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Pediatric Feeding Disorders
What do 1 in 4 children have in common? About 25% of children have some form of pediatric feeding disorder. A pediatric feeding disorder is a broad term for one of the numerous states (and its causes) where a child doesn't consume adequate nutrition to develop normally.
This lesson goes over the different types, signs, and treatments of pediatric feeding disorders.
Types & Signs
Feeding disorders can develop as a result of a wide variety of issues. Some children may have a physical problem that prohibits them from chewing their food or sucking from a mother's breast. They may also have a problem keeping food in their mouth or swallowing it. The end result is that there is an anatomical and/or neuromuscular dysfunction that prevents them from properly eating even if they want to eat a wide variety of healthy foods. General signs of such issues may be choking or gagging while eating, problems chewing or breast feeding, or they have food or liquid coming out of their mouth or nose when they do eat.
Other children may have a feeding disorder because they have a gastrointestinal condition, a problem with the stomach and/or intestines. This problem may cause them to avoid food because they associate eating with some sort of unpleasant issue like pain, vomiting or diarrhea after eating. Signs of such a problem could be vomiting, diarrhea or complaints of tummy aches after eating. Refusal to eat food in general or specific foods that may worsen their symptoms may be a sign of this problem.
Further still, a child may not want to eat certain types of food because of a sensory aversion to the food. In other words, they don't like something like the taste, smell or texture of the food. If the child doesn't accept or swallow foods of certain textures, this could be a sign of sensory aversion. For instance, maybe the child only likes liquid or pureed food or maybe they only like crunchy foods.
Sometimes, there is no underlying medical issue or sensory aversion. It's a matter of a behavioral problem. Perhaps the parents are simply unaware of how to properly feed their child or they set a bad example of how to properly eat and the child simply mimics this environment. The child may have inappropriately learned feeding patterns as a result. They may throw temper tantrums to try and manipulate the parents into giving them something they want as opposed to what they really need. Or, they may eat well for mom but not for dad. Perhaps they'll simply refuse to open their mouth until they get what they want.
Other feeding and eating disorders include:
- Pica, which refers to the eating of substances that have no nutritional value, such as dirt, for a relatively long period of time.
- Rumination, where the child regurgitates the food in their stomach back up into their mouth in order to re-chew it.
- ARFID, avoidant/restrictive food intake disorder. This, in short, refers to a general problem of either being picky in what the child eats and/or eating very little food in general.
Regardless of the cause, treatment for a pediatric feeding disorder is very important. This is because a feeding disorder can lead to poor growth, inappropriate cognitive (brain) development, serious illness, and even death!
As you can tell, however, there is no one single cause or type of feeding problem and so there is no single treatment. Pediatric feeding disorders span a wide range of nutritional, medical and behavioral issues, sometimes in combination all in one child. This is why a treatment approach may include a team of medical professionals such as nutritionists, gastroenterologists, psychologists and even occupational therapists as each individual case may necessitate.
For example, some anatomical defects may need surgical correction. If there is a gastrointestinal problem, such as acid reflux that causes something like heartburn, then medication can be given to help control the levels of stomach acid.
Some children may need to have a nasogastric tube inserted into their body. This is a long, thin and flexible tube that is inserted into the nose ('naso'), passes into the throat, then the esophagus (food tube) and ends up in the stomach ('gastro-'). This will allow a physician or parent to feed the child adequate nutrition when there is no other alternative.
Other treatments involve modifying the food the child eats. The temperature of the food can be varied, different foods might be tried or calories can be added to the food that they do eat. Occupational/physical therapy may include exercises to make the muscle of the mouth and tongue stronger and better able to move and chew.
The term pediatric feeding disorder is a general term for one or more conditions that leads to a child consuming an inadequate amount (or variety) of nutrition to develop normally.
There are numerous types of pediatric feeding disorders:
- Those stemming from anatomical and/or neuromuscular dysfunction. Children with such problems might gag when eating. Treatment may involve surgery and occupational/physical therapy.
- Some sort of gastrointestinal condition, like acid reflux. Children with this problem may complain of pain around feeding time or may simply refuse to eat. Treatment can include medication that helps address the underlying problem.
- A sensory aversion to the food. Perhaps the child only likes to eat liquid food but not solid food. Treatment can include behavioral therapy as well as sensory modification of the food they do eat.
- A behavioral problem. The child may throw a temper tantrum when they don't get what they want. Behavioral therapy with a therapist skilled in this area can help not only address the issue the child is displaying but any potential things the parents are doing that may be contributing to it.
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