Prevalence of drooling, swallowing, and feeding problems in cerebral palsy across the lifespan: a systematic review and meta‐analyses

Aim: To determine the prevalence of drooling, swallowing, and feeding problems in persons with cerebral palsy (CP) across the lifespan. Method: A systematic review was conducted using five different databases (AMED, CINAHL, Embase, MEDLINE, and PubMed). The selection process was completed by two independent researchers and the methodological quality of included studies was assessed using the STROBE and AXIS guidelines. Meta-analyses were conducted to determine pooled prevalence estimates of drooling, swallowing, and feeding problems with stratified group analyses by type of assessment and Gross Motor Function Classification System level. Results: A total of 42 studies were included. Substantial variations in selected outcome measures and variables were observed, and data on adults were limited. Pooled prevalence estimates determined by meta-analyses were as high as 44.0% (95% confidence interval [CI] 35.6–52.7) for drooling, 50.4% (95% CI 36.0–64.8) for swallowing problems, and 53.5% (95% CI 40.7–65.9) for feeding problems. Group analyses for type of assessments were non-significant; however, more severely impaired functioning in CP was associated with concomitant problems of increased drooling, swallowing, and feeding. Interpretation: Drooling, swallowing, and feeding problems are very common in people with CP. Consequently, they experience increased risks of malnutrition and dehydration, aspiration pneumonia, and poor quality of life. What this paper adds: Drooling, swallowing, and feeding problems are very common in persons with cerebral palsy (CP). The prevalence of drooling, swallowing, and feeding problems is 44.0%, 50.4%, and 53.5% respectively. There are limited data on the prevalence of drooling, swallowing, and feeding problems in adults. Higher Gross Motor Function Classification System levels are associated with higher prevalence of drooling, swallowing, and feeding problems. There is increased risk for malnutrition, dehydration, aspiration pneumonia, and poor quality of life in CP

Crying and feeding problems in infancy and cognitive outcome in preschool children born at risk : a prospective population study

Objective: To investigate whether regulatory problems, i.e., crying and feeding problems in infants > 3 months of age, predict cognitive outcome in preschool children born at risk even when controlled for confounding factors. Methods: A prospective longitudinal study of children born in a geographically defined area in Germany. N = 4427 children of 6705 eligible survivors (66%) participated at all four assessment points (neonatal, 5, 20, and 56 months of age). Excessive crying and feeding problems were measured at 5 months. Mental development was assessed with the Griffiths Scale at 20 months, and cognitive assessments were conducted at 56 months. Neonatal complications, neurological, and psychosocial factors were controlled as confounders in structural equation modeling and analyses of variance. Results: One in five infants suffered from single crying or feeding problems, and 2% had multiple regulatory problems, i.e., combined crying and feeding problems at 5 months. In girls, regulatory problems were directly predictive of lower cognition at 56 months, even when controlled for confounders, whereas in boys, the influence on cognition at 56 months was mediated by low mental development at 20 months. Both in boys and girls, shortened gestational age, neonatal neurological complications, and poor parent-infant relationship were predictive of regulatory problems at 5 months and lower cognition at 56 months. Conclusion: Regulatory problems in infancy have a small but significant adverse effect on cognitive development

Feeding for health and welfare

Content: Feeding of livestock in organic production systems was discussed in four different groups: beef production, dairy production, pig production and poultry production. A. Beef production The general consensus was that most of these problems require solutions on management and systems level, rather than further nutritional research. Research and development needs are described. B. Dairy production The discussion on health and welfare related problems in dairy feeding focused on many issues. Some management solutions are given. Research and development needs are demonstrated. C. Pig production Research and development needs are demonstrated. D. Poultry production Potential solutions to these problems were suggested. Research and development needs are displayed

Mothers and fathers with Binge Eating Disorder and their 18-36 months old children: a longitudinal study on parent-infant interactions and offspring\u2019s emotional-behavioral profiles

Maternal Binge Eating Disorder (BED) has been suggested to be associated with poor parent\u2013infant interactions during feeding and with children\u2019s emotional and behavioral problems during infancy (Blissett and Haycraft, 2011). The role of fathers has received increasing consideration in recent years, yet the research has not focused on interactional patterns between fathers with BED and their children. The present study aimed to longitudinally investigate the in\ufb02uence of BED diagnosis, in one or both parents, on parent\u2013infant feeding interactions and on children\u2019s emotional\u2013behavioral functioning. 612 subjects (408 parents; 204 children), recruited in mental health services and pre-schools in Central Italy, were divided into four groups: Group 1 included families with both parents diagnosed with BED, Group 2 and 3 included families with one parent diagnosed with BED, Group 0 was a healthy control. The assessment took place at T1 (18 months of age of children) and T2 (36 months of age of children): feeding interactions were assessed through the Scale for the Assessment of Feeding Interactions (SVIA) while child emotional\u2013behavioral functioning was evaluated with the Child Behavior Check-List (CBCL). When compared to healthy controls, the groups with one or both parents diagnosed with BED showed higher scores on the SVIA and on the CBCL internalizing and externalizing scales, indicating poorer adult\u2013child feeding interactions and higher emotional\u2013behavioral dif\ufb01culties. A direct in\ufb02uence of parental psychiatric diagnosis on the quality of mother\u2013infant and father\u2013infant interactions was also found, both at T1 and T2. Moreover, dyadic feeding interactions mediated the in\ufb02uence of parental diagnosis on children\u2019s psychological functioning. The presence of BED diagnosis in one or both parents seems to in\ufb02uence the severity of maladaptive parent\u2013infant exchanges during feeding and offspring\u2019s emotional\u2013behavioral problems over time, consequently affecting different areas of children\u2019s psychological functioning. This is the \ufb01rst study to demonstrate the speci\ufb01c effects of maternal and paternal BED on infant development. These results could inform prevention and intervention programs in families with one or both parents diagnosed with BED

A prospective study on the persistence of infant crying, sleeping and feeding problems and preschool behaviour

Aim: To determine the persistence of regulatory problems (RP), i.e. excessive crying (>3 months of age), feeding and sleeping difficulties from infancy to preschool age, and to evaluate whether RP at 5 months are predictive of preschool adaptive behaviour and social skills. Method: A prospective population study of newborns admitted to neonatal care. RP at 5, 20 and 56 months of age were obtained via parent interviews and neurological examination and preschool adaptive behaviour and social skills by parent ratings. Logistic and linear regression analyses were conducted and controlled for psychosocial and neurological factors. Results: More than half of the sample had RP at least at one measurement point. In about 8% of infants, RP persisted across the preschool years. Multiple RP and feeding problems increased the odds of eating problems at 20 and 56 months. Persistent RP and feeding problems were predictive of deficits in preschool adaptive behaviour and social skills. In addition, sex differences were found. Conclusions: Multiple RP and feeding problems had the highest stability. Persistent RP were predictive of adverse social and adaptive behaviour. Understanding of the aetiology may help to prevent persistent RP

The foster caregiving relationship with newborns who have feeding difficulties : a thesis presented in partial fulfilment of the requirements for the Master of Arts endorsed in Psychology at Massey University, Albany, New Zealand

The purpose of this study was to expand on foster care and attachment literature by investigating how the relationship is impacted between a foster caregiver and newborn who experiences feeding difficulties. The most common types of feeding difficulties experienced include reflux, allergies, colic, arousal to feed, and sucking problems, with prenatal methamphetamine exposure being the most frequently cited reason for causality. Newborns who have been prenatally exposed to methamphetamine are at higher risk of preterm births. Prematurity has been widely associated with developmental issues in newborns, such as poor sucking reflexes. All newborns discussed in this study were of Māori descent, highlighting a possible association between Māori children in care and feeding difficulties. This association is thought to be strengthened by the social determinants faced by many Māori, and the punitive neo-liberal nature of the welfare system. Phenomenological interpretive analysis was used to understand the experiences of seven foster caregivers who were highly skilled in caring for newborns with feeding difficulties, and how the feeding difficulties could impact the attachment relationship and contribute to placement breakdowns. Additionally, the strategies that foster caregivers used to minimise the impact of the difficulty and optimise attachment interactions were explored. The feeding difficulties of newborns were found to make attachment interactions more difficult to achieve, but due to the fortitude of the caregivers in providing the best opportunities for newborns in their care, attachment interactions were reportedly always accomplished. Although feeding difficulties placed extra demand on the caregiver role, the commitment and motivation of the caregivers, and the intervention strategies they used to reduce the impact, promoted bonding and stabilised placements. Therefore, feeding difficulties were not associated with placement breakdowns. Rather, unanticipated extended placement timeframes, which impacted the caregiver’s ability to provide a consistent and stable environment, were found to be more detrimental to the placement stability. Understanding feeding difficulties and their impact on attachment for babies in foster care is crucial when caring for the nation’s most vulnerable citizens and ensuring that they have the greatest opportunities for healthy development from the start of their lives

Improving women's and children's nutrition in sub-Saharan Africa : an issues paper

The main sources of malnutrition in Africa, as elsewhere, are inadequate food intake, excessive disease, maternal malnutrition, and deleterious food and health behavior. The authors review several successful innovative approaches to addressing nutrition problems in Africa: the Iringa Nutrition Program in Tanzania, the Zimbabwe Children's Supplementary Feeding Program, the Zaire Weaning Foods Processing Program, and the Senegal Growth Promotion Program. They identify the lessons from these programs, including the need: (a) to involve the community actively in program development; (b) for training in nutrition at all levels, from doctor to village health worker; (c) for strong growth monitoring and nutrition education components; (d) for close supervision, including regular supervisory visits to villages and health huts, discussions with clients, and observations; and (e) for a variety of institutional and financing mechanisms. Africa's nutrition problems require many of the same services as problems elsewhere - growth monitoring, nutrition education, targeted feeding, and food fortification. Africa shares the universal need for good training, management, communications, and information systems. But new and innovative institutional mechanisms are needed to address Africa's nutrition problems. Each country must look for its own institutional strengths and weaknesses in developing nutrition programs.Early Child and Children's Health,Nutrition,Agricultural Knowledge&Information Systems,Primary Education,Health Monitoring&Evaluation

Helmet feedport

A helmet design is described which encapsules the head of the wearer, is capable of being pressurized and provides a means for gaining internal access for the purpose of eating. A mechanically actuated valve that combines the purging of carbon dioxide and feeding operations by a simple movement of a mechanical lever obviates problems that are attendant in the type of feed and purge ports previously incorporated in pressurized helmets