Systematic review of psychological interventions for pediatric feeding problems.

OBJECTIVE To conduct a systematic review of the research evaluating the effect of psychological interventions for pediatric feeding problems. METHODS A search was conducted to identify studies using psychological interventions for pediatric feeding problems published between 1998 and 2013. Randomized controlled trials (RCTs) and nonrandomized studies that examined aggregated outcome data were included. Primary outcomes were child mealtime behavior, nutritional status, and caregiver stress. A risk of bias assessment was conducted and the quality of the evidence rated using Grading of Recommendations Assessment, Development, and Evaluation methodology. RESULTS 13 studies were identified and a narrative synthesis framework was used to report findings. CONCLUSIONS The preponderance of evidence suggests positive effects of psychological intervention for the treatment of feeding problems. However, limited data and the paucity of studies using RCT methodologies limit conclusions that can be drawn regarding the efficacy of these interventions. Future studies using more rigorous research methods are needed to enhance understanding of these interventions.