6533b7dcfe1ef96bd1273188

RESEARCH PRODUCT

Early artificial nutrition: consequences on feeding disorders in children

subject

description

Background and objectives: several pathologies (metabolic, neurologic and prematurity) may involve. the use of artificial nutrition (AN) in the first months of life. The absence of oral feeding during this. essential period for the formation of eating behavior may be associated to long-term deleterious. consequences, especially when it is associated to an invasive treatment (i.e. naso-gastric tubing). The. objective here was 1) to develop a questionnaire aimed at characterizing feeding disorders, food. preferences and food habits in children with (FD) or without feeding disorders (CT) ; and 2) to evaluate. the consequences of timing of early AN on eating behavior. Methods: FD children were included in several hospitals (Lyon, Paris, and Lille), according to the. following criteria: age between 2 and 8 years, AN during the first 2 years of life during at least 2 months,. current AN representing ≥50% of energy intake accompanied by oral feeding. Control children (CT), in. the same age range, without pathology and never having been fed artificially were recruited in Paris and. Lyon. First, parents of FD children (N=8) as well as psychologists and speech specialists were. interviewed to define the potential feeding difficulties of those children. This led to the establishment of a. questionnaire including 97 questions (5-point scale) to evaluate feeding difficulties. Another. questionnaire evaluated frequency of consumption (6 levels) and preference (4-point scale) for a list of. 148 foods, categorized in 13 groups. Both questionnaires were approved by the CCTIRS. Responses from. the FD and the CT children were compared with t-tests (P< 0.05) and a principal component analysis help. to define dimensions in the feeding difficulties questionnaire. Period of early exposure to AN were. defined (< 6 mo; ≥6mo-< 12mo; ≥12mo) and ANOVA evaluated the impact of early AN on feeding. difficulties and food consumption frequency and liking. Results: Across both groups (FD, N=59, 4.9±2.4 years ; CT, N=101, 5.2±1.8 years) significant. differences in responses were observed for 67 questions out of 97. A PCA on a selection of 78. questions revealed that the first axis clearly opposed FD to CT children. Further, questions were grouped. in dimensions: eating difficulties, oral tactile sensitivity, appetite, interest for food, autonomy, selectivity,. sensitivity to food texture, sweet food liking, sensitivity to temperature. For all dimensions, the difference. between the FD and the CT children was important (P< 0.0001). Moreover, for each food group,. consumption frequency and number of consumed foods were lower for the FD compared to the CT. children. The FD children liked less all food groups, except vegetables, eggs-processed meat, cheeses,. spices-sauces and beverages. When AN started during the 6-12 mo period rather than after 12 mo, at their. current age children are less autonomous, more hyper-selective, more neophobic and appreciate less foods. with strong flavors. Conclusion : The use of such questionnaires could make it possible to better understand consequences of. various artificial nutrition modes and could help guide the feeding re-education according to food. preferences.