Feeding difficulties in childhood: A narrative review and proposal for an interdisciplinary approach

Introduction and aims Feeding difficulties (FDs) in childhood are highly prevalent and a common reason for medical consultation. Historically, clinical approaches have been fragmented. The Pediatric Feeding Disorder (PFD) model provides a comprehensive framework that incorporates medical, nutritional, feeding skill, and psychosocial dimensions. Our aims were to (1) describe the current definitions of FDs in children, (2) identify their main risk factors and existing classifications, and (3) propose a clinical algorithm to guide the diagnostic and therapeutic approach from an interdisciplinary perspective. Materials and methods A narrative review was carried out by the Feeding Difficulties Working Group of the Latin American Society of Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN), reviewing the literature published between January 2000 and April 2025 from the PubMed, Scopus, SciELO, and LILACS databases. Results Three classification systems were identified: sensory-based, medical/nutritional, and functional. Risk factors included prematurity, gastrointestinal and neuromotor diseases, negative feeding experiences, inadequate feeding practices, and psychosocial factors. A comprehensive and interdisciplinary clinical algorithm was developed. Conclusions Pediatric FDs require an interdisciplinary and family-centered approach, adapted to the Latin American context. Terminology standardization and clinical criteria harmonization are key steps for optimizing diagnosis, treatment, and research in the region. The development of a clinical algorithm outlining their approach is a first step toward this goal.