Atypical Eating Behaviors Identified in Children with Fetal Alcohol Spectrum Disorders, Aged 3 to 5 Years, Using the Children’s Eating Behavior Questionnaire in a Caregiver-Reported Online Survey
DOI:
https://doi.org/10.6000/2292-2598.2016.04.04.2Keywords:
Fetal alcohol syndrome, prenatal alcohol exposure, atypical eating behavior, preschool-aged children, and Children’s Eating Behavior Questionnaire.Abstract
Background: Children with fetal alcohol spectrum disorders (FASDs), aged 3 to 5 years, have physical, behavioral, and functional problems. Because of alcohol-related deficits, children with FASDs are at risk for malnutrition; yet, little is known about how FASD affects eating behavior and nutrition.
Aim: The purpose of this study was to identify atypical eating behavior in children with FASDs, aged 3 to 5 years, and their associations with socio-demographic characteristics.
Method: This descriptive cross-sectional study gathered data from a caregiver-reported online survey targeting the eating behavior of preschool-aged children with FASDs. The survey included the Children’s Eating Behavior Questionnaire (CEBQ) and a socio-demographic questionnaire.
Participants/Setting: Seventy-four caregivers qualified for the study with nine having two children with FASDs. Responses to survey questions varied since caregivers had permission to omit any question.
Results: Significant differences were found between the preschool-aged children with FASDs and Wardle’s published normative sample by gender and age. Compared to reported norms, study children scored higher in Desire to Drink, Food Responsiveness, Emotional Overeating, and Food Fussiness, and lower in Enjoyment of Food. Regarding socio-demographic characteristics, there was greater Enjoyment of Food with larger families and Food Avoidance with college-educated caregivers.
Conclusion: Children with FASDs, aged 3 to 5 years, have atypical eating behaviors characteristic of maladaptive appetites, overeating under stress, selective eating, slowness in eating, and an excessive need for drinks, in comparison with a published normative sample.
References
Streissguth AP, Bookstein FL, Barr HM, Sampson PD, O'Malley K, Young JK. Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. JDBP 2004; 25(4): 228-38.
https://doi.org/10.1097/00004703-200408000-00002 DOI: https://doi.org/10.1097/00004703-200408000-00002
Haycock PC. Fetal alcohol spectrum disorders: the epigenetic perspective. Biol Reprod 2009; 81(4): 607-17.
https://doi.org/10.1095/biolreprod.108.074690 DOI: https://doi.org/10.1095/biolreprod.108.074690
Burd L, Martsolf JT. Fetal alcohol syndrome: diagnosis and syndromal variability. Physiol Behav 1989; 46(1): 39-43.
https://doi.org/10.1016/0031-9384(89)90318-1 DOI: https://doi.org/10.1016/0031-9384(89)90318-1
Clarren SK, Smith DW. The fetal alcohol syndrome. N Engl J Med 1978; 298: 1063-7.
https://doi.org/10.1056/NEJM197805112981906 DOI: https://doi.org/10.1056/NEJM197805112981906
Van Dyke DC, Mackay L, Ziaylek EN. Management of severe feeding dysfunction in children with fetal alcohol syndrome. Clin Pediatr (Phila)1982; 21(6): 336-9.
https://doi.org/10.1177/000992288202100603 DOI: https://doi.org/10.1177/000992288202100603
Abel EL, Sokol RJ. Fetal alcohol syndrome is now leading cause of mental retardation. Lancet 1986; 2(8517): 1222.
https://doi.org/10.1016/S0140-6736(86)92234-8 DOI: https://doi.org/10.1016/S0140-6736(86)92234-8
Livingston J, Lyall H. Contribution of fetal alcohol syndrome to mental retardation. Lancet 1986; 2(8519): 1337-8.
https://doi.org/10.1016/S0140-6736(86)91468-6 DOI: https://doi.org/10.1016/S0140-6736(86)91468-6
Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N. Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ 2005; 172(5 Suppl): S1-21.
https://doi.org/10.1503/cmaj.1040302 DOI: https://doi.org/10.1503/cmaj.1040302
May PA, Gossage JP. Estimating the prevalence of fetal alcohol syndrome. A summary. Alcohol Res Health 2001; 25(3): 159-67.
Presson AP, Partyka G, Jensen KM, Devine OJ, Rasmussen SA, McCabe LL, et al. Current estimate of down syndrome population prevalence in the United States. J Pediatr 2013; 163(4): 1163-8.
https://doi.org/10.1016/j.jpeds.2013.06.013 DOI: https://doi.org/10.1016/j.jpeds.2013.06.013
Boulet SL, Gambrell D, Shin M, Honein MA, Mathews TJ. Racial/Ethnic differences in the birth prevalence of spina bifida—United States, 1995-2005. MMWR [serial on the Internet] 2009 Jan 9 [cited on 2016 Aug 6]; 57(53): 1409-13.
Spohr H-L, Willms J, Steinhausen H-C. Fetal alcohol spectrum disorders in young adulthood. J Pediatr 2007; 150(2): 175-9, 179.e1. DOI: https://doi.org/10.1016/j.jpeds.2006.11.044
Werts RL, Van Calcar SC, Wargowski DS, Smith SM. Inappropriate feeding behaviors and dietary intakes in children with fetal alcohol spectrum disorder or probable prenatal alcohol exposure. Alcohol Clin Exp Res 2014; 38(3): 871-8.
https://doi.org/10.1111/acer.12284 DOI: https://doi.org/10.1111/acer.12284
Truong KD, Reifsnider OS, Mayorga ME, Spitler H. Estimated number of preterm births and low birth weight children born in the United States due to maternal binge drinking. Maternal Child Health J 2013; 17(4): 677-88.
https://doi.org/10.1007/s10995-012-1048-1 DOI: https://doi.org/10.1007/s10995-012-1048-1
Bruns DA, Thompson SD. Feeding challenges in young children toward a best practice model. Infant Young Child 2010; 23(2): 93-102.
https://doi.org/10.1097/IYC.0b013e3181d5c379 DOI: https://doi.org/10.1097/IYC.0b013e3181d5c379
Uc A, Vasiliauskas E, Piccoli DA, Flores AF, Di Lorenzo C, Hyman PE. Chronic intestinal pseudoobstruction associated with fetal alcohol syndrome. Dig Dis Sci 1997; 42(6): 1163-7.
https://doi.org/10.1023/A:1018833503080 DOI: https://doi.org/10.1023/A:1018833503080
Kvigne VL, Leonardson GR, Borzelleca J, Neff-Smith M, Welty TK. Hospitalizations of children who have fetal alcohol syndrome or incomplete fetal alcohol syndrome. S D Med 2009; 62(3): 97, 9, 101-3. DOI: https://doi.org/10.1542/peds.2008-2423
Fuglestad AJ, Fink BA, Eckerle JK, Boys CJ, Hoecker HL, Kroupina MG, et al. Inadequate intake of nutrients essential for neurodevelopment in children with fetal alcohol spectrum disorders (FASD). Neurotoxicol Teratol 2013; 39: 128-32.
https://doi.org/10.1016/j.ntt.2013.06.005 DOI: https://doi.org/10.1016/j.ntt.2013.06.005
Rosales FJ, Reznick JS, Zeisel SH. Understanding the role of nutrition in the brain and behavioral development of toddlers and preschool children: identifying and addressing methodological barriers. Nutr Neurosc 2009; 12(5): 190-202.
https://doi.org/10.1179/147683009X423454 DOI: https://doi.org/10.1179/147683009X423454
Wardle J, Guthrie CA, Sanderson S, Rapoport L. Deve-lopment of the children's eating behaviour questionnaire. J Child Psychol Psychiatry 2001; 42(7): 963-70.
https://doi.org/10.1111/1469-7610.00792 DOI: https://doi.org/10.1111/1469-7610.00792
Braet C, O'Malley G, Weghuber D, Vania A, Erhardt É, Nowicka P, et al. The assessment of eating behaviour in children who are obese: a psychological approach. A position paper from the European Childhood Obesity Group. Obesity Facts 2014; 7(3): 153-64. DOI: https://doi.org/10.1159/000362391
Golan M, Weizman A. Reliability and validity of the Family Eating and Activity Habits Questionnaire. Eur J Clin Nutr 1998; 52(10): 771-7.
https://doi.org/10.1038/sj.ejcn.1600647 DOI: https://doi.org/10.1038/sj.ejcn.1600647
Anandakrishna L, Bhargav N, Hegde A, Chandra P, Gaviappa D, Shetty A. Problematic eating and its association with early childhood caries among 46-71-month-old children using Children's Eating Behavior Questionnaire (CEBQ): a cross sectional study. Indian J Dent Res 2014; 25(5): 602-6.
https://doi.org/10.4103/0970-9290.147101 DOI: https://doi.org/10.4103/0970-9290.147101
Steinhausen HC, Spohr HL. Long-term outcome of children with fetal alcohol syndrome: psychopathology, behavior, and intelligence. Alcohol Clin Exp Res 1998; 22(2): 334-8.
https://doi.org/10.1111/j.1530-0277.1998.tb03657.x DOI: https://doi.org/10.1111/j.1530-0277.1998.tb03657.x
Mogharreban C, Nahikan-Nelms M. Autonomy at mealtimes: building healthy food preferences and eating behavior in young children. Early Child Educ J 1996; 24(1): 29-32.
https://doi.org/10.1007/BF02430547 DOI: https://doi.org/10.1007/BF02430547
Kvigne VL, Leonardson GR, Neff-Smith M, Brock E, Borzelleca J, Welty TK. Characteristics of children who have full or incomplete fetal alcohol syndrome. J Pediatr 2004; 145(5): 635-40.
https://doi.org/10.1016/j.jpeds.2004.07.015 DOI: https://doi.org/10.1016/j.jpeds.2004.07.015
Achenbach TM, Rescorla, LA. Manual for the ASEBA preschool forms & profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families 2000.
Hogan H, Cantwell PJ, Devine J, Mule VT, Velkoff V. Quality and the 2010 census. Popul Res Policy Rev 2013; 32(5): 637-62.
https://doi.org/10.1007/s11113-013-9278-5 DOI: https://doi.org/10.1007/s11113-013-9278-5
United States™ Census 2010 Explore the form. [homepage on the Internet]. Washington, DC: United States Bureau™. [updated 2014 April 21, cited 2016 Nov 15]: Available from: http://www.census.gov/2010census/about/interactive-form.php.
Hazrati S, Hourigan SK, Waller A, Yui Y, Gilchrist N, Huddleston K, et al. Investigating the accuracy of parentally reported weights and lengths at 12 months of age as compared to measured weights and lengths in a longitudinal childhood genome study. BMJ Open [serial on the Internet]. 2016 April 8;[cited 2016 Oct 6]6:e011659. DOI: https://doi.org/10.1136/bmjopen-2016-011653
Adegboye A, Heitmann B. Accuracy and correlates of maternal recall of birthweight and gestational age. BJOG 2008; 115(7): 886-93.
https://doi.org/10.1111/j.1471-0528.2008.01717.x DOI: https://doi.org/10.1111/j.1471-0528.2008.01717.x
Dean AG, Sullivan, K., Arner TG, Sangam, S., Sunki, G. Friedman, R. et al. A database and statistics program for public health professionals for use on Windows 95, 98, and NT computers. Atlanta, GA: Centers for Disease Control and Prevention; 2000.
Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI, Dietz WH. Validity of body mass index compared with other body-composition screening indexes for the assessment of body fatness in children and adolescents. Am J Clin Nutr 2002; 75(6): 978. DOI: https://doi.org/10.1093/ajcn/75.6.978
Webber L, Hill, C., Saxton, J., Van Jaarsveld, CHM, Wardle, J. Eating behavior and weight in children. Int J Obesity 2009; 33(1): 1-14.
https://doi.org/10.1038/ijo.2008.219 DOI: https://doi.org/10.1038/ijo.2008.219
Santos JL, Ho-Urriola JA, Gonzalez A, Smalley SV, Dominguez-Vasquez P, Cataldo R, et al. Association between eating behavior scores and obesity in Chilean children. Nutr J [serial on the Internet] 2011 October 11;[cited 2016 Oct 9] 10(1): 108. DOI: https://doi.org/10.1186/1475-2891-10-108
Grube M, Bergmann S, Keitel A, Herfurth-Majstorovic K, Wendt V, von Klitzing K, et al. Obese parents - obese children? Psychological-psychiatric risk factors of parental behavior and experience for the development of obesity in children aged 0-3: study protocol. BMC Public Health [serial on the Internet] 2013 February 8 [cited 2016 Oct 9]; 13(1): 1193. DOI: https://doi.org/10.1186/1471-2458-13-1193
U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Child Health USA 2014. Rockville, Maryland: U. S. Department of Health and Human Services, 2014. Available from: http://mchb.hrsa.gov/chusa14/
Cohen J. Statistical power analysis for behavioral sciences (2nd ed.) [book on the Internet]. New Jersey: Lawrence Erlbaum; 1988 [cited on 2016 Aug 12]. Available from: http://www.sciencedirect.com/science/book/9780121790608.
Ogden CL, Carroll MD, Brian KK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA 2014; 311(8): 806-14.
https://doi.org/10.1001/jama.2014.732 DOI: https://doi.org/10.1001/jama.2014.732
Rolland-Cachera MF, Deheeger M, Bellisle F, Sempé M, Guilloud-Bataille M, Patois E. Adiposity rebound in children: a simple indicator for predicting obesity. Am J Clin Nutr 1984; 39(1): 129-35. DOI: https://doi.org/10.1093/ajcn/39.1.129
Centers for Disease Control and Prevention National Center for Health Statistics. National Vital Statistics System. Birth Data. [homepage on the Internet] Atlanta, GA: U. S. Department of Health & Human Services 2013 [updated on 2015 Sept 29; cited on 2016 Aug 12]. Available from: http://www.cdc.gov/nchs/births.htm.
Milagro FI, Mansego ML, De Miguel C, Martinez JA. Dietary factors, epigenetic modifications and obesity outcomes: progresses and perspectives. Mol Aspects Med 2013; 34(4): 782-812.
https://doi.org/10.1016/j.mam.2012.06.010 DOI: https://doi.org/10.1016/j.mam.2012.06.010
Carr JL, Agnihotri S, Keightley M. Sensory processing and adaptive behavior deficits of children across the fetal alcohol spectrum disorder continuum: sensory processing and adaptive behaviors across the FASD continuum. Alcohol Clin Exp Res 2010; 34(6): 1022-32.
https://doi.org/10.1111/j.1530-0277.2010.01177.x DOI: https://doi.org/10.1111/j.1530-0277.2010.01177.x
Freudenberg N, Ruglis J. Reframing school dropout as a public health issue. Preventing Chronic Disease. Centers for Disease Control and Prevention. Washington, DC: U. S. Department of Health and Human Services; 2007 4(4): A107 [updated on 2012 March 30; cited on 2016 Aug 12].
Bremer AA, Lustig RH. Effects of sugar-sweetened beverages on children. Pediatr Ann 2012; 41(1): 26-30.
https://doi.org/10.3928/00904481-20111209-09 DOI: https://doi.org/10.3928/00904481-20111209-09
Nickelson J, Lawrence JC, Parton JM, Knowlden AP, McDermott RJ. What proportion of preschool-aged children consume sweetened beverages? J Sch Health 2014; 84(3): 185-94.
https://doi.org/10.1111/josh.12136 DOI: https://doi.org/10.1111/josh.12136
Gidding SS, Dennison BA, Birch LL, Daniels SR, Gilman MW, et al. Dietary recommendations for children and adolescents: a guide for practitioners. Pediatr 2006; 117(2): 544-59.
https://doi.org/10.1542/peds.2005-2374 DOI: https://doi.org/10.1542/peds.2005-2374
Committee on Nutrition. American Academy of Pediatrics: The use and misuse of fruit juice in pediatrics. Pediatr 2001; 107(5): 1210-13.
https://doi.org/10.1542/peds.107.5.1210 DOI: https://doi.org/10.1542/peds.107.5.1210
Perry B, Wang Y. Appetite regulation and weight control: the role of gut hormones. Nutr Diabetes 2012; 2(1): e26.
https://doi.org/10.1038/nutd.2011.21 DOI: https://doi.org/10.1038/nutd.2011.21
Hofer R, Burd L. Review of published studies of kidney, liver, and gastrointestinal birth defects in fetal alcohol spectrum disorders. Birth Defects Res A Clin Mol Teratol 2009; 85(3): 179-83.
https://doi.org/10.1002/bdra.20562 DOI: https://doi.org/10.1002/bdra.20562
Olson HC, Jirikowic T, Kartin D, Astley S. Responding to the challenge of early intervention for fetal alcohol spectrum disorders. Infants Young Child 2007; 20(2): 172-89.
https://doi.org/10.1097/01.IYC.0000264484.73688.4a DOI: https://doi.org/10.1097/01.IYC.0000264484.73688.4a
Atkins L, Michie S. Designing interventions to change eating behaviours. Proc Nutr Soc 2015; 74(2): 164-70.
https://doi.org/10.1017/S0029665115000075 DOI: https://doi.org/10.1017/S0029665115000075
Rader RK, Mullen KB, Sterkel R, Strunk RC, Garbutt JM. Opportunities to reduce children’s excessive consumption of calories from beverages. Clin Pediatr (Phila) 2014; 53(11): 1047-54.
https://doi.org/10.1177/0009922814540989 DOI: https://doi.org/10.1177/0009922814540989
Satter E. Eating competence: definition and evidence for the Satter Eating Competence model. J Nutr Educ Behav 2007; 39(5 Suppl): S142-53.
https://doi.org/10.1016/j.jneb.2007.01.006 DOI: https://doi.org/10.1016/j.jneb.2007.01.006
Satter E. The feeding relationship: problems and interventions. J Pediatr 1990; 117(2 Pt 2): S181-9.
https://doi.org/10.1016/S0022-3476(05)80017-4 DOI: https://doi.org/10.1016/S0022-3476(05)80017-4
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