When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Disorders of infant feeding

Última revisión: 7 Aug 2025
Última actualización: 24 Jul 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

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

Otros factores de diagnóstico

  • 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
Todos los datos

Factores de riesgo

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

Pruebas diagnósticas

Pruebas diagnósticas que deben considerarse

  • 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
Todos los datos

Algoritmo de tratamiento

Agudo

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

Divulgaciones

HM declares that she has no competing interests.

Agradecimientos

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

Divulgaciones

SG and US declare that they have no competing interests.

Revisores por pares

Alexander K.C. Leung, MBBS

Pediatric Consultant

Alberta Children's Hospital

University of Calgary

Alberta

Canada

Divulgaciones

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

Divulgaciones

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.

Referencias

Nuestros equipos internos de evidencia y editoriales colaboran con colaboradores expertos internacionales y revisores pares para garantizar que brindemos acceso a la información más clínicamente relevante posible.

Artículos principales

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. Resumen

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

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

Artículos de referencia

Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
  • Disorders of infant feeding images
  • Diferenciales

    • Physiological gastroesophageal reflux
    • Malrotation with intermittent volvulus
    • Intermittent intussusception
    Más Diferenciales
  • Guías de práctica clínica

    • Identification and management of ankyloglossia and its effect on breastfeeding in infants: clinical report
    • Gastro-oesophageal reflux disease in children and young people: diagnosis and management
    Más Guías de práctica clínica
  • Folletos para el paciente

    Reflux in infants

    Más Folletos para el paciente
  • padlock-lockedInicie sesión o suscríbase para acceder a todo el BMJ Best Practice

El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad