Feeding Problems and Weight in Infants and Children with Down Syndrome

Childhood overweight and obesity is a significant global public health concern with significant consequences for health. In children with Down syndrome, prevalence of overweight and obesity is higher than the typically developing population. This is problematic because children with Down syndrome are at a higher risk of various negative health outcomes, which can be worsened by excess weight, making proper nutrition particularly crucial for this group. However, these children are also more prone to feeding difficulties that can adversely affect their nutrition and diet. The current understanding of how feeding issues and weight develop in these children is limited. This thesis aims to address this gap by exploring factors associated with feeding problems, weight management, and parental support needs during the early years (from birth to five years old). A mixed-methods approach was taken to explore these issues. This included conducting a scoping review of relevant literature, longitudinal studies, parent questionnaires and interviews, and video-recorded mealtime observations. The findings reveal that feeding difficulties and weight are influenced by a complex interplay of factors, including sensitivity to food textures, underlying health conditions, motor delays, sensory issues, children's eating behaviours, and parental feeding practices. As a result, early and comprehensive interventions are crucial for addressing feeding, eating, and weight concerns in order to prevent development of secondary issues like oral aversions. To facilitate this, feeding and eating behaviours should be part of routine developmental assessments for children with Down syndrome. Currently, mothers face barriers in accessing high quality support which meets their needs, leading to significant distress. Mothers need access to specialists with expertise in Down syndrome and ongoing, proactive support, especially during critical stages like breastfeeding and introducing complementary foods. Ultimately, the findings of this thesis indicate a need for policy changes and increased funding to enhance early intervention programs, ensure consistent quality of feeding support, and address disparities in support across different regions in the UK.