Researchers studied 102 preschoolers with developmental concerns to understand why some have trouble eating. They found that children who struggle with feeding often also have behavioral challenges like being overly active, anxious, or having trouble focusing. Interestingly, feeding problems weren’t directly linked to delays in learning or physical development. The study suggests that when helping kids with eating difficulties, doctors should pay special attention to their behavior and emotions, not just their physical development. This is especially important in developing countries where more children are being seen for mild developmental delays.
The Quick Take
- What they studied: Whether young children with developmental concerns who have trouble eating also have behavioral or developmental problems
- Who participated: 102 preschool-aged children (typically ages 2-5) who were referred to a developmental pediatrics clinic because of concerns about their growth, learning, or development. The study was conducted in a Eurasian country.
- Key finding: Children with feeding difficulties were significantly more likely to have behavioral problems like hyperactivity, anxiety, or attention issues. However, feeding problems were not directly connected to delays in learning, language, or motor skills.
- What it means for you: If your young child struggles with eating, it may be worth discussing their behavior and emotions with their doctor, not just their physical development. Addressing behavioral issues might help improve eating habits. However, this study shows a connection, not proof that one causes the other.
The Research Details
This was a cross-sectional study, which means researchers looked at a group of children at one point in time rather than following them over months or years. The 102 children all came to a developmental pediatrics clinic (a doctor’s office that specializes in children with developmental concerns) and were assessed using four different questionnaires. Parents and doctors filled out forms about the children’s development, behavior, and eating habits. The researchers then used statistical analysis to look for patterns and connections between feeding problems and other issues.
This approach is useful for identifying which problems tend to occur together in children with developmental concerns. By looking at many children at once, researchers can spot patterns that might help doctors understand what to focus on when treating feeding problems. The study is particularly important because most previous research focused on children with severe developmental delays, but this study included children with milder concerns.
The study used well-established, validated assessment tools that are commonly used by pediatricians and developmental specialists. The sample size of 102 children is reasonable for this type of research. However, because this is a cross-sectional study (snapshot in time), it can show that two problems occur together but cannot prove that one causes the other. The study was conducted in one clinic in a Eurasian country, so results may not apply equally to all populations worldwide.
What the Results Show
The most important finding was a clear connection between feeding difficulties and behavioral problems. Children who struggled with eating were significantly more likely to have behavioral issues such as hyperactivity, anxiety, aggression, or attention problems. This relationship was strong and consistent across different types of behavioral problems measured. In contrast, feeding difficulties were not significantly linked to delays in language development, motor skills (like running or climbing), or cognitive abilities (like problem-solving). This was surprising to researchers because they expected feeding problems to be connected to overall developmental delays.
The study found positive correlations across all behavioral problem categories and all feeding assessment measures, meaning that as behavioral problems increased, feeding difficulties tended to increase as well. This suggests that behavioral factors play an important role in how children eat. The researchers noted that children with milder developmental delays (not just severe ones) were being referred to the clinic, indicating a growing recognition of feeding problems in this population.
Most previous research on feeding problems in young children focused on those with severe developmental delays or specific neurodevelopmental disorders like autism or cerebral palsy. This study is notable because it examined children with milder developmental concerns, which represents a growing population seeking help. The finding that behavior is more closely linked to feeding problems than developmental delays is somewhat different from previous assumptions and suggests that doctors should broaden their approach to treating feeding difficulties.
This study has several important limitations. First, it only looked at children at one point in time, so we cannot know if behavioral problems cause feeding difficulties or if feeding difficulties cause behavioral problems. Second, the study was conducted in one clinic in a Eurasian country, so the results may not apply to children in other parts of the world or different healthcare settings. Third, the study relied on parent and doctor reports rather than direct observation of eating behavior in all cases. Finally, the study did not include a comparison group of typically developing children without developmental concerns, which would have provided helpful context.
The Bottom Line
If your preschooler has feeding difficulties, discuss their behavior and emotional well-being with their pediatrician or developmental specialist. Consider a comprehensive evaluation that looks at behavioral factors (like anxiety, hyperactivity, or attention issues) alongside physical and developmental assessment. Behavioral interventions or counseling may be helpful in addition to feeding therapy. These recommendations are based on this single study, so discuss with your healthcare provider how they apply to your child’s specific situation.
Parents and caregivers of preschoolers with feeding difficulties should pay attention to this research. Pediatricians and developmental specialists should consider behavioral factors when evaluating and treating feeding problems. This is particularly relevant in developing countries where more children are being identified with mild developmental delays. Children with severe developmental disorders or neurodevelopmental conditions may have different feeding issues not fully addressed by this study.
Changes in eating behavior typically take weeks to months to develop, especially if behavioral factors are involved. If behavioral issues are addressed through counseling or other interventions, improvements in feeding may take 2-3 months or longer to become noticeable. Every child is different, so discuss realistic timelines with your healthcare provider.
Want to Apply This Research?
- Track your child’s eating behavior daily by noting: (1) meals/snacks completed, (2) types of foods accepted, (3) any behavioral challenges during meals (tantrums, refusal, distraction), and (4) mood before and after eating. Rate behavioral difficulty on a scale of 1-10 to identify patterns.
- Work with your pediatrician to identify one specific behavioral goal related to mealtimes (for example: reducing distractions, managing anxiety before meals, or improving focus during eating). Use the app to set reminders for this behavior and track daily progress. Celebrate small wins to build positive associations with eating.
- Review your tracking data weekly to identify patterns between your child’s behavior and eating success. Share this data with your healthcare provider at appointments. Look for trends such as: better eating when calm, worse eating when anxious, or improved eating after behavioral interventions. Adjust strategies based on what the data shows works best for your child.
This research describes an association between feeding difficulties and behavioral problems in preschoolers with developmental concerns, but does not prove that one causes the other. This study was conducted in one clinic and may not apply to all children or populations. If your child has feeding difficulties or developmental concerns, consult with your pediatrician or a developmental specialist for personalized evaluation and treatment recommendations. Do not use this information to self-diagnose or replace professional medical advice. Feeding problems can have multiple causes including medical, developmental, behavioral, and environmental factors that require professional assessment.