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Treatment of Feeding Disorders
Kathryn Stubbs & William Sharp
Importance of Feeding in Childhood
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No human activity has greater biological and social significance than eating: – Required for survival – Important role in socialization – Develops seemingly automatically most children – Central role for caregivers to support growth and development
Typical Dietary Fluctuations
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- Common problem for children and source of stress for
caregivers:
– Up to 40% of children experience some mealtime problems (Manikam & Perman, 2000; Mayes & Volkmar, 1993) – Sharp estimate: 100% – Issues include:
- “Picky” eating patterns
- Strong food preferences – insist on eating the same
foods
- Behaviors aimed at ending meals prematurely
Fluctuating hunger
- Reluctance to self feed
Mild Feeding Difficulties
- Typically resolve spontaneously or with low
intensity interventions such as:
– Caregiver education about meal structure – Modifications to food presentation/preparation – Nutrition Guidance
- Not associated with significant concerns
regarding:
– Growth – Nutrient deficiencies – Child’s relationship with food and social
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Pediatric Feeding Disorders
- Chronic feeding concerns generally involve either:
– 1) Volume ‐ Food Refusal – 2) Variety ‐ Food Selectivity
- Affect 3‐5% of children (Satter, 1990)
Severe problem behaviors during meals:
– Crying – Disruptions – Elopement – Aggression – Spitting – Expulsion
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Volume: Associated Factors
- Medical Issues:
- Congenital or acquired respiratory, cardiac, and
gastrointestinal problems, which cause difficult or painful eating experiences
- These include:
- Gastroesophageal reflux
- Food allergies
- Gastroenteritis
- Dysmotility
- Prematurity (with intubation)
- Bronchopulmonary dysplasia
- Short bowel syndrome
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