Feeding practices, behaviours and disorders in infants and children with cystic fibrosis: A scoping review.

Abstract

Feeding practices and behaviours in children with cystic fibrosis (cwCF) are thought to be atypical, with evidence pertaining to lower breastfeeding rates and higher problematic mealtime behaviours compared to the general population. To date, there has been no systematic approach to synthesising this evidence. This review aims to map the available literature on feeding practices, feeding behaviours and feeding disorders in infants and cwCF. Six electronic databases (MEDLINE, Embase, Emcare, PsycINFO, Cochrane and CINAHL) were searched on September 13^th, 2024 and last updated on June 16^th, 2026. Studies exploring feeding practices, behaviours and feeding in cwCF 0-12 years, or their parents, were included. The search was limited to English-language and published empirical studies. Two authors independently screened studies for inclusion in a two-staged process and charting followed standardised JBI methodology. Quality appraisal was performed using Critical Appraisal Skills Programme and JBI checklists. The search yielded 6116 articles; 279 full-text studies were screened and 38 were included in the final synthesis. Twenty-two studies described breastfeeding practices, 15 studies described feeding behaviours and 1 study explored feeding disorders in cwCF. Eighty-two percent (31 of 38) were observational studies, 71% (27 of 38) were conducted in the United States. Exclusive breastfeeding rates at 3 months were 14-25%, reducing to 10-16% by 6 months. Problematic mealtime behaviours were twice as common in cwCF, compared to healthy counterparts; 40-43% compared to 21-22%, respectively. Problematic mealtime behaviours were associated with parental stress and authoritarian parenting styles. There were no studies exploring the impact of CF transmembrane conductance regulator modulator (CFTRm) therapy on feeding practices, behaviours or disorders in cwCF. Future research should include breastfeeding exclusivity, duration, support and associated child and maternal health outcomes; strategies for improving the bidirectional relationship between parent and child during feeding and mealtimes; and the impact of early life CFTRm therapy on feeding practices and behaviours in cwCF.