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van Heerden C, Cheng DR, McNab S, Burgess R, Russell A, Wang Y, Bleathman F, Maharaj I, Zhang J, Easterbrook M, Papadopulos M, Ibrahim LF. Scurvy and vitamin C deficiency in an Australian tertiary children's hospital. J Paediatr Child Health 2024. [PMID: 39031615 DOI: 10.1111/jpc.16594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/29/2023] [Accepted: 06/01/2024] [Indexed: 07/22/2024]
Abstract
AIM We aimed to investigate the frequency of vitamin C deficiency scurvy in the Australian paediatric context, describe cohorts at risk, and identify factors associated with development of symptoms in children with vitamin C deficiency. We also aimed to propose a management guideline for children with features of scurvy. METHOD A retrospective study was done at a tertiary paediatric hospital in Australia over a three-year period, from August 2019 to July 2022. Children from birth to 18 years old, whose vitamin C levels were low (<23 μmol/L), were included. Data extracted from hospital medical records included demographics, weight, co-morbidities, eating disorder diagnoses, clinical features, investigations and treatment. Descriptive statistics and risk statistics were performed. RESULTS In a cohort of 887 patients who had their vitamin C levels checked, we identified 272 (31%) who had a vitamin C level <23 μmol/L. Of these, 13 (5%) were symptomatic of vitamin C deficiency and 19 (7%) may have been symptomatic. In patients with vitamin C deficiency, 248 (91%) had comorbidities, neurodevelopmental disorders being most common, and 176 (65%) had restricted eating. When the asymptomatic and symptomatic groups were compared, in the symptomatic group, there was a significantly lower vitamin C level and disordered eating related to autism spectrum disorders was more common. CONCLUSION In order to avoid delayed diagnoses and unnecessary investigations, clinicians should be familiar with symptoms of scurvy and perform a dietary assessment, vitamin C assay, and commence empiric vitamin C supplementation where appropriate.
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Affiliation(s)
- Carolyn van Heerden
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Daryl R Cheng
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Centre for Health Analytics, Melbourne, Victoria, Australia
| | - Sarah McNab
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Rosemary Burgess
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | | | - Yichun Wang
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Freya Bleathman
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Isabella Maharaj
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Jerry Zhang
- The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Laila F Ibrahim
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Tengilimoglu-Metin MM, Kabasakal-Cetin A. Effect of maternal eating behaviors and attitudes towards the feeding process on feeding problems of pre-school age children. Clin Nutr ESPEN 2024; 61:224-229. [PMID: 38777438 DOI: 10.1016/j.clnesp.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/12/2024] [Accepted: 03/29/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND & AIMS Feeding problems in pre-school children are common and negative maternal feeding practices may even worsen the child's problematic eating behavior. Therefore, investigating the effects of maternal eating behaviors and attitudes towards the feeding process on pre-school children's feeding problems may be helpful for preventing feeding problems. This study sought to investigate the effects of maternal eating behaviors and attitudes towards the feeding process on feeding problems of pre-school children. METHODS Mothers of 373 children aged 3-6 were included in this cross-sectional study and data was collected by an online questionnaire including the scales of three-factor eating questionnaire (TFEQ), mother's attitudes towards the feeding process (MATFPS) and behavioral pediatric feeding assessment (BPFAS), as well as demographics and anthropometric measures (height and weight). Spearman's rho test was used to calculate correlation coefficients between the TFEQ, MATFP and BPFA scales. In order to identify independent predictors of child feeding behaviors, a multiple linear regression model was used. RESULTS Results showed that uncontrolled eating subscale was positively (r = 0.160, p < 0.001) and cognitive restriction subscale negatively (r = -0.126, p < 0.05) correlated with MATFP. MATFP was also positively correlated with BPFA (r = 0.368, p < 0.001). Regression analysis indicated that BPFA was significantly predicted by MATFP which was the most important contributor of child feeding problems (β = 0.24, t = 4.88, p < 0.001). CONCLUSIONS This study indicated that maternal eating behaviors were related to maternal attitudes towards the feeding process and, mothers' attitudes were associated with feeding problems of their pre-school children.
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Affiliation(s)
- M Merve Tengilimoglu-Metin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Sihhiye, Anakara, Turkey.
| | - Arzu Kabasakal-Cetin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, 06100, Sihhiye, Anakara, Turkey.
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Silva LC, Nakano EY, Zandonadi RP. Division of Responsibility in Child Feeding and Eating Competence: A Cross-Sectional Study in a Sample of Caregivers of Brazilian Children with Celiac Disease. Nutrients 2024; 16:1052. [PMID: 38613085 PMCID: PMC11013579 DOI: 10.3390/nu16071052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
The objective of this cross-sectional study was to assess eating competence (EC) and the adherence to the division of responsibility in child feeding (sDOR) of Brazilian caregivers of children with celiac disease (CD). It also examined the association between EC and sDOR, children's adherence to a gluten-free diet, and sociodemographic data. This study administered a survey set that included sociodemographic data, health-related data, eating habits, and the instruments ecSI2.0TMBR and sDOR.2-6yTM BR, validated for a Brazilian population. The sample comprised 50 caregivers of children with CD (between 24 and 72 months of age). The participants following a gluten-free diet (GFD) presented higher scores for all EC domains and the total EC. The total EC scores were higher for the participants over 40 y/o, frequently having meals as a family, with their children consuming more than three servings of fruit and at least one serving of vegetables daily and complying with a GFD. Different from the EC, the sDOR.2-6yTM scores did not differ between the participants complying with a GFD. The sDOR.2-6yTM mealtime structure domain scores were significantly associated with the EC eating attitude, food acceptance, contextual skills, and total. These findings support the need for greater attention to exploring the division of responsibility in feeding and EC in pediatric celiac disease, potentially enhancing intervention strategies for patients and their families.
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Affiliation(s)
- Larissa Caetano Silva
- Nutrition Department, Faculty of Health Sciences, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília 70910-900, Brazil;
| | - Eduardo Yoshio Nakano
- Department of Statistics, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília 70910-900, Brazil;
| | - Renata Puppin Zandonadi
- Nutrition Department, Faculty of Health Sciences, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília 70910-900, Brazil;
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Kefford J, Marshall J, Packer RL, Ward EC. Feeding Characteristics in Children With Food Allergies: A Scoping Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:132-148. [PMID: 38040005 DOI: 10.1044/2023_jslhr-23-00303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND Food allergy (FA) affects approximately 8% of children and may be immunoglobulin E (IgE)-mediated or non-IgE-mediated. It is recognized clinically that children with both subtypes of FA may present with features of pediatric feeding disorder (PFD); however, there is currently a limited detail of presenting characteristics. OBJECTIVE The objective of this study was to synthesize the current evidence regarding the feeding characteristics of children with FA, with a focus on the feeding skills and psychosocial domains of PFD. METHOD This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Papers published between 2001 and 2022 describing feeding characteristics in the feeding skills and psychosocial domains in children with FA/history of FA were included. Papers that focused solely on characteristics from the medical or nutritional domains were excluded. Descriptive information regarding demographics, methodology, allergy profile and history, and the characteristics of PFD observed was extracted using a preconceived data extraction form. RESULTS Overall, 40 papers contained descriptions of feeding characteristics of children with non-IgE-mediated FA (n = 22) and IgE-mediated FA (n = 11), while four were nonspecific. In the psychosocial domain, food refusal/aversion, anxiety with eating, and poor intake were the most frequently reported, regardless of FA subtype. Less information was reported regarding feeding skills, although slowness in eating, immature diet, and delays in oral sensory-motor skills were described. CONCLUSIONS Children with FA/history of FA may present with a range of characteristics that map across the feeding skill and psychosocial domains of PFD. Systematic research is needed to fully describe the feeding characteristics of children with FA. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24562732.
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Affiliation(s)
- Jennifer Kefford
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Northern Sydney Local Health District, New South Wales Health, Sydney, Australia
| | - Jeanne Marshall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, Brisbane, Australia
| | - Rebecca L Packer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research (CFAHR), Metro South Hospital and Health Service, Brisbane, Queensland, Australia
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Sdravou K, Printza A, Emmanouilidou-Fotoulaki E, Michou E, Sotiriadou F, Fotoulaki M. Developmental Feeding Stages and Their Impact on Child Feeding Behavior. J Pediatr Gastroenterol Nutr 2023; 77:769-778. [PMID: 37490588 DOI: 10.1097/mpg.0000000000003892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
OBJECTIVES Previous research has shown that critical periods of feeding skills development exist and feeding problems can arise in children due to delays in attaining feeding developmental milestones. This study aims to delineate the transitional process of feeding development in healthy children and children with gastrointestinal diseases (GIDs) and to examine the relationship between feeding milestones and the appearance of later feeding problems. METHODS A cross-sectional case-control study among 711 healthy Greek children and 119 children with GID, aged 2-7 years. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale and "self-reported" questionnaires assessing child's feeding history. RESULTS Differences in feeding behavior of preschoolers between the 2 groups were found concerning the time of introduction of complementary (pureed), lumpy, and table foods as well as finger feeding and regular cup-drinking. Age-specific milestones as proposed by guidelines were not reached. Late introduction of complementary and lumpy foods (>6 months and >9 months, respectively) as well as finger feeding (>9 months) were predictive of more problematic feeding behaviors later on. CONCLUSIONS The trajectory of feeding development, including less studied feeding milestones, both in healthy children and children with GIDs, indicates that there are discrepancies between current feeding practices and infant feeding guidelines, and a tendency to delay the acquisition of all assessed feeding milestones.
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Affiliation(s)
| | - Athanasia Printza
- the 1st Otolaryngology Department, School of Medicine, Aristotle University of Thessaloniki, University Hospital AXEPA, Thessaloniki, Greece
| | - Elpida Emmanouilidou-Fotoulaki
- the 1st Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General Hospital "Ippokrateio", Thessaloniki, Greece
| | - Emilia Michou
- the Speech and Language Therapy Department, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
- the Centre for Gastrointestinal Sciences, The University of Manchester, Manchester, UK
| | - Fotini Sotiriadou
- the 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General "Papageorgiou" Hospital, Thessaloniki, Greece
| | - Maria Fotoulaki
- the 4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General "Papageorgiou" Hospital, Thessaloniki, Greece
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Chang MC, Lee BJ, Park D. The Quality, Reliability, and Accuracy of Videos Regarding Exercises and Management for Dysphagia in Pediatric Populations Uploaded on YouTube. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101514. [PMID: 36291450 PMCID: PMC9600706 DOI: 10.3390/children9101514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/28/2022]
Abstract
Objectives: YouTube is well known for providing easy access to various kinds of video content. In this study, we investigated the quality and reliability of videos on YouTube addressing exercise or dysphagia management in the pediatric population. Methods: Video quality and reliability were assessed by using the Global Quality Scale (GQS) and a modified DISCERN tool, respectively. The accuracy of the information in each video was also evaluated. Other information, including the video source, length, date of upload, as well as the number of views, likes, dislikes, and comments were investigated, and statistical significance was determined. Results: In total, 22 videos on exercises and dysphagia management in pediatric populations were evaluated; 36.4% and 72.7% of these videos did not have high quality or reliability, respectively. Moreover, half of the videos did not contain accurate information. Even when videos were created by medical specialists, many of these YouTube videos were of low quality, reliability, and accuracy. Conclusions: The reliability, quality, and accuracy of many videos on exercise or dysphagia management in the pediatric population were low. Video creators, especially medical specialists, should strive to create videos with high quality, reliability, and accuracy.
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Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, Yeungnam University Hospital, Daegu 41404, Korea
| | - Byung Joo Lee
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu 41199, Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, College of Medicine, Ulsan University Hospital, University of Ulsan, Ulsan 44033, Korea
- Correspondence: ; Tel.: +82-52-250-7222; Fax: +82-52-250-7228
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The Polish Version of the Avoidant/Restrictive Food Intake Disorder Questionnaire—Parents Report (ARFID-Q-PR) and the Nine Items Avoidant/Restrictive Food Intake Disorder Screen—Parents Report (NIAS-PR): Maternal Perspective. Nutrients 2022; 14:nu14153175. [PMID: 35956354 PMCID: PMC9370130 DOI: 10.3390/nu14153175] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 12/10/2022] Open
Abstract
The aim of the present study was to develop and validate the Avoidant/Restrictive Food Intake Disorder Questionnaire—Parents Report (ARFID-Q-PR), a new tool to diagnose ARFID, based on a report submitted by Polish mothers of children aged 2 to 10 years. In total, 167 mothers of boys and girls aged 2 to 10 participated in the study. We used the ARFID-Q-PR and the Nine Items Avoidant/Restrictive Food Intake Disorder Screen—Parents Report (NIAS-PR). In addition, all mothers were asked to provide information on age, sex, height and weight, chronic somatic diseases, neurodevelopmental and mental disorders as well as intellectual disability of their children. Results of the reliability analysis demonstrated that the ARFID-Q-PR had adequate internal consistency (Cronbach’s alpha of 0.84). The stability of the ARFID-Q-PR factorial structure was confirmed. It is composed of three subscales: (1) attitudes to food; (2) justification for restrictions; (3) somatic symptoms. Our findings demonstrated that the ARFID-Q-PR total score was positively associated with the NIAS-PR total score. In addition, children with developmental and mental disorders substantially demonstrated more ARFID symptoms than did the children in the general population. The Polish version ARFID-Q-PR can be used to recognize the ARFID symptoms in young children by the main feeder in the family—mother or father.
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