Feeding Proem.x
Feeding Proem.x
Feeding Proem.x
weight and neuro- the diagnosis. Most research has reported on case series iden-
tified from child development centres and special interest
clinics and, therefore, may suffer from ascertainment bias.
developmental Feeding skills emerge in a predictable sequence in normal-
ly developing children, and the progression of these skills is
outcomes usually associated with the sequential attainment of motor,
language, and social milestones (Bartz and Deubler 1990).
Feeding is a complex task requiring significant neuromuscu-
lar coordination, and integration of motor and sensory path-
Sara Motion MRCP, Specialist Paediatric Registrar; ways. Neuromotor and neurosensory dysfunction affecting
Kate Northstone MSc, Research Statistician; the oropharynx and oesophagus is likely to be behind the
Alan Emond* FRCP, Consultant Paediatrician, Unit of early feeding difficulties in children who will subsequently be
Paediatric and Perinatal Epidemiology, Institute of Child diagnosed with CP (Shapiro et al. 1986).
Health, Bristol; There is little population-based data on the prevalence of
Sally Stucke MRCP, Professor of Community Child Health, feeding problems in the normally developing population,
Neville Hall Hospital, Abergevenney; and there is a paucity of prospectively collected data on
Jean Golding PhD, Professor of Paediatric and Perinatal infant feeding difficulties in CP. The relation of early feeding
Epidemiology and the Avon Longitudinal Study of Parents problems in CP with subsequent growth and neurodevelop-
and Children Study Team, Unit of Paediatric and Perinatal mental outcomes appears not to have been studied before.
Epidemiology, Institute of Child Health, Bristol, UK. The aims of this study were to: (1) identify and characterize
a representative CP cohort, derived from a longitudinal popu-
*Correspondence to third author at Unit of Paediatric and lation-based study; (2) determine the frequency of feeding
Perinatal Epidemiology, Institute of Child Health, 24 Tyndall problems in the normally developing population and the CP
Avenue, Bristol BS8 1TQ, UK. cohort; (3) determine whether feeding problems at 4 weeks of
E-mail: alan.emond@bristol.ac.uk age were predictive of a subsequent diagnosis of CP; and (4)
explore the relation in children with CP between infant feed-
ing problems and weight, and neurodevelopmental outcomes
at 4 and 8 years of age