Feeding difficulties in typical children, sociodemographic factors, and family perception

Trofino, Bruna Franciele Guimarães; Friche, Amélia Augusta de Lima; Britto, Denise Brandão de Oliveira e

doi:10.1590/2317-1782/e20240160pt

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Original Article • CoDAS 37 (2) • 2025 • https://doi.org/10.1590/2317-1782/e20240160en linkcopy

Feeding difficulties in typical children, sociodemographic factors, and family perception

Authorship SCIMAGO INSTITUTIONS RANKINGS

Purpose To verify the association between signs of feeding difficulties in typical children and sociodemographic and economic aspects, parental age and education level, and family perception of feeding difficulties.

Methods Observational, analytical, cross-sectional study with a probabilistic sample of 113 children aged 2 years to 5 years and 11 months, registered at the Unified Health System in a town in inland Minas Gerais, Brazil. The study applied a sample characterization questionnaire, the Brazilian Child Feeding Scale (EBAI), and the Brazilian Economic Classification Criteria (CCEB) and performed descriptive, univariate, and multivariate analyses with multiple logistic regression.

Results Children aged 2 and 3 years tended to have more feeding difficulties (p = 0.002) than older children. Preterm children were 3.64 times more likely to have feeding difficulties (p = 0.033) than their peers. Children with signs of feeding difficulties had greater difficulty in food introduction (p = 0.007), ate poorly until 2 years old (p = 0.014), and were 3.7 times more likely to have signs of sensory changes (p = 0.001) than the others.

Conclusion Children aged 2 and 3 years tend to have more feeding difficulties than older ones. Prematurity, difficulty in introducing foods, and sensory changes are associated with childhood feeding difficulties.

Keywords:
Feeding Behavior; Sociodemographic Factors; Food Fussiness; Child Nutrition; Speech, Language and Hearing Sciences

Variables	N	%
Delivery
Normal	32	28.3
Cesarean	81	71.7
Total	113	100.0
Gestational age
Full term	94	83.2
Preterm	19	16.8
Total	113	100.0
Breastfeeding
No	13	11.5
Yes	100	88.5
Total	113	100.0
Age at food introduction
Before 6 months	46	40.7
After 6 months	67	59.3
Total	113	100.0
Food introduction
Easy	34	30.1
Difficult	79	69.9
Total	113	100.0
Feeding up to 2 years old
Ate well	93	82.3
Ate poorly	20	17.7
Total	113	100.0
Bothered by noise/smell/touch
No	79	70.5
Yes	33	29.5
Total	112	100.0

Variables	N	%
EBAI
No difficulties	77	68.1
Mild difficulty	27	23.9
Moderate difficulty	7	6.2
Severe difficulty	2	1.8
Total	113	100.0
Mealtime companion
Mother	43	38.1
Others	70	61.9
Total	113	100.0
How the family eats
Together	71	62.8
Separately	42	37.2
Total	113	100.0
How the child eats
At the table with the family	69	61.1
Somewhere else	44	38.9
Total	113	100.0
The child watches TV, tablet, mobile phone during meals
No	35	31.0
Yes	78	69.0
Total	113	100.0
When they watch TV, tablet, mobile phone during meals
They eat less food amount and variety	11	14.1
They eat the same food amount and variety	35	44.9
They eat a greater food amount and variety	32	41.0
Total	78	100.0
Do you consider it harmful to watch TV, tablet, or mobile phone during meals?
Yes, I do not allow it	31	27.4
Yes, but I allow it so they can eat well	69	61.1
No	13	11.5
Total	113	100.0
How do you perceive your child’s current eating?
Very good	21	18.8
Good	61	54.4
Poor	24	21.4
Very poor	6	5.4
Total	112	100.0

Variables	EBAI
	No difficulties	With difficulties	p-value
	N (%)	N (%)	p-value
Sex
Females	45 (58.4)	17 (47.2)	0.264
Males	32 (41.6)	19 (52.8)
Total	77 (100.0)	36 (100.0)
Age
2-3 years	9 (11.7)	13 (36.1)	0.002*
4-5 years	68 (88.3)	23 (53.9)
Total	77 (100.0)	36 (100.0)
Paternal age
Up to 40 years	54 (70.1)	21 (58.3)	0.226
Over 40 years	23 (29.9)	15 (41.7)
Total	77 (100.0)	36 (100.0)
Paternal education level
Illiterate/High School Incomplete	41 (53.2)	18 (50.0)	0.748
High School Graduate/Higher Education	36 (46.8)	18 (50.0)
Total	77 (100.0)	36 (100.0)
Maternal age
Up to 40 years	68 (88.3)	30 (83.3)	0.467
Over 40 years	9 (11.7)	6 (16.7)
Total	77 (100.0)	36 (100.0)
Maternal education level
Illiterate/High School Incomplete	23 (29.9)	10 (27.8)	0.820
High School Graduate/Higher Education	54 (70.1)	26 (72.2)
Total	77 (100.0)	36 (100.0)
CCEB
A/B	55 (71.4)	30 (80.3)	0.172
C/D-E	22 (28.6)	6 (16.7)
Total	77 (100.0)	36 (100.0)

Variables	EBAI
	No difficulties	With difficulties	p-value
	N (%)	N (%)	p-value
Delivery
Normal	21 (27.3)	11 (30.6)	0.718
Cesarean	56 (72.7)	25 (69.4)
Total	77 (100.0)	36 (100.0)
Gestational age
Full term	68 (88.3)	26 (72.2)	0.033*
Preterm	9 (11.7)	10 (27.8)
Total	77 (100.0)	36 (100.0)
Breastfeeding
Less than 6 months	8 (10.4)	5 (13.9)	0.587
More than 6 months	69 (89.6)	31 (86.1)
Total	77 (100.0)	36 (100.0)
Food introduction
Before 6 months	33 (42.9)	13 (36.1)	0.496
After 6 months	44 (57.1)	23 (63.9)
Total	77 (100.0)	36 (100.0)
How was the food introduction
Easy	17 (22.1)	17 (47.2)	0.007*
Difficult	60 (77.9)	19 (52.8)
Total	77 (100.0)	36 (100.0)
Feeding up to 2 years old
Ate well	68 (88.3)	25 (69.4)	0.014*
Ate poorly	9 (11.7)	11 (30.6)
Total	77 (100.0)	36 (100.0)
Bothered by noise/smell/touch
No	61 (80.3)	18 (50.0)	0.001*
Yes	15 (19.7)	18 (50.0)
Total	77 (100.0)	36 (100.0)
Mealtime companion
Mother	28 (36.4)	15 (41.7)	0.589
Others	49 (63.6)	21 (58.3)
Total	77 (100.0)	36 (100.0)
How the family eats
Together	50 (64.9)	21 (58.3)	0.499
Separately	27 (35.1)	15 (41.7)
Total	77 (100.0)	36 (100.0)
How the child eats
At the table with the family	47 (61.0)	22 (61.1)	0.994
Somewhere else	30 (39.0)	14 (38.9)
Total	77 (100.0)	36 (100.0)
The child watches TV/tablet/mobile phone during meals
No	27 (35.1)	8 (22.2)	0.169
Yes	50 (64.9)	28 (77.8)
Total	77 (100.0)	36 (100.0)
Do you consider it harmful to watch TV, tablet, or mobile phone during meals?
Yes, I do not allow it	23 (29.9)	8 (22.2)	0.653
Yes, but I allow it so they can eat well	46 (59.7)	23 (63.9)
No	8 (10.4)	5 (13.9)
Total	77 (100.0)	36 (100.0)
How do you perceive your child’s current eating?
Good	59 (77.6)	23 (63.9)	0.125
Poor	17 (22.4)	13 (36.1)
Total	76 (100.0)	36 (100.0)

Variables	Abnormal EBAI Result
	Initial model			Final model
	OR	CI	p-value	OR	CI	p-value
Age	0.250	0.075-0.829	0.023	0.323	0.078 – 0.693	0.009*
CCEB	0.490	0.135-1.782	0.279	---	---	---
Gestational age	3.210	0.847-12.1673	0.086	3.415	1.067 – 10.931	0.039*
Food introduction	0.695	0.209-2.313	0.695	---	---	---
Discomfort with noise/smell/touch	2.229	0.675-7.366	0.189	3.743	1.465 – 9.565	0.006*
Mealtime screen exposure	1.621	0.538-4.882	0.391	---	---	---
Current feeding	1.214	0.397-3.710	0.734	---	---	---
Feeding up to 2 years old	1.501	0.350 – 6.440	0.585	---	---	---

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[1] Caption: N = number of individuals