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Disorders of infant feeding

Last reviewed: 21 Aug 2025
Last updated: 24 Jul 2025

Summary

Definition

Анамнез и осмотр

Ключевые диагностические факторы

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

Другие диагностические факторы

  • 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
Полная информация

Факторы риска

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

Диагностические исследования

Исследования, проведение которых нужно рассмотреть

  • 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
Полная информация

Алгоритм лечения

Острый

anatomic abnormalities

gastrointestinal disorders

short bowel syndrome

neurologic impairment

prematurity

respiratory disorders

cardiac disorders

behavioral problems

Составители

Авторы

Helen McElroy, MBChB, MSc, FRCPCH

Consultant Neonatologist

Medway NHS Foundation Trust

Gillingham

Kent

UK

Раскрытие информации

HM declares that she has no competing interests.

Выражение благодарностей

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

Раскрытие информации

SG and US declare that they have no competing interests.

Рецензенты

Alexander K.C. Leung, MBBS

Pediatric Consultant

Alberta Children's Hospital

University of Calgary

Alberta

Canada

Раскрытие информации

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

Раскрытие информации

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.

Список литературы

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Основные статьи

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. Аннотация

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

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

Статьи, указанные как источники

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