Evidence-Based Practices

Evidence-based practice in Pediatric Feeding Disorder (PFD) has moved to a multidimensional, interdisciplinary approach. The current framework considers the interaction between medical, nutritional, feeding skill, and psychosocial domains (Goday et al., 2019).

●      Medical: Identifying and managing underlying anatomical, neurological, or developmental issues that impede safe or efficient intake (Dharmaraj et al., 2023).

●      Nutritional: Monitoring anthropometric data (weight, height, BMI) to identify malnutrition, growth faltering, or micronutrient deficiencies, and calculating specific energy and protein requirements (Dharmaraj et al., 2023).

●      Feeding Skills: Assessing the mechanics of swallowing and oral-motor function. Recent research emphasizes that skill-based deficits are highly prevalent in children with PFD and often co-occur with medical conditions (Morris, 2026).

●      Psychosocial: Evaluating the mealtime environment, caregiver-child feeding dynamics, and the family's treatment goals (Dharmaraj et al., 2023; Kerzner et al., 2015).

Current Trends and Research Areas

●      Standardized Data Collection: There is a significant movement toward using a universal Case Report Form (CRF) to characterize patients consistently across different clinical settings. This promotes rigorous research and better communication between multidisciplinary teams (Volkert, 2025).

●      Phenotype-Oriented Frameworks: Research is moving away from broad labels toward a "continuum-based, phenotype-oriented" approach for issues like picky eating. This helps distinguish between developmentally typical food selectivity and persistent, clinically relevant impairment (Alarcon, 2026).

●      Early Intervention: Establishing consistent early identification protocols is a priority to prevent long-term nutritional and psychosocial consequences. This involves identifying "red flags" (e.g., signs of aspiration, growth failure) early in the primary care setting (Kerzner et al., 2015).

Clinical Interventions

Treatment strategies are generally multimodal, incorporating:

●      Behavioral Intervention: Historically the most heavily researched intervention, focusing on antecedents and consequences to improve mealtime performance (Sharp et al., 2010).

●      Oral-Motor Support: Techniques such as non-nutritive sucking (NNS) and perioral stimulation are frequently used in neonatal intensive care units to facilitate the transition to oral feeding, though evidence for some specific sensory techniques remains mixed.

●      Multidisciplinary Management: Evidence suggests that children with complex presentations benefit most from teams that integrate medical, nutrition, speech-language pathology, and psychology expertise (Goday et al., 2019; Kerzner et al., 2015).

References

●      Alarcon, P. (2026). Beyond “It’s Just a Phase”: A Review of Picky Eating in Children. Nutrients, 18(8), 1247.

●      Dharmaraj, R., Elmaoued, R., Alkhouri, R., Vohra, P., & Castillo, R. O. (2023). Evaluation and Management of Pediatric Feeding Disorder. Gastrointestinal Disorders, 5(1), 75–86. https://doi.org/10.3390/gidisord5010008. Cited by: 41

●      Goday, P. S., Huh, S. Y., Silverman, A., Lukens, C. T., Dodrill, P., Cohen, S. S., et al. (2019). Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework. Journal of Pediatric Gastroenterology and Nutrition, 68(1), 124–129. https://doi.org/10.1097/mpg.0000000000002188. Cited by: 808

●      Kerzner, B., Milano, K., MacLean, W. C., Berall, G., Stuart, S., & Chatoor, I. (2015). A Practical Approach to Classifying and Managing Feeding Difficulties. Pediatrics, 135(2), 344–353. https://doi.org/10.1542/peds.2014-1630. Cited by: 617

●      Morris, N. R. (2026). Utilising the diagnostic criteria of paediatric feeding disorder: Updated findings from a population-based cohort study. Journal of Pediatric Gastroenterology and Nutrition, 82(1), 33–41.

●      Sharp, W. G., Jaquess, D. L., Morton, J. F., & Herzinger, C. V. (2010). Pediatric Feeding Disorders: A Quantitative Synthesis of Treatment Outcomes. Clinical Child and Family Psychology Review, 13(4), 348–365. https://doi.org/10.1007/s10567-010-0079-7. Cited by: 383

●      Volkert, V. M. (2025). An updated framework for characterizing patients with pediatric feeding disorder. Frontiers in Child and Adolescent Psychiatry.