purpose of this study was to define the prevalence and feeding characteristics of FD in children with eosinophilic gastrointestinal diseases (EGIDs).
The study included children previously evaluated in the multidisciplinary EGID program at Children's Hospital National Jewish Health (Aurora, CO) between January and December 2008.
Retrospective analysis of medical records (N = 200) assessed patients for EGID and FD (determined by feeding therapists using a feeding assessment that addressed symptoms, observation of functional skills, learned behaviors, mealtime dynamics with caregivers, and developmental skills).
Thirty-three (16.5%) patients (age range: 14–113 months) were identified as having both EGID and FD. Food sensitivity was noted in 88% of the patients, and 52% of them had clinical evidence of other allergic disease. Twenty-five of the 33 patients (76%) had eosinophilic esophagitis, defined by ≥15 eosinophils per high-powered field. Learned maladaptive feeding behaviors were the predominant form of FD and were noted in 93.9% of the children; gagging or vomiting was seen in 84.8% of them. Twenty-one percent were diagnosed with failure to thrive, and nearly 70% required individual or group feeding therapy.
Feeding difficulties are prevalent in children with EGIDs and might persist even after eosinophilic inflammation is treated.
This study highlights the importance of assessing for FD in children with EGIDs and vice versa, because appropriate management of both disease states might enhance outcomes. The authors were able to examine the records of a relatively large number of patients. Potential limitations of the study were its retrospective design, lack of a universally accepted feeding-assessment protocol, and possible referral bias.
- Copyright © 2011 by the American Academy of Pediatrics