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Observational Study
. 2024 May 22;16(11):1563.
doi: 10.3390/nu16111563.

Assessing Feeding Difficulties in Children Presenting with Non-IgE-Mediated Gastrointestinal Food Allergies-A Commonly Reported Problem

Adriana Chebar-Lozinsky  1 , Claire De Koker  2 , Robert Dziubak  3 , Daniel Lorber Rolnik  4 , Heather Godwin  3 , Gloria Dominguez-Ortega  5   6 , Ana-Kristina Skrapac  7 , Yara Gholmie  8 , Kate Reeve  9 , Neil Shah  7 , Rosan Meyer  10   11
Affiliations
Observational Study

Assessing Feeding Difficulties in Children Presenting with Non-IgE-Mediated Gastrointestinal Food Allergies-A Commonly Reported Problem

Adriana Chebar-Lozinsky et al. Nutrients. .

Abstract

Many guidelines have been published to help diagnose food allergies, which have included feeding difficulties as a presenting symptom (particularly for non-IgE-mediated gastrointestinal allergies). This study aimed to investigate the prevalence of feeding difficulties in children with non-IgE-mediated gastrointestinal allergies and the association of such difficulties with symptoms and food elimination. An observational study was performed at Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK. Children aged 4 weeks to 16 years without non-allergic co-morbidities who improved on an elimination diet using a previously published Likert scale symptom score were included. This study recruited 131 children, and 114 (87%) parents completed the questionnaire on feeding difficulties. Feeding difficulties were present in 61 (53.5%) of the 114 children. The most common feeding difficulties were regular meal refusals (26.9%), extended mealtimes (26.7%), and problems with gagging on textured foods (26.5%). Most children (40/61) had ≥2 reported feeding difficulties, and eight had ≥4. Children with feeding difficulties had higher rates of constipation and vomiting: 60.7% (37/61) vs. 35.8% (19/53), p = 0.008 and 63.9% (39/61) vs. 41.5% (22/53), p = 0.017, respectively. Logistic regression analysis demonstrated an association between having feeding difficulties, the age of the child, and the initial symptom score. Gender and the number of foods excluded in the elimination diet were not significantly associated with feeding difficulties. This study found that feeding difficulties are common in children with non-IgE-mediated gastrointestinal allergies, but there is a paucity of food allergy specific tools for establishing feeding difficulties, which requires further research in the long-term and consensus in the short term amongst healthcare professions as to which tool is the best for food allergic children.

Keywords: children; feeding difficulties; food allergy; food refusal; non-IgE-mediated food allergy.

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Conflict of interest statement

R.M. reports grants with Danone/Nutricia, honoraria from Reckitt Benckiser, Nestle Nutrition Institute, Danone, and Abbott Nutrition, and consultancy fees from Else Nutrition and CoMISS supported by Nestle Nutrition. A.-K.S. and N.S. were employed by HCA Healthcare. HCA Healthcare is a private hospital chain, not a company that has any involvement in any medical products. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Foods eliminated by patients enrolled in this study.
Figure 2
Figure 2
Association between age and the development of feeding difficulties. (quadratic relationship = coefficient of age × individual’s age + coefficient for initial symptoms score × individual’s symptom score).
See this image and copyright information in PMC

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Publication types

Grants and funding

This study was funded by the Great Ormond Street Children Hospital Charity.