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Symptoms of problematic feeding in children with CHD compared to healthy peers

Published online by Cambridge University Press:  20 November 2018

Britt F. Pados Open the ORCID record for Britt F. Pados [Opens in a new window]
Britt F. Pados*
Affiliation:
Boston College William F. Connell School of Nursing, Chestnut Hill, MA, USA
*
Author for correspondence: Britt F. Pados, Boston College William F. Connell School of Nursing, Chestnut Hill, MA, USA. Tel: +1 617 552 4088; E-mail: [email protected]
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Abstract

Children with CHD often experience difficulty with oral feeding, which contributes to growth faltering in this population. Few studies have explored symptoms of problematic feeding in children with CHD using valid and reliable measures of oral feeding. The purpose of this study was to describe symptoms of problematic feeding in children with CHD compared to healthy children without medical conditions, taking into account variables that may contribute to symptoms of problematic feeding. Oral feeding was measured by the Pediatric Eating Assessment Tool, a parent report assessment of feeding with evidence of validity and reliability. This secondary analysis used data collected from web-based surveys completed by parents of 1093 children between 6 months and 7 years of age who were eating solid foods by mouth. General linear models were used to evaluate the differences between 94 children with CHD and 999 children without medical conditions based on the Pediatric Eating Assessment Tool total score and four subscale scores. Covariates tested in the models included breathing tube duration, type of CHD, gastroesophageal reflux, genetic disorder, difficulty with breast- or bottle-feeding during infancy, cardiac surgery, and current child age. Children with CHD had significantly more symptoms of problematic feeding than healthy children on the Pediatric Eating Assessment Tool total score, more physiologic symptoms, problematic mealtime behaviours, selective/restrictive eating, and oral processing dysfunction (p <0.001 for all), when taking into account relevant covariates. Additional research is needed in children with CHD to improve risk assessment and develop interventions to optimise feeding and growth.

Keywords

CHDeatingfeedingchildrenmealtime
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 2 , February 2019 , pp. 152 - 161
Copyright
© Cambridge University Press 2018 

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Footnotes

Cite this article: Pados BF. (2018) Symptoms of problematic feeding in children with CHD compared to healthy peers. Cardiology in the Young page 152 of 161. doi: 10.1017/S1047951118001981

References

1. Maurer, I, Latal, B, Geissmann, H, Knirsch, W, Bauersfeld, U, Balmer, C. Prevalence and predictors of later feeding disorders in children who underwent neonatal cardiac surgery for congenital heart disease. Cardiol Young 2011; 21: 303–309.Google Scholar
2. Kogon, BE, Ramaswamy, V, Todd, K, et al. Feeding difficulty in newborns following congenital heart surgery. Congenit Heart Dis 2007; 2: 332–337.Google Scholar
3. Hill, GD, Silverman, AH, Noel, RJ, et al. Feeding dysfunction in children with single ventricle following staged palliation. J Pediatr 2014; 164: 243–246.Google Scholar
4. Clemente, C, Barnes, J, Shinebourne, E, Stein, A. Are infant behavioural feeding difficulties associated with congenital heart disease? Child Care Health Dev 2001; 27: 47–59.Google Scholar
5. Hehir, DA, Easley, RB, Byrnes, J. Noncardiac challenges in the cardiac ICU: feeding, growth and gastrointestinal complications, anticoagulation, and analgesia. World J Pediatr Congenit Heart Surg 2016; 7: 199–209.Google Scholar
6. Medoff-Cooper, B, Ravishankar, C. Nutrition and growth in congenital heart disease: a challenge in children. Curr Opin Cardiol 2013; 28: 122–129.Google Scholar
7. Costello, CL, Gellatly, M, Daniel, J, Justo, RN, Weir, K. Growth restriction in infants and young children with congenital heart disease. Congenit Heart Dis 2015; 10: 447–456.10.1111/chd.12231Google Scholar
8. Tregay, J, Brown, K, Crowe, S, Bull, C, Knowles, R, Wray, J. “I was so worried about every drop of milk” – feeding problems at home are a significant concern for parents after major heart surgery in infancy. Matern Child Nutr 2017; 13: e12302. https://doi.org/10.1111/mcn.12302 Google Scholar
9. March, S. Parents’ perceptions during the transition to home for their child with a congenital heart defect: how can we support families of children with hypoplastic left heart syndrome? J Spec Pediatr Nurs 2017; 22: e12185. https://doi.org/10.1111/jspn.12185 Google Scholar
10. Indramohan, G, Pedigo, TP, Rostoker, N, Cambare, M, Grogan, T, Federman, MD. Identification of risk factors for poor feeding in infants with congenital heart disease and a novel approach to improve oral feeding. J Pediatr Nurs 2017; 35: 149–154.Google Scholar
11. Berlin, KS, Davies, WH, Silverman, AH, Woods, DW, Fischer, EA, Rudolph, CD. Assessing children’s mealtime problems with the mealtime behavior questionnaire. Child Health Care 2010; 39: 142–156.Google Scholar
12. Thoyre, SM, Pados, BF, Park, J, et al. Development and content validation of the Pediatric Eating Assessment Tool (Pedi-EAT). Am J Speech Lang Pathol 2014; 23: 46–59.Google Scholar
13. Thoyre, SM, Pados, BF, Park, J, Estrem, H, McComish, C, Hodges, EA. The Pediatric Eating Assessment Tool: Factor structure and psychometric properties. J Pediatr Gastroenterol Nutr 2018; 66: 299–305.Google Scholar
14. Pados, BF, Thoyre, SM, Park, J. Age-based norm-reference values for the Pediatric Eating Assessment Tool (PediEAT). Pediatric Research 2018; Online ahead of print. https://doi.org/10.1038/s41390-018-0067-z Google Scholar
15. Strychowsky, JE, Rukholm, G, Gupta, MK, Reid, D. Unilateral vocal fold paralysis after congenital cardiothoracic surgery: a meta-analysis. Pediatrics 2014; 133: e1708–1723.Google Scholar
16. McGrattan, KE, McGhee, H, DeToma, A, et al. Dysphagia in infants with single ventricle anatomy following stage 1 palliation: physiologic correlates and response to treatment. Congenit Heart Dis 2017; 12: 382–388.Google Scholar
17. Pados, BF, Thoyre, SM, Estrem, HH, Park, J, Knafl, GJ, Nix, B. Effects of milk flow on the physiological and behavioural responses to feeding in an infant with hypoplastic left heart syndrome. Cardiol Young 2017; 27: 139–153.Google Scholar
18. Souza, PC, Gigoski, VS, Etges, CL, Barbosa, LDR. Findings of postoperative clinical assessment of swallowing in infants with congenital heart defect. Codas 2018; 30: e20170024. https://doi.org/10.1590/2317-1782/20182017024 Google Scholar
19. Sables-Baus, S, Kaufman, J, Cook, P, da Cruz, EM. Oral feeding outcomes in neonates with congenital cardiac disease undergoing cardiac surgery. Cardiol Young 2012; 22: 42–48.Google Scholar
20. Jadcherla, SR, Vijayapal, AS, Leuthner, S. Feeding abilities in neonates with congenital heart disease: a retrospective study. J Perinatol 2009; 29: 112–118.Google Scholar
21. Karsch, E, Irving, SY, Aylward, BS, Mahle, WT. The prevalence and effects of aspiration among neonates at the time of discharge. Cardiol Young 2017; 27: 1241–1247.Google Scholar
22. Davis, D, Davis, S, Cotman, K, et al. Feeding difficulties and growth delay in children with hypoplastic left heart syndrome versus d-transposition of the great arteries. Pediatr Cardiol 2008; 29: 328–333.Google Scholar
23. Saenz, RB, Beebe, DK, Triplett, LC. Caring for infants with congenital heart disease and their families. Am Fam Physician 1999; 59: 1857–1868.Google Scholar
24. Pourmoghadam, KK, DeCampli, WM, Ruzmetov, M, et al. Recurrent laryngeal nerve injury and swallowing dysfunction in neonatal aortic arch repair. Ann Thorac Surg 2017; 104: 1611–1618.Google Scholar
25. Pham, V, Connelly, D, Wei, JL, Sykes, KJ, O’Brien, J. Vocal cord paralysis and Dysphagia after aortic arch reconstruction and Norwood procedure. Otolaryngol Head Neck Surg 2014; 150: 827–833. https://doi.org/10.1177/0194599814522413 Google Scholar
26. Rommel, N, De Meyer, AM, Feenstra, L, Veereman-Wauters, G. The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. J Pediatr Gastroenterol Nutr 2003; 37: 75–84.Google Scholar
27. Estrem, HH, Thoyre, SM, Knafl, KA, Pados, BF, Van Riper, M. “It’s a Long-Term Process”: Description of daily family life when a child has a feeding disorder. J Pediatr Health Care 2018; 32: 340–347.Google Scholar
28. Medeiros, GC, Sassi, FC, Mangilli, LD, Zilberstein, B, Andrade, CR. Clinical dysphagia risk predictors after prolonged orotracheal intubation. Clinics (Sao Paulo) 2014; 69: 8–14.Google Scholar
29. Tsai, MH, Ku, SC, Wang, TG, et al. Swallowing dysfunction following endotracheal intubation: age matters. Medicine 2016; 95: e3871. https://doi.org/10.1097/MD.0000000000003871 Google Scholar
30. Janes, E, Riby, DM, Rodgers, J. Exploring the prevalence and phenomenology of repetitive behaviours and abnormal sensory processing in children with Williams Syndrome. J Intellect Disabil Res 2014; 58 (8): 746–757.Google Scholar
31. Wuang, YP, Su, CY. Correlations of sensory processing and visual organization ability with participation in school-aged children with Down syndrome. Res Dev Disabil 2011; 32: 2398–2407.Google Scholar
32. Cermak, SA, Curtin, C, Bandini, LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. J Am Diet Assoc 2010; 110: 238–246.Google Scholar
33. Pados, BF, Estrem, HH, Thoyre, SM, Park, J, McComish, C. The neonatal eating assessment tool: development and content validation. Neonatal Netw 2017; 36: 359–367.Google Scholar
34. Pados, BF, Thoyre, SM, Estrem, HH, Park, J, McComish, C. Factor structure and psychometric properties of the neonatal eating assessment tool-bottle-feeding (NeoEAT-Bottle-Feeding). Adv Neonatal Care 2018; 18: 232–242.Google Scholar
35. Pados, BF, Thoyre, SM, Estrem, HH, Park, J, McComish, C. Factor structure and psychometric properties of the neonatal eating assessment tool-breastfeeding. J Obstet Gynecol Neonatal Nurs 2018; 47: 396–414.Google Scholar