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Disorders of infant feeding

Última revisão: 5 Aug 2025
Última atualização: 24 Jul 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • time taken to feed >30 minutes
  • stressful mealtimes
  • faltering growth (crossing downward 2 centiles)
  • food refusal
  • craniofacial abnormalities
  • abnormal neurodevelopmental assessment
Detalhes completos

Outros fatores diagnósticos

  • inappropriate volume of feed
  • vomiting
  • abdominal pain, distension, or colic
  • apnea, desaturations, and bradycardias in premature infants
  • irritability or lethargy at mealtimes
  • abnormal feeding pattern on observation
  • underlying illnesses and previous hospitalizations
  • previous gastrointestinal or cardiac surgery
  • family history of atopy
  • family history of feeding problems
  • recurrent pulmonary infections and wheeze
  • coughing or retching at meal times
  • posture changes during feeds
  • atopic features
  • apparent life-threatening event (ALTEs)
  • drooling
  • ankyloglossia (tongue-tie)
  • features of genetic conditions
Detalhes completos

Fatores de risco

  • prematurity
  • intrauterine growth restriction
  • developmental delay
  • anatomic abnormalities of the oropharynx or gastrointestinal tract
  • gastrointestinal surgery
  • neonatal cardiac surgery
  • Down syndrome
Detalhes completos

Investigações diagnósticas

Investigações a serem consideradas

  • temporary exclusion of cows’ milk protein
  • esophageal 24-hour pH study
  • upper gastrointestinal contrast study
  • esophageal impedance study
  • CXR
  • videofluoroscopic swallow
  • fiberoptic endoscopic evaluation of swallowing with sensory testing
  • upper gastrointestinal endoscopy with biopsy
  • radioallergosorbent testing (RAST) to cows' milk protein
  • trial of lactose-free diet
  • fecal-reducing substances
  • tissue transglutaminase (TTG) antibodies and total IgA
Detalhes completos

Algoritmo de tratamento

AGUDA

anatomic abnormalities

gastrointestinal disorders

short bowel syndrome

neurologic impairment

prematurity

respiratory disorders

cardiac disorders

behavioral problems

Colaboradores

Autores

Helen McElroy, MBChB, MSc, FRCPCH

Consultant Neonatologist

Medway NHS Foundation Trust

Gillingham

Kent

UK

Declarações

HM declares that she has no competing interests.

Agradecimentos

Dr Helen McElroy would like to gratefully acknowledge Dr Stephanie Gill and Dr Uma Sothinathan, previous contributors to this topic.

Declarações

SG and US declare that they have no competing interests.

Revisores

Alexander K.C. Leung, MBBS

Pediatric Consultant

Alberta Children's Hospital

University of Calgary

Alberta

Canada

Declarações

AKCL declares that he has no competing interests.

Sarah N. Taylor, MD

Assistant Professor

Division of Neonatology

Medical University of South Carolina

Children's Hospital

Charleston

SC

Declarações

SNT declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Rommel N, De Meyer AM, Feenstra L, et al. The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. J Pediatr Gastroenterol Nutr. 2003 Jul;37(1):75-84. Resumo

Arvedson JC. Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Dev Disabil Res Rev. 2008;14(2):118-27. Resumo

Delaney AL, Arvedson JC. Development of swallowing and feeding: prenatal through first year of life. Dev Disabil Res Rev. 2008;14(2):105-17. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Disorders of infant feeding images
  • Diagnósticos diferenciais

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  • Diretrizes

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    • Gastro-oesophageal reflux disease in children and young people: diagnosis and management
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    Mais Folhetos informativos para os pacientes
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