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J Pediatr Gastroenterol Nutr. 2018 Oct 24. doi: 10.1097/MPG.0000000000002188. [Epub ahead of print]

Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework.

Author information

1
Director, Feeding, Swallowing and Nutrition Center, Children's Hospital of Wisconsin, Professor of Pediatrics Medical College of Wisconsin.
2
Director, Growth and Nutrition Program, Associate Director, Center for Nutrition, Boston Children's Hospital, Division of Gastroenterology and Nutrition, Assistant Professor, Harvard Medical School.
3
Feeding, Swallowing and Nutrition Center, Children's Hospital of Wisconsin, Associate Professor of Pediatrics, Medical College of Wisconsin.
4
Psychosocial Program Manager, Pediatric Feeding and Swallowing Center, The Children's Hospital of Philadelphia.
5
Feeding and Developmental Therapy Team, Brigham & Women's Hospital NICU.
6
Medical Director, Pediatric Feeding and Swallowing Center, Program Director, Nutrition Fellowship, Clinical Associate Professor, Perelman School of Medicine at the University of Pennsylvania, The Children's Hospital of Philadelphia.
7
Speech-Language Pathologist.
8
Advanced Practice Dietitian, Feeding, Swallowing and Nutrition Center, Children's Hospital of Wisconsin.
9
Associate Professor of Pediatrics, Division Chief, Pediatric Gastroenterology, Hepatology, and Nutrition, Duke University Medical Center.
10
Professor Emerita, McGill University, School of Physical & Occupational Therapy.
11
Vice President and Clinical Services Director Southwest Autism Research & Resource Center.
12
Developmental and Behavioral Pediatrician, Clinical Professor of Pediatrics, University of Arizona College of Medicine-Phoenix.
13
Associate Professor McMaster University - Ron Joyce Children's Health Centre.
14
Clinical Professor of Pediatrics and Psychiatry, University of Colorado School of Medicine, Anschutz Medical Campus, Faculty, Fielding Graduate University.
15
Developmental-Behavioral Pediatrician University Health System, University Medicine Associates, Adjunct Professor of Pediatrics, UT Health San Antonio Clinical Professor of Pediatrics, Uniformed Services University.

Abstract

Pediatric feeding disorders lack a universally accepted definition. Feeding disorders require comprehensive assessment and treatment of four closely-related, complementary domains (medical, psychosocial, and feeding skill-based systems and associated nutritional complications). However, previous diagnostic paradigms have typically defined feeding disorders using the lens of a single professional discipline and fail to characterize associated functional limitations that are critical to plan appropriate interventions and improve quality of life. Using the framework of the World Health Organization (WHO) International Classification of Functioning, Disability, and Health (ICF), a unifying diagnostic term is proposed: "Pediatric Feeding Disorder" (PFD), defined as impaired oral intake that is not age-appropriate, and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction. By incorporating associated functional limitations, the proposed diagnostic criteria for PFD should enable practitioners and researchers to better characterize the needs of heterogeneous patient populations, facilitate inclusion of all relevant disciplines in treatment planning, and promote the use of common, precise, terminology necessary to advance clinical practice, research, and health-care policy.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.

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