Examining Financial Impacts and Community Resources Utilization of Children with Feeding Difficulties

April 21, 2022 1:30 pm

Little is known about the impact of socio-contextual factors on children with feeding difficulties, which can affect the child and caregiver’s well-being. The purpose of this study was to examine the extent to which financial impacts and community resources utilization are associated with feeding difficulties in young children. We performed a secondary analysis of cross-sectional data from the 2017-2018 National Survey of Children’s Health. Our main outcome was the presence of a feeding difficulty. Financial impacts exposures included out-of-pocket costs, whether caregivers left a job due to child’s health, and experiences of food insufficiency. Community resources utilization exposures included receival of food or cash assistance, special services for developmental needs, and special education/Early Intervention (EI). We used a logistic regression model to examine the associations. The sample had 14,737 children ages 0-5 years and 272 with feeding difficulties. We found a that children with feeding difficulties had a higher-odds of: 1) having out- of-pocket health care costs > $1000, 2) caregivers that left a job due to their child’s health, 3) received food or cash assistance, and  4) received special services for their developmental needs. Children who received special education/EI had lower odds of having feeding difficulties. These findings highlight the socio-contextual factors that impact children with feeding difficulties. This information can be used to tailor interventions to improve family-centered care and outcomes for patients and caregivers. Further research is indicated to understand the relationship between socio-contextual factors and longitudinal outcomes.

Learning Objective
Participants will be able to:

  • Identify financial impacts and community resource utilization factors that are associated with pediatric feeding difficulties.


  • June Okada, MS, CF-SLP, CLC

    June Okada is a speech-language pathology clinical fellow at Boston Children's Hospital. She received her masters degree from MGH Institute of Health Professions and is currently specializing in pediatric feeding difficulties.

    Financial Disclosures: None
    Non-Financial Disclosures: None

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  • Stephanie Harshman, PhD, RD, Lda

    Stephanie Harshman, PhD RD LD, is a research fellow in Neuroendocrinology at Mass General Hospital and a dietitian in The Center for Feeding and Nutrition at Massachusetts General Hospital for Children. Dr. Harshman’s research focuses on identifying the impact of the gut microbiome and neuroendocrine signaling in pediatric feeding and eating disorders.

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  • Erin Wilson, PhD

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  • John Wong, PhD

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  • Lauren Fiechtner, MD, MPH

    Lauren Fiechtner, MD, MPH

    Lauren Fiechtner, MD, MPH is the Director of Nutrition in the Divisions of Gastroenterology and Nutrition and General Academic Pediatrics at MassGeneral Hospital for Children and the Senior Health and Research Advisor at the Greater Boston Food Bank. Her interests include reducing nutrition related health disparities with a particular focus on childhood obesity and feeding disorders.

    Financial Disclosures: Nothing to disclosure

    Nonfinancial Disclosures: Nothing to disclosure

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  • Meg Simione, PhD, CCC-SLP

    Meg Simione, PhD CCC-SLP, is an Instructor of Pediatrics at Harvard Medical School, research scientist, and speech-language pathologist at MassGeneral Hospital for Children. She specializes in pediatric feeding and swallowing. Dr. Simione’s research focuses on infant and child feeding and growth, pediatric feeding disorders, and implementation science.

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