title: Inappropriate feeding behaviors and dietary intakes in children with fetal alcohol spectrum disorder or probable prenatal alcohol exposure.
abstract: BACKGROUND
  Prenatal alcohol exposure (PAE) is a leading cause of significant neurobehavioral and neurocognitive deficits. Its potential consequences for eating behaviors, nutritional status, and other nutritional issues in childhood have received little attention.
  
  
  METHODS
  Nineteen children (11 boys, 8 girls) of mean age 9.6 years, referred for fetal alcohol spectrum disorder (FASD) screening and assessment, were analyzed with physical exams and caregiver questionnaires to identify possible abnormalities in food and eating behaviors. Fourteen children contributed 24-hour diet recalls and were assessed for nutritional status.
  
  
  RESULTS
  Seventy-nine percent of participants were diagnosed with FASD and 63.2% had confirmed PAE. Fifty percent of girls were overweight or obese, whereas 37% of boys had reduced stature, weight, or body mass index for their age. Recurring feeding problems included constant snacking (36.8%), lack of satiety (26.3%), and picky eating/poor appetite (31.6%). None had oral feeding problems. Constipation was common (26.3%). Macronutrient intakes were largely normal, but sugar consumption was excessive (140 to 190% of recommendations) in 57% of subjects. Vitamin A intake exceeded the upper limit for 64% of participants, whereas ≥50% had intakes <80% of recommended daily allowances (RDAs) for choline, vitamin E, potassium, β-carotene, and essential fatty acids; 100% had vitamin D intakes <80% of the RDA.
  
  
  CONCLUSIONS
  PAE may be associated with altered acquisition and distribution of body mass with increasing age. Disordered eating was common. The increased feeding behaviors surrounding lack of satiety suggest that self-regulation may be altered. Constipation could reflect low dietary fiber or altered gastrointestinal function. These exploratory data suggest that children with PAE may be at risk for nutritional deficiencies, which are influenced by inappropriate food preferences, disordered eating patterns, medication use, and the stressful dynamics surrounding food preparation and mealtime.
authors.affiliation: Waisman Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Werts
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Van Calcar
authors.forename: David S
authors.initials: DS
authors.lastname: Wargowski
authors.forename: Susan M
authors.initials: SM
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004032:Diet / Q000706:statistics & numerical data*; D005247:Feeding Behavior; D019959:Feeding and Eating Disorders of Childhood / Q000209:etiology*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000523:psychology*; D006801:Humans; D008297:Male; D009752:Nutritional Status; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects
keywords: Abnormal Feeding; Choline; Fetal Alcohol Spectrum Disorders; Nutrition; Pediatric Obesity; Vitamin D