Associations Between Feeding Skills & Mealtime Routines of Children With Down Syndrome

Toddlers with Down syndrome (Ds) are at high risk for feeding problems. Because routines may enhance skill development, we were interested in examining the relationship between feeding skills and mealtime routines in toddlers with Ds.

DESIGN: We conducted a cross-sectional study of secondary data from a clinical trial. Toddlers between 12 and 36 months old with Ds were included. Children with feeding tubes and limited mobility were excluded.

METHOD: Data were collected by parent report using a web-based REDCap platform. Measures included the Meals in Our Household questionnaire, the Pediatric Eating Assessment Tool (PediEAT), the Eating Assessment in Toddlers Food Frequency Questionnaire (EAT-FFQ), and demographic data. Descriptive statistics and bivariate correlations were used to analyze data using SPSS.

RESULTS: We recruited 20 toddlers with Ds who were mainly male (60%) and ranged in age from 14-35 months (M = 27.2, SD = 7.2). Frequently eating meals in the kitchen or dining room was associated with readily accepting new foods (r = .48, p = .05), lower PediEAT feeding problems scores (r = .53, p = .02), and higher EAT-FFQ scores (r = .46, p =. 04), indicating a wider food variety. Frequently sharing the same food options as family members was associated with more flexible food preferences (r = .50, p = .03), less picky eating behaviors (r = .52, p = .02), and higher EAT-FFQ scores (r = .60, p = .01). Alternately, a higher frequency of rushed mealtimes was associated with higher scores on the PediEAT selective eating subscale (r = .53, p = .02) and higher total PediEAT scores (r = .48, p = .05), indicating more problematic feeding.

CONCLUSION: For toddlers with Ds, meals eaten in the kitchen or dining room and eating the same food as family members may facilitate better feeding skills.

IMPACT STATEMENT: Our study indicates that pediatric occupational therapists may want to emphasize predictable family meal routines that are not rushed to promote feeding skill development for toddlers with Ds.

References

Mudholkar, A., Korostenski, L., Blackwell, D., & Lane, A. E. (2022). Factors associated with the early emergence of atypical feeding behaviours in infants and young children: A scoping review. Child: Care, Health and Development, 49(1), 1–19. https://doi.org/10.1111/cch.13005

Orrell-Valente, J. K., Hill, L. G., Brechwald, W. A., Dodge, K. A., Pettit, G. S., & Bates, J. E. (2007). “just three more bites”: An observational analysis of parents’ socialization of children’s eating at mealtime. Appetite, 48(1), 37–45. https://doi.org/10.1016/j.appet.2006.06.006

Surette, V. A., Smith-Simpson, S., Fries, L. R., Forde, C. G., & Ross, C. F. (2023). Observations of feeding practices of us parents of young children with Down Syndrome. Maternal & Child Nutrition, 19(4). https://doi.org/10.1111/mcn.13548