A questionnaire developed by the neonatal unit (parent report). Dysfunctional feeding was defined as any of the following: 1) a physician's order not to feed by mouth; 2) the need for a gastrostomy or tube feeding; 3) vomiting/suffocating cough when feeding; 4) documented history of aspiration; 5) excessive salivation during feeding; or 6) di Difficulty swallowing. The type and consistency of food were also recorded by Adams-Chapman et al. (41) .. Retrospective US cohort n = 467 infants born <1000 and without major congenital anomalies or infections.. gt; 12 months–7 years no. 6–12 months = 166 full-term infants were selected from a parallel cohort study that began in 1973. The infants were born to mothers with "excellent prenatal and postpartum care." This sample was relatively well-educated, healthy, and a middle-class sample. Recruitment letters were sent to the parents of those born male at > 37 weeks' gestation and without congenital malformations (n = 143 responses). At the time of the study, full-term children were significantly younger than preterm children (CA; difference ~8 months) Oromotor feeding skills and eating behavior Parental dietary patterns.
TABLE2(Continued) Authors, citationCountryStudy design Prior sample characteristics Age groupTerm comparison?Outcomes assessed Measures introduction to solids, breastfeeding duration, amount of junk food eaten, amount of food eaten snacks and meals) Choetal.(48) the infantry in South Korea on across 30-20 stations. without chromosomal abnormalities, congenital metabolic/endocrine disorders, major congenital anomalies, or surgery for gastrointestinal anomalies. Data extracted forn=263 infants, aged≥8 moat time of data collection (8,12 or 18moCA) 6–12 months and >12mo–7yNoOromotor skills and behavioral behaviors Foodparenting. A reference population of n=771 term healthy Dutch children, whereas they were between 8 and 30 months old at the time of assessment, was also included to compare the NICU (premature infants treated in the NICU) sample with the healthy term sample Oromotor skills and behavioral patterns. 6-12 months = 20 infants born > 38 weeks' gestation were recruited from well-baby visits at the same hospitals. Term infants were matched to preterm infants on age, race, sex, and SES and excluded if they had a history of feeding problems, reflux≥ with solid infants, oroneurologic impairments, or 2 years. omotor skillseating behavior Foodparenting Dietary patterns.
TABLE2(Continued) Authors, CitationCountryStudy DesignPreterm Sample CharacteristicsAge GroupTerm Comparison?Assessed OutcomesMeasuresMcComish(71)USProspective Cohortn=42African American infants born at <35 weeks of gestation and weighing <1500 g or requiring mechanical ventilation. Exclusion criteria: congenital neurological problems, substance exposure, hospitalized for >2 mo postterms, mothers <15 years old with substance abuse problems, who did not have custody of the child, have a history of psychiatric diagnosis, or did not speak English 6–12mo No Or motor eating skills and eating behavior. TABLE 2 (Continued) Authors, citationCountry Study design Preterm sample characteristics Age group Terms comparison? Outcomes assessed Measures Milton and King (72) United Kingdom Prospective cohort n=169 infants born at <34 weeks' gestation and admitted to a NICU. Infants were between 12 and 18 months of age at the time of data collection. gt;12mo–7yNoOromotoreatingskillsandeatingbehaviorFootpatterns. 6–12 months and >12 months–7yn=979 children born at ≥ 37 weeks of gestation, recruited using the same methods. Exclusion criteria were included if the child had any language or developmental delay; hearing or vision disorder; structural abnormality of the mouth, face or gastrointestinal tract; or significant health conditions (e.g., congenital heart disease, autism, cerebral palsy). Oromotor eating skills and eating behavior.
TABLE2(Continued)Authors, citationCountryStudy designPreterm sample characteristicsAge groupTerm comparison?Assessed outcomesMeasuresPierrehumber et al.(32)SwitzerlandProspective cohortn=50infants born <33 weeks post-pregnancy and admitted to a NICU. abuse, or their parents had difficulty speaking French. Same as Forcada -Guexetal.(28). gt;12mo–7yn=25terminal infants were recruited from the maternity ward of the same hospital. Infants were excluded if there were problems during pregnancy or childbirth, the child had somatic abnormalities, or the parents had psychiatric or language problems, or if motor eating skills and eating behavior were present. 6–12 months = 52 full-term infants were recruited from general practices, apediatric primary care clinics, and women, infants, and children's (WIC) clinics in the areas of oromotor eating skills and eating behavior Food Parenting. Recruited in the first two weeks of life in a tertiary NICU. Excluded in case of intraventricular hemorrhage (grade 3 and 4); perinatal asphyxia; metabolic, genetic or syndromic disease; or if parents meet psychosocial criteria: teenage pregnancy, single parents or unemployment of both parents. Followed during the first phase of life from 6–12 months No Oromotor eating skills and eating behavior .
TABLE 2 (Continued) Authors, citationCountryStudy design Preterm test characteristics Age groupTerm comparison?Results assessed Measure Steinberg number. 23)Brazil Cross-sectional=62 infants born prematurely without metabolic diseases or medical diagnosis of neuropathies, syndromes, craniofacial malformations, heart disease or severe respiratory disease that prevented safe eating. Infants were recruited from outpatients, if follow-up children have been started, if they have been started with 2-risk patients. month >12 months–7yNoOromotor abilities and behavioral habits Food parenting Dietary patterns.
Food parenting
Dietary patterns
Risk of bias and certainty of evidence assessment Risk of bias assessed by the NOS suggested that 0 of 14
Other concerns included a large proportion of studies using non-standardized questionnaires to quantify eating challenges, different methods for assessing behavioral eating challenges, and individual studies not distinguishing between types of eating challenges (oromotor versus behavioral).
Discussion
Any eating challenges refers to items that did not distinguish between oromotor eating difficulties or behavioral eating challenges. Those born prematurely seem to take longer to master the skills necessary for successful oral feeding, which would require more support to close this gap earlier between them and their peers and ensure so that the difficulties do not continue. Our meta-analysis found that 18% of those born preterm experienced eating behavior challenges such as food refusal or mealtime tantrums during the developmental years, and children born preterm had 1.5 times higher odds (or CI for such difficulties than their full-term peers, although the quality of the evidence was very low.
In contrast, our results looking at "any eating challenge" found that 28% of children born preterm experienced some type of oromotor eating difficulty or behavioral eating challenge. Any eating challenge refers to studies that did not differentiate between oromotor eating problems or eating behavior challenges. Future research should use observational methods to elucidate the extent and severity of challenging eating behaviors among children born prematurely.
Future research and intervention initiatives should focus on positive parent-child relationships as children learn to eat and as parents learn to eat to help preterm children reach oromotor milestones and reduce challenging mealtime interactions. Food parenting sub-theme Findings for infants and children born prematurely2 Term-born comparison3 Parental concern and feelings. 3Summary of results for articles reporting on parenting that included a term comparison group, highlighting comparisons of birth groups only (preterm versus term).
Our narrative review suggested that preterm infants' feeding patterns were poor from late infancy through early childhood; This finding is not surprising given the high prevalence of both oromotor eating problems and eating behavior problems. Dietary subtheme Findings for preterm infants and children2 Comparison of full-term infants3 Breast milk feeding duration. 2Summary of results for all articles reporting on feeding patterns (articles with and without a full-term comparison group), with an emphasis on findings relevant only to premature infants/children.
3 Summary of results for articles reporting on dietary patterns that included a comparison group born at term, highlighting only comparisons of birth groups (preterm versus term). parents' disappointment and anxiety about the child's growth and development. However, our results indicated that the inadequate dietary patterns present in preterm infants persist throughout childhood and may be worse than those of their full-term peers. Although not included in this review because of our age restriction, limited research suggests that inadequate dietary intake among preterm children carries over into adulthood (90, 91).
Limitations
Introduction to solids usually occurred between 4 and 6 months CA, but could occur as early as 2 months CA (55) and 3.5 months postnatal age (8). In the same way, early introduction to solid food can be due to parental concern about the child's growth. Therefore, it is important to provide parents of preterm infants with advance guidance and support to promote healthy eating patterns, with a focus on improving child eating and parental nutrition.
Third, due to the limited number and heterogeneity among studies, we reviewed the literature on food education and dietary patterns in a narrative manner. Finally, it is also possible that the differences found between preterm infants and their full-term peers can be attributed to socio-demographic differences. However, at the individual item level, many matched their birth group based on sociodemographic characteristics, used random sampling to recruit comparisons of full-term individuals, or used similar inclusion and exclusion criteria to assess eligibility for each group.
Future research should use rigorous recruitment and matching methods to enroll term-born comparison groups.
Conclusions
Acknowledgments
Data Availability
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