婴儿喂养障碍常发于出生至 1 岁。这些类型的障碍很常见, 见于25%~40% 发育正常的儿童。[1]Milnes SM, Piazza CC, Carroll-Hernandez TA. Assessment and treatment of pediatric feeding disorders. Encyclopedia on early childhood development. March 2004. http://www.child-encyclopedia.com/ (last accessed 5 July 2017).http://www.child-encyclopedia.com/sites/default/files/textes-experts/en/535/assessment-and-treatment-of-pediatric-feeding-disorders.pdf在发育延迟的患者中,喂养 75%~80%病例存在喂养困难。[7]Manikam R, Perman JA. Pediatric feeding disorders. J Clin Gastroenterol. 2000;30:34-46.http://www.ncbi.nlm.nih.gov/pubmed/10636208?tool=bestpractice.com与足月出生的婴儿相比,喂养障碍更常发于早产儿。[2]Rommel N, De Meyer AM, Feenstra L, et al. The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. J Pediatr Gastroenterol Nutr. 2003;37:75-84.http://www.ncbi.nlm.nih.gov/pubmed/12827010?tool=bestpractice.com美国一支多学科喂养研究团队报告在他们的转诊患者中,具有早产病史的患者高达 38%,而在一项欧洲的研究中,[8]Burklow KA, Phelps AN, Schultz JR, et al. Classifying complex paediatric feeding disorders. J Pediatr Gastroenterol Nutr. 1998;27:143-147.http://www.ncbi.nlm.nih.gov/pubmed/9702643?tool=bestpractice.com 孕龄低于 34 周即出生的婴儿所占的比例尤其高。[2]Rommel N, De Meyer AM, Feenstra L, et al. The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. J Pediatr Gastroenterol Nutr. 2003;37:75-84.http://www.ncbi.nlm.nih.gov/pubmed/12827010?tool=bestpractice.com在各类喂养障碍中,未发现显著的性别差异。[2]Rommel N, De Meyer AM, Feenstra L, et al. The complexity of feeding problems in 700 infants and young children presenting to a tertiary care institution. J Pediatr Gastroenterol Nutr. 2003;37:75-84.http://www.ncbi.nlm.nih.gov/pubmed/12827010?tool=bestpractice.com[8]Burklow KA, Phelps AN, Schultz JR, et al. Classifying complex paediatric feeding disorders. J Pediatr Gastroenterol Nutr. 1998;27:143-147.http://www.ncbi.nlm.nih.gov/pubmed/9702643?tool=bestpractice.com
喂养障碍的发生率正在上升,我们认为部分原因在于出生体重极低的极度早产儿的存活率上升,或者存在复杂的医疗情况。[9]Arvedson JC. Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Dev Disabil Res Rev. 2008;14:118-127.http://www.ncbi.nlm.nih.gov/pubmed/18646015?tool=bestpractice.com
大多数喂养障碍源于多种因素,其中发现致病因素单一的喂养障碍症只有 15%。[8]Burklow KA, Phelps AN, Schultz JR, et al. Classifying complex paediatric feeding disorders. J Pediatr Gastroenterol Nutr. 1998;27:143-147.http://www.ncbi.nlm.nih.gov/pubmed/9702643?tool=bestpractice.com在发现 1 个以上致病因素后,转诊向专科医生会诊寻求评估和治疗的患者中,有 80% 存在行为问题,70% 存在神经性疾病,60% 存在解剖学异常的情况。[8]Burklow KA, Phelps AN, Schultz JR, et al. Classifying complex paediatric feeding disorders. J Pediatr Gastroenterol Nutr. 1998;27:143-147.http://www.ncbi.nlm.nih.gov/pubmed/9702643?tool=bestpractice.com大多数研究中最常报告的喂养障碍是胃食管反流病。[10]Gremse DA. GERD in the pediatric patient: management considerations. MedGenMed. 2004;6:13.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1395762/http://www.ncbi.nlm.nih.gov/pubmed/15266239?tool=bestpractice.com