Eating Disorders of Infancy and Childhood: Definition, Symptomatology, Epidemiology, and Comorbidity (original) (raw)
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Clinical Investigation of Feeding Difficulties in Young Children: A Practical Approach
Clinical Pediatrics, 2009
Many young children are thought by their parents to eat poorly. Although the majority of these children are mildly affected, a small percentage have a serious feeding disorder. Nevertheless, even mildly affected children whose anxious parents adopt inappropriate feeding practices may experience consequences. Therefore, pediatricians must take all parental concerns seriously and offer appropriate guidance. This requires a workable classification of feeding problems and a systematic approach. The classification and approach we describe incorporate more recent considerations by specialists, both medical and psychological. In our model, children are categorized under the 3 principal eating behaviors that concern parents: limited appetite, selective intake, and fear of feeding. Each category includes a range from normal (misperceived) to severe (behavioral and organic). The feeding styles of caregivers (responsive, controlling, indulgent, and neglectful) are also incorporated. The objective is to allow the physician to efficiently sort out the wide variety of conditions, categorize them for therapy, and where necessary refer to specialists in the field.
Feeding problems of infants and toddlers
Canadian family physician Médecin de famille canadien, 2006
To propose a diagnostic and therapeutic approach to feeding problems in early childhood. Articles were retrieved through a MEDLINE search from January 1990 to December 2005 using the MeSH terms eating disorders, infant, and child. Recommended practice is based mainly on levels II and III evidence. Feeding problems are classified under structural abnormalities, neurodevelopmental disabilities, and behavioural disorders, with overlap between categories. A medical approach also needs an evaluation of diet and an assessment of the interaction between parent and child. Treating medical or surgical conditions, increasing caloric intake, and counseling about general nutrition can alleviate mild to moderate problems. More complicated cases should be referred to multidisciplinary teams. Behavioural therapy aims to foster appropriate behaviour and discourage maladaptive behaviour. Feeding problems in early childhood often have multifactorial causes and a substantial behavioural component. Fam...
A practical approach to classifying and managing feeding difficulties
Pediatrics, 2015
Many young children are thought by their parents to eat poorly. Although the majority of these children are mildly affected, a small percentage have a serious feeding disorder. Nevertheless, even mildly affected children whose anxious parents adopt inappropriate feeding practices may experience consequences. Therefore, pediatricians must take all parental concerns seriously and offer appropriate guidance. This requires a workable classification of feeding problems and a systematic approach. The classification and approach we describe incorporate more recent considerations by specialists, both medical and psychological. In our model, children are categorized under the 3 principal eating behaviors that concern parents: limited appetite, selective intake, and fear of feeding. Each category includes a range from normal (misperceived) to severe (behavioral and organic). The feeding styles of caregivers (responsive, controlling, indulgent, and neglectful) are also incorporated. The object...
A Functional Approach to Feeding Difficulties in Children
Current Gastroenterology Reports, 2019
Purpose of Review This review provides an approach for resolving a variety of feeding difficulties in children, ranging from normal eating behavior that is misperceived as a problem to substantial feeding disorders. Recent Findings Criteria to identify pediatric feeding disorders have been thoroughly addressed in the newly established designations of avoidant restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD). These diagnostic criteria improve the accuracy of identifying, classifying, and managing significant feeding disorders in young children. Summary While recent definitions of feeding difficulties are particularly appropriate in multidisciplinary settings, in this paper, we advocate for a progressive approach of managing feeding problems in all clinical settings. It begins by identifying red flags indicative of serious threats to the child, screening for oral motor dysfunction, stabilizing nutrient intake, and eliminating aversive feeding practices. The next step, if eating behavior does not improve, involves strategies that target specific eating behaviors and parental feeding styles. In severe or resistant cases, referral to specialists or interdisciplinary feeding teams is advised.
Feeding disorders of early childhood: an empirical study of diagnostic subtypes
The International journal of eating disorders, 2013
The aim of this study was to examine the differences among three subtypes of feeding disorders (FD), defined through the criteria of the DC:0-3R: "Infantile Anorexia" (IA), "Feeding Disorder Associated with Insults to the Gastrointestinal Tract" (FDIGT), and "Sensory Food Aversions" (SFA), by exploring mother-child interactions during feeding, children's temperament and emotional-adaptive functioning, and mothers' psychological profile and eating attitudes. The sample consisted of 146 Italian mother-child pairs, of which 51 children with IA, 47 children with FDIGT, and 48 mothers and their children with SFA. All dyads were videotaped during feeding; mothers completed questionnaires assessing their psychological profiles and eating attitudes, as well as their children's temperament and emotional/behavioral functioning. Analyses revealed significant differences between the diagnostic groups of FD in relation to mother-child interactions during...
Concept of Pediatric Feeding Problems From the Parents' Perspective
MCN. The American journal of maternal child nursing, 2016
Feeding difficulties in early childhood are common, affecting approximately 25% of typically developing children and up to 80% of children with developmental disabilities. There is no interdisciplinary consensus on the definition of a feeding problem and there is no input from families in the conceptualization. Lack of common language is a barrier to effective communication between clinicians, researchers, and caregivers, and inhibits collaboration. The purpose of this study was to examine conceptualization of pediatric feeding problems by family caregivers (parents). This study reports an empirical phase of a concept analysis. Data from interviews with 12 parents of children with feeding problems were coded for related concepts, attributes, antecedents, and consequences of feeding problems, and then analyzed for themes within conceptual categories. Conceptual elements across interviews are presented with an emphasis on shared perspectives. Parents related pediatric feeding problems...
Research Square (Research Square), 2023
To investigate factors associated with pediatric feeding disorders (PFD) among children of parents that reported to have had feeding disorders during their own childhood compared to children with PFD with no history of parental PFD. Methods We retrospectively reviewed the medical records of children diagnosed with PFD according to the recent WHO-based de nition. Demographic and clinical characteristics of children with PFD with a parental history of PFD were compared to those of children with a PFD with no history of parental PFD. Results Included were 231 children with PFD (median [interquartile range] age 10 (5.5-29) months at diagnosis, 58% boys) of whom 133 children had parents without PFD and 98 children had parents with PFD. Unexpectedly, children of parents without PFD had a higher rate of low birth weight (28% vs. 19%, respectively, p = 0.007), more delivery complications (10% vs. 2%, p = 0.006), more hospitalizations (33% vs. 17%, p = 0.004), more prescription medications (27% vs. 18%, p = 0.05), and a higher percent of gastrostomy tube use (6% vs. 0, p = 0.02). Moreover, more parents with PFD had an academic background compared with parents without PFD (72% vs. 59%, p = 0.05). There were no signi cant group differences in sex, history of breastfeeding, parental marital status, or type of the child's feeding disorder. Conclusions PFD among children with a parental history of PFD comprise a distinct group of patients with unique characteristics and outcomes. Since parental feeding history may explain their child's PFD in highly differing ways, treatment should be family-based and multidisciplinary. What is known Pediatric feeding disorder (PFD) is relatively common and its prevalence is increasing. Late parental eating disorders (anorexia nervosa, bulimia nervosa and binge eating) may impact their children's feeding and eating patterns.
Feeding disorders of infancy: a longitudinal study to middle childhood
International Journal of Eating Disorders, 2012
Objective: To evaluate over time feeding behavior and emotional–behavioral functioning in a sample of children diagnosed with Infantile Anorexia (IA) and a group of typically developing children; and to investigate the relationship between maternal psychological functioning and the children’s feeding patterns and emotional-behavioral functioning. Method: Seventy-two children diagnosed with IA and 70 children in the control group were prospectively evaluated through several measures at two, five, and eight years of age. Results: Our findings revealed partial improvement in the nutritional status of the children with IA. However, they continued to show ongoing eating problems and, in addition, anxiety/depression and withdrawal, as well as rule-breaking behaviors and social problems. There were significant correlations between the children’s eating problems and their emotional difficulties and their mothers’ increased emotional distress and disturbed eating attitudes. Discussion: Our longitudinal study points out that the natural course of untreated IA is characterized by the persistence of difficulties in eating behavior and emotional–behavioral adjustment in both, the children and their mothers. Keywords: infantile anorexia; emotional– behavioral adjustment; longitudinal outcome
Assessment of behavioral feeding difficulties in young children
Annals of Medical Research, 2019
Aim: Feeding difficulties are common in typically developing children and the prevalence ranges from 25% to 45%. Although using an assessment tool is the best approach when planning an intervention, assessment of feeding disorders is mostly accomplished by informal parent interviews in clinical practice. This study was designed to assess the mealtime behaviours of young children with 'Feeding Difficulties' (FD) by an instrument and to compare the results with 'Typically Developing' (TD) children. Material and Methods: A total of 61 children with FDs and 63 TD children aged 6-42 months were included. The Behavioral Pediatric Feeding Assessment Scale (BPFAS) was completed to describe the child's feeding behaviors and the parents' mealtime strategies. Results:FD group had higher scores than TD group in all BPFAS subtests' scores. The mean 'Total Frequency Score' was 104.6 in FD group whereas 72.9 in TD group (p=0.0001). The FD group had more problematic feeding behaviours in comparison to TD group. The mean 'Total Problem Score' of TD group was 6.1 whereas 20.1 in children with FD (p=0.0001). Conclusion: This study supports the BPFAS to be a useful and practical feeding assessment tool and also has the advantage of incorporating parents' feelings about child's feeding behaviors.
Concept of Pediatric Feeding Problems From the Parent Perspective
Carolina Digital Repository (University of North Carolina at Chapel Hill), 2016
As advancements have been made in medical and nursing care, infants with previously fatal congenital anomalies and infants born at younger gestational ages are surviving in greater numbers and living longer lives (Berry, Hall,