Eating behaviors of children with intestinal failure and those who achieve enteral autonomy: An observational cross-sectional study

Background: Children with intestinal failure (IF) receiving prolonged parenteral nutrition (PN) are exposed to risk factors that predispose them to developing disordered eating behavior. This study aimed to assess the food interest patterns of PN-dependent children with IF and those who achieved enteral autonomy (EA).

Methods: A cross-sectional study was conducted in children aged 1-14 years with IF currently receiving PN for >60 days and in children who achieved EA. The American Speech-Language-Hearing Association-National Outcomes Measurement System (ASHA-NOMS) scale for oral feeding assessment and Children's Eating Behavior Questionnaire (CEBQ) for eating behavior were used. Children were divided into two groups, G1 (currently using PN) and G2 (achieved EA by discontinuation of PN), for the analysis of each subscale of the questionnaire. The PN dependency index (PNDI) was also assessed.

Results: Fifty-one children were evaluated, and the median (IQR) age was 47.0 (26.0-69.0) months. Thirty-five (68.6%) children were in G1, and 16 (31.4%) were in G2. Children in G2 had better mean scores than those in G1 on the satiety responsiveness, food responsiveness, and enjoyment of food subscales. These scores were significantly different among children with high/moderate PN dependence compared with those with mild dependence or those who achieved EA.

Conclusion: Compared with children who achieved EA, those with PN-dependent IF showed food avoidance patterns of less interest in and enjoyment of food. This pattern was more pronounced in those with moderate/high dependence on PN.