A Cross-Sectional Study of Pediatric Feeding Disorder in Children with Cystic Fibrosis

Background: The exact prevalence of feeding problems in children with cystic fibrosis (CF) is unknown. Pediatric Feeding Disorder (PFD) encompasses poor oral intake with associated medical, nutrition, psychosocial, or feeding skill dysfunction. We hypothesized that PFD is common in CF and aimed to categorize feeding dysfunction across various domains in children with CF.Methods: An observational cross-sectional study was conducted in children with CF. Data collected included anthropometrics, nutrition data (including need for tube feeding/enteral nutrition [EN] or high-energy beverages, dietary diversity), feeding skills (Pediatric version of the Eating Assessment tool [pEAT]), and psychosocial function (About Your Child Eating questionnaire [AYCE] in children 2-17 years of age/Behavioral Pediatric Feeding Assessment Scale [BPFAS] in children 12-23 months of age). PFD was defined as poor oral intake with: (a) pEAT score > 5; and/or (b) AYCE or BPFAS score > 2 SD of normative controls; and/or (c) nutrition dysfunction (BMI/weight-for-length z score < -1 and/or preference of oral high energy beverageszor dependence on EN and/or decreased dietary diversity).Results: Of 103 children in the study, 62 (60.1%) had PFD, 7 children (6.8%) were malnourished, 10 needed EN (9.7%) and 30 (29.1%) needed oral high-energy beverages. Dietary diversity was decreased in 42 children (41.5%), 1 child had feeding skill dysfunction, and 11 (10.8%) met criteria for psychosocial dysfunction.Conclusion: Almost 2/3 rd of children with CF have PFD and many have poor dietary diversity. A significant percentage of children rely on enteral nutrition and oral supplements, but psychosocial dysfunction is less prevalent.