Feeding outcomes and prevalence of paediatric feeding disorder in children with congential heart disease: a retrospective study of 159 children 18 to 24 months of age.

BACKGROUND

Children with CHD are at increased risk for feeding difficulties, yet the prevalence and predictors of paediatric feeding disorder in this population remain underexplored.

OBJECTIVE

To evaluate the prevalence of paediatric feeding disorder and identify consistent predictors of feeding difficulties in children with CHD 18-<25 months of age.

METHODS

A retrospective review was conducted on 159 children diagnosed with CHD. Paediatric feeding disorder was defined using consensus criteria encompassing nutritional status and feeding skill domains. Feeding outcomes were assessed at 18-<25 months, regardless of the method of feeding (oral or tube-fed). Medical history, growth, and neurodevelopmental status were analysed to identify predictors of paediatric feeding disorder.

RESULTS

At 18-<25 months, 58% of children met criteria for paediatric feeding disorder. Among exclusively orally fed children, 41% still qualified, indicating persistent dysfunction beyond tube dependence. Significant challenges were observed in nutrition and feeding skill domains. One-third relied on formula and overnight feeds, reflecting high energy needs and possibly inefficiencies. While 74% had transitioned to cup drinking, 21% struggled, particularly those born preterm or with neurodevelopmental delays. Texture progression was delayed: 29% had no table foods, and among those who did, 67% had chewing difficulties. Predictors of paediatric feeding disorder included medical/genetic comorbidities, low weight, prolonged hospitalisation, low maternal education, and delays in cognitive, language, and motor development.

CONCLUSIONS

Paediatric feeding disorder is highly prevalent in children with CHD, including those feeding orally. Early risk factors are associated with domain-specific feeding challenges, emphasising the need for individualised, developmentally informed feeding and nutrition care plans in this high-risk population.