Introduction:
Feeding requires a multitude of factors that have to work together well. It is the most difficult and physically demanding thing a baby will do in their first few days or months. Infants and young children can have trouble eating and drinking when one or more parts of the feeding pathways are missing or out of order. It is important to know the underlying issue or the cause of concern to overcome the problem.
What Is Pediatric Feeding Disorder (PFD)?
A pediatric feeding disorder is a label for children who do not get enough food for their age to provide the body with the nutrition, calories, and fluids it needs to develop and flourish. This could mean that a child is still eating pureed foods, only drinking from a bottle or nursing after a year, that they eat few or no fruits, vegetables, or protein sources, or that they only eat soft or crunchy foods and can be caused by a medical, nutritional, feeding skill, or social problem. Parents may not know about these root causes, and children with this diagnosis often have trouble eating for two years or more unless they are diagnosed as infants or toddlers, which is possible. If left untreated, feeding issues may affect a child's physical, social, and emotional development.
What Are the Causes of Pediatric Feeding Disorders?
Children's feeding disorders and eating problems are caused by the following:
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Medical Conditions: Feeding problems can be caused by various health conditions such as gastrointestinal issues (like gastroesophageal reflux, constipation, or esophagitis), autism spectrum disorder, down syndrome or cerebral palsy, and chronic heart and lung problems.
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Psycho-Social Problems: PFD can occur as a result of developmental issues that cause delays in motor skills, language, sociability, and cognition. Frequently, these delays cause a mismatch between the child's feeding skills and the expectations of the adult caregivers who are in charge of feeding the child. For instance, if a caregiver continues to try to provide the kid in a chronological age-based manner despite their expectations not matching what the child can eat owing to delays in skill development. This incongruence can contribute to adverse feeding experiences that end in a PFD.
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Nutritional Factors: Many children with PFD consume limited amounts, types, and quality of food and drink, putting them at risk for dehydration, malnutrition, excess weight, micronutrient deficiencies, and overeating. Twenty-five percent to 50 percent of kids with PFD suffer from malnutrition, which is more common in people with chronic illnesses or neurodevelopmental abnormalities.
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Feeding Skills: Feeding abilities may be impaired by altered feeding experiences caused by illness, injury, or developmental delay. Any time in the first several years of life during changes in oropharyngeal architecture and neuromuscular coordination. Particular sensory-motor deficits may also impair feeding abilities in the mouth and pharynx. Feeding skills impairment results from altered oral experiences brought on by physical damage, deficiencies in brain functioning, aberrant oral anatomy or function, and uncomfortable or limited feeding experiences.
What Are the Different Types of Pediatric Feeding Disorders?
Pediatric feeding disorders are conditions that affect a child's ability to eat and consume enough nutrients for proper growth and development. Pediatric feeding disorders can appear in different forms, and clinicians usually classify them based on their symptoms and causes. Below are some of the common types of these disorders.
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Food Aversion: Sometimes children develop food aversion, which means they refuse to eat specific foods or even whole food groups. This can be caused by sensory issues, like being strongly affected by certain textures, tastes, or smells. It can also result from negative experiences with food, such as choking incidents or being forced to eat something they dislike.
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Oral Motor Disorders: Oral motor disorders involve difficulties with the muscles and movements needed for eating and swallowing. Children with oral motor disorders may have problems sucking, chewing, or swallowing food properly, leading to difficulties in gaining adequate nutrition.
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Dysphagia: Dysphagia refers to difficulty swallowing, which can result from physical abnormalities or neuromuscular conditions affecting the structures involved in the swallowing process. It can lead to choking or aspiration (food entering the airway), potentially causing respiratory issues.
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Gastrointestinal Disorders: Some feeding difficulties in children can be related to gastrointestinal issues, such as gastroesophageal reflux disease (GERD), food allergies, or intolerances. These conditions may cause discomfort or pain during eating, leading to food refusal or aversion.
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Failure to Thrive: Failure to thrive is when a child is not gaining weight or growing at the expected rate for their age and sex. Various factors can lead to this condition, such as issues with feeding that result in insufficient calorie consumption. These factors can contribute to the development of the condition.
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Restrictive Food Intake Disorder: It is an eating disorder where a person consistently refuses to eat certain foods or has limited food choices. Unlike anorexia or bulimia, ARFID is not related to body image issues but is caused by aversions or sensitivities to specific foods.
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Psychological or Behavioral Factors: Some feeding difficulties may be related to psychological factors, anxiety, or behavioral issues surrounding mealtime. These can be triggered by previous negative experiences or stressful events during feeding.
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Neurological Disorders: Children with certain neurological conditions, such as cerebral palsy, autism spectrum disorders, or brain injuries, may experience feeding difficulties due to the impact on muscle control and coordination.
How to Identify a Feeding Disorder in the Child?
One can suspect a feeding disorder if:
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There is a lot of trouble getting the child to eat.
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The child coughs, gags, or throws up frequently before, during, or after meals.
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The child needs to eat foods that are right for their age.
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The child is worried or scared about mealtime or trying new foods.
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The child shows a strong refusal to eat food.
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The child is either losing weight or not gaining weight.
How Are Feeding Disorders Treated?
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There is no quick fix for a food disorder or a straightforward method that works for everyone. The child might need to spend some time in the hospital if the feeding issue has gotten bad enough to be problematic. Many of today's treatments combine physiological assessment and care with behavioral therapy to help kids develop healthy eating habits.
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The treatment strategies will be based on the child's age, physical and cognitive capabilities, and particular swallowing and eating issues. Remember that some older children with concurrent intellectual disabilities, babies, and young children with feeding and swallowing difficulties frequently require intervention strategies that do not require them to follow straightforward verbal or nonverbal instructions. Intervention might include environmental alterations or indirect treatment modalities to increase feeding efficiency and safety in these situations.
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Professionals working with parents of children with feeding disorders might employ a variety of therapeutic approaches or combinations of treatments because patients react differently to various treatments. Among the most common are:
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Direct feeding through a feeding tube.
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Simple and direct medical care (for example, a medicine prescribed for reflux).
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Dietary adjustments (for example, different foods, adding calories to food).
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Temperature and texture adjustments for food.
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Positioning adjustments (for example, different seating).
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Conclusion:
It can be upsetting to know that the child has a feeding disorder, but being aware that the child has PFD may be pretty beneficial as a parent. Until now, parents of extremely picky eaters cannot understand or express to others the struggles their child is facing and have dealt with unsolicited advice that does not relate to or help the child. Instead, now that knowing the situation, one can start helping the child. However, children with PFD require specific care. Research suggests that 40 to 60 percent will not outgrow the diagnosis if they do not get it. That means their eating issues will continue. This usually has an impact on their social life also. So addressing PFD as soon as possible is important. It is easier if treated early. However, with appropriate therapies, teens and adults can overcome pediatric feeding disorders, even if they have been battling eating for many years.
