Psychological and social impact on parents of children with feeding difficulties

Abstract

Objectives: The prevalence of feeding disorders (FDs) and picky eating in children is high in our region, based on the parents' perceptions. Although organic disease or a nutritional impact is rarely observed in these children, the problem frequently has an effect on family dynamics. We aimed to estimate the impact of these disorders on the stress level, quality of life and psychological health of families.

Methods: Study of cases (FDs) and controls (healthy controls and controls with digestive disorders or other illness). We assessed parental stress and the risk of psychological distress in these families using validated scales (Parent Stress Index Short Form [PSI-SF] and Goldberg's General Health Questionnaire [GHQ-28]) and a parental opinion survey.

Results: We collected a total of 238 surveys, 102 corresponding to healthy controls, 88 to controls with digestive disorders and 48 to children with FDs. We found that 45.8% of parents in the FD group felt neglected by their paediatricians and 47.9% did not agree with the paediatrician's recommendations. In addition, 54.2% reported limitations to their social life, 25% problems in their relationship, 47.9% feeling judged by others (12.5% by their own partner) for how they managed mealtimes, and 37.5% having sought or considered seeking psychological support. All these problems were significantly more frequent compared to controls. Based on the GHQ-28, the risk of anxiety and depression was more frequent in parents in the FD group: 54.2% compared to the reference (adjusted odds ratio [aOR] compared to controls, 4.18; 95% confidence interval [CI], 1.96-8.87; OR compared to sick controls, 6.25; 95% CI, 2.79-13.98) and 33.3% compared to the healthy control group. They also had higher stress scores (PSI-SF) compared to the healthy control group (adjusted mean difference [AMD], 21; 95% CI, 12.19-29.81) and the sick control group (AMD, 20; 95% CI, 9.81-30.19).

Conclusions: Parents of children with FDs have a high level of stress and risk of anxiety and depression, with repercussions at the social, family, couple and work levels. The relationship with the paediatrician may also be affected.

Keywords: Behavioural disorders; Childhood eating and feeding disorders; Conducta alimentaria; Conflicto psicológico; Escalas de estado psicológico; Family relations; Feeding behaviour; Mother-child relationship; Psychiatric status rating scales; Relaciones familiares; Relación madre-hijo; Trastorno de conducta alimentaria infantil.