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      Factors Associated with Feeding Problems in Young Children with Gastrointestinal Diseases

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          Abstract

          Feeding problems are associated with the consumption of a limited amount or restricted variety of foods and often occur in children with gastrointestinal diseases. The majority of studies to date do not use valid and reliable measurements to detect feeding problems. The aim of this cross-sectional study was to assess behavioral and skill-based feeding problems in young children with gastrointestinal diseases by using a well-established parent-reported feeding measure and identify demographic, anthropometric, and environmental factors associated with maladaptive feeding behaviors in this pediatric population. Parents completed the Greek version of the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and self-reported questionnaires assessing mealtime environment and parental feeding practices. It was found that 18.6% of the sample had abnormal Total Frequency Score (TFS) (frequency of problematic feeding behaviors) and 39.5% had abnormal Total Problem Score (TPS) (number of behaviors perceived as problematic by parents). Younger children, with lower body mass index, lower birth weight, and only children were more likely to have feeding problems. The study showed that parent-reported feeding problems are increased in young children with gastrointestinal diseases and are associated with specific aspects of mealtime environment and parental feeding practices.

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          Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults.

          Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE.
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            Food neophobia and 'picky/fussy' eating in children: a review.

            Two factors have been shown to contribute to rejection or acceptance of fruits and vegetables: food neophobia and 'picky/fussy' eating. Food neophobia is generally regarded as the reluctance to eat, or the avoidance of, new foods. In contrast, 'picky/fussy' eaters are usually defined as children who consume an inadequate variety of foods through rejection of a substantial amount of foods that are familiar (as well as unfamiliar) to them. Through understanding the variables which influence the development or expression of these factors (including age, personality, gender, social influences and willingness to try foods) we can further understand the similarities and differences between the two. Due to the inter-relationship between 'picky/fussy' eating and food neophobia, some factors, such as pressure to eat, personality factors, parental practices or feeding styles and social influences, will have similar effects on both magnitude and duration of expression of these behaviours. On the other hand, these constructs may be differentially affected by factors such as age, tactile defensiveness, environment and culture. The effects of these variables are discussed within this review. Behavioural interventions, focusing on early life exposure, could be developed to attenuate food neophobia and 'picky/fussy' eating in children, so promoting the ready acceptance and independent choice of fruits and vegetables.
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              Pediatric Gastroesophageal Reflux Clinical Practice Guidelines

              This document serves as an update of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) 2009 clinical guidelines for the diagnosis and management of gastroesophageal reflux disease (GERD) in infants and children and is intended to be applied in daily practice and as a basis for clinical trials. Eight clinical questions addressing diagnostic, therapeutic and prognostic topics were formulated. A systematic literature search was performed from October 1, 2008 (if the question was addressed by 2009 guidelines) or from inception to June 1, 2015 using Embase, MEDLINE, the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Clinical Trials. The approach of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to define and prioritize outcomes. For therapeutic questions, the quality of evidence was also assessed using GRADE. Grading the quality of evidence for other questions was performed according to the Quality Assessment of Studies of Diagnostic Accuracy (QUADAS) and Quality in Prognostic Studies (QUIPS) tools. During a 3-day consensus meeting, all recommendations were discussed and finalized. In cases where no randomized controlled trials (RCT; therapeutic questions) or diagnostic accuracy studies were available to support the recommendations, expert opinion was used. The group members voted on each recommendation, using the nominal voting technique. With this approach, recommendations regarding evaluation and management of infants and children with GERD to standardize and improve quality of care were formulated. Additionally, 2 algorithms were developed, 1 for infants <12 months of age and the other for older infants and children.
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                Author and article information

                Contributors
                Role: Academic Editor
                Role: Academic Editor
                Journal
                Healthcare (Basel)
                Healthcare (Basel)
                healthcare
                Healthcare
                MDPI
                2227-9032
                17 June 2021
                June 2021
                : 9
                : 6
                : 741
                Affiliations
                [1 ]4th Department of Pediatrics, School of Medicine, Aristotle University of Thessaloniki, General “Papageorgiou” Hospital, 56403 Thessaloniki, Greece; elpisemfot@ 123456hotmail.com (E.E.-F.); mfotoul@ 123456otenet.gr (M.F.)
                [2 ]1st Otolaryngology Department, School of Medicine, University Hospital AHEPA, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; aprintza@ 123456auth.gr
                [3 ]Hellenic Centre for Mental Health and Research, Department of Thessaloniki, Adult Psychiatric Unit, 36 Kaftatzoglou Str, 55337 Thessaloniki, Greece; eliasandreoulakis@ 123456gmail.com
                [4 ]Department of Pediatrics, General Hospital of Kozani (Mamatseio), 1 K. Mamatsiou, 50100 Kozani, Greece; sberopouli@ 123456gmail.com
                [5 ]Department of Speech and Language Therapy, School of Health Sciences, University of Peloponnese, 2400 Kalamata, Greece; glog_makris@ 123456yahoo.gr
                Author notes
                [* ]Correspondence: sdravouk@ 123456tcd.ie
                Author information
                https://orcid.org/0000-0002-2495-4584
                https://orcid.org/0000-0002-8560-967X
                https://orcid.org/0000-0001-6433-872X
                https://orcid.org/0000-0001-7067-9467
                Article
                healthcare-09-00741
                10.3390/healthcare9060741
                8234215
                fe2ead9d-36ef-42d0-9e56-7dc881b5a260
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 01 June 2021
                : 11 June 2021
                Categories
                Article

                feeding problems,children,gastrointestinal diseases,mealtime environment,parental feeding practices,risk factors

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