Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework

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. https://ift.tt/OBJ4xP Address correspondence and reprint requests to Praveen Goday, MBBS, CNSC, Professor, Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, 8701 Watertown Plank Road Milwaukee, WI 53226 (e-mail: pgoday@mcw.edu). Received 6 July, 2018 Accepted 27 September, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). Funding Source: This paper was possible through a grant from Comerica Bank to Feeding Matters, Inc. to enable a consensus meeting held in Phoenix, AZ on March 4-5, 2016. Financial Disclosure: Dr Goday serves as consultant to Nutricia and serves on a Data Safety and Monitoring Board for Shire Pharmaceuticals. The remaining authors have no financial relationships relevant to this article to disclose. Conflict of Interest: None of the authors have any conflicts of interest to disclose. Contributors statement: Drs. Goday, Huh, Silverman, Lukens, Dodrill, Cohen, Delaney, Mrs. Feuling, Drs. Noel, Gisel, and Phalen participated in the initial consensus work, drafted sections of the initial manuscript, reviewed and revised the manuscript, and approved the final manuscript as submitted. Drs. Kenzer, Kessler, and Browne participated in the initial consensus work, reviewed and revised the manuscript, and approved the final manuscript as submitted. Dr. de Camargo provided input into key elements of the consensus work, reviewed and revised the manuscript, and approved the final manuscript as submitted. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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