# Utilising the diagnostic criteria of paediatric feeding disorder: Updated findings from a population‐based cohort study

## TL;DR

This study highlights the high prevalence of skill-based feeding issues in children with PFD and suggests updating diagnostic criteria for better identification and care.

## Contribution

The study is the first to report the high prevalence of skill-based deficits in PFD and proposes clarifying diagnostic criteria.

## Key findings

- Skill-based feeding deficits are the most common features in PFD but are under-reported.
- Neurodevelopmental and gastrointestinal conditions are the most frequent medical comorbidities in PFD.
- PFD typically involves multiple coexisting conditions, making accurate diagnosis challenging.

## Abstract

Paediatric feeding disorder (PFD) is highly prevalent but frequently underdiagnosed in the United Kingdom. Existing diagnostic criteria provide a valuable framework for identifying and managing PFD. However, inconsistent use of these criteria results in under‐reporting of prevalence and presentation. This study aims to expand current clinical evidence and evaluate the diagnostic framework to better reflect the real‐world prevalence of PFD in United Kingdom practice. By reviewing and applying these criteria, we aim to enhance diagnostic accuracy, support early identification and improve care implementation.

This observational cohort study enrolled 51 patients with PFD. Patients were examined against the current PFD diagnostic criteria and characterised according to the four areas of impairment for diagnosis of PFD, identifying the prevalence of medical, nutritional, psychosocial and feeding skill conditions.

The most prominent clinical features in patients with PFD were medical and skill‐based. All PFD patients had conditions associated with skill‐based difficulties; 96% presented with a medical condition, 51% had a psychosocial condition, and 20% had a diagnosed nutritional deficiency. There was a high incidence of multiple, co‐occurring conditions.

This is the first study to report the high prevalence of skill‐based deficits in PFD, along with the type and frequency of clinical features observed in affected patients. Based on these findings, we propose a clarification of the diagnostic criteria, with greater emphasis on medical and skill‐based factors. This study underscores the importance of a comprehensive, multidisciplinary assessment of feeding, incorporating a thorough evaluation of feeding skills and the functional impact of medical conditions on feeding development.

Paediatric feeding disorder (PFD) affects an estimated 2.5%–3.5% of children under five, with prevalence reaching up to 80% in those with developmental disabilities.Understanding the interplay of presenting conditions in PFD is critical for identifying at‐risk children, enabling early diagnosis and treatment, and mitigating poor growth and related complications.

Paediatric feeding disorder (PFD) affects an estimated 2.5%–3.5% of children under five, with prevalence reaching up to 80% in those with developmental disabilities.

Understanding the interplay of presenting conditions in PFD is critical for identifying at‐risk children, enabling early diagnosis and treatment, and mitigating poor growth and related complications.

Skill‐based feeding deficits are the most observed features in PFD but remain under‐reported in paediatric populations.Neurodevelopmental and gastrointestinal conditions are the most frequent medical comorbidities.PFD typically involves multiple coexisting conditions, complicating accurate diagnosis.This study offers clinical evidence to inform diagnostic refinement, aiding differentiation between PFD and other feeding disorders and enhancing clinical decision‐making.

Skill‐based feeding deficits are the most observed features in PFD but remain under‐reported in paediatric populations.

Neurodevelopmental and gastrointestinal conditions are the most frequent medical comorbidities.

PFD typically involves multiple coexisting conditions, complicating accurate diagnosis.

This study offers clinical evidence to inform diagnostic refinement, aiding differentiation between PFD and other feeding disorders and enhancing clinical decision‐making.