Complications
Malnutrition may result from feeding problems such as food refusal.
The condition may make it difficult to treat feeding disorders due to the infant becoming weaker.[7][27]
Management requires optimising dietary intake with any necessary nutritional supplements under the supervision of a paediatrician and paediatric dietician.
Food refusal prevents infants practising eating different foods and textures, and therefore they may not acquire the skills needed to become independent feeders.[7]
Acquisition of these skills is time-critical. An infant who is not encouraged to gain the skills at a certain point in development may be slow to attain normal feeding.[8] Early multidisciplinary assessment and management is crucial to development of oral motor skills.
Eating conflicts, struggles with food, and unpleasant mealtimes are a significant risk factor for development of anorexia nervosa or bulimia nervosa in young adulthood.[88]
Untreated feeding disorders of any aetiology can result in faltering growth, a slower than expected rate of weight gain for age and height. Suggested thresholds for concern about faltering growth are: a fall across 1 or more weight centile spaces, if birthweight was below the 9th centile; a fall across 2 or more weight centile spaces, if birthweight was between the 9th and 91st centiles; a fall across 3 or more weight centile spaces, if birthweight was above the 91st centile; or when current weight is below the 2nd centile for age, whatever the birth weight.[86]
Approach by an interdisciplinary team (e.g., paediatric gastroenterologist, dietician, behavioural psychologist, speech and language therapist, occupational therapist) may help to avoid or resolve this complication.[2][86]
Nasogastric feeds may be started in children with an unsafe swallow or with inadequate oral intake.[84] These are associated with complications such as tube misplacement, but do allow families some independence and respite from difficult oral feeding.
Some studies have shown that the implementation of intensive interdisciplinary feeding programmes may decrease the need for nasogastric tubes and surgical gastrostomies.[7][84][85]
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