Journal of Pediatric Gastroenterology & Nutrition:
Notices: 39th Annual Meeting of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition Dresden, Germany, June 7-10, 2006: Abstracts: PN2-16
1Emma Kinderziekenhuis AMC, Amsterdam, The Netherlands. 2Emma Kinderziekenhuis AMC, Amsterdam, The Netherlands.
To examine the clinical evidence on the effectiveness of interventions for feeding disorders in infants and toddlers.
An evidence based review was conducted on the literature concerning interventions for feeding disorders in infants and toddlers. Online bibliographic databases were searched using two search strategies, namely 1) predefined keywords and 2) PICO search. Both search strategies were run in: PsycINFO, Embase, Ovid Medline(r), PubMed, the Cochrane Database of Systematic Reviews, and Web of Science from inception to March 2005. All studies of any intervention for feeding disorders or non-organic failure to thrive in infants and toddlers (0-36 months) were included.
In total 887 studies were identified of which 34 studies met the inclusion criteria. The following treatment strategies have been examined: hospitalisation, medical interventions, psychological interventions, multidisciplinary treatment, and home visiting. Most studies reported positive effects of the interventions. However, the studies were of poor methodological quality: non-randomized studies with small sample sizes, intervention procedures not (well) described and quantified, and lack of long-term follow-up measurements. Only six randomized controlled trials (RCT) were identified including a total of 656 infants. Five RCT's assessed the effect of home intervention. In three studies no significant effects were found on weight gain for infants who received the home intervention compared with control infants.
Feeding disorders in infants and toddlers are often complex and can be life threatening. At present no standard protocol for treatment is available. In this review studies on the effectiveness of interventions have been evaluated. It was concluded that most of the interventions were effective. However, the majority of the studies were of poor quality.
There is clearly a need for more evidence-based research - randomized clinical trials with clear descriptions of the methods, interventions and results and long-term follow-up measurements - to examine the effectiveness of interventions for feeding disorders in infants and toddlers.