Pediatric Eating / Feeding Disorders
What is a pediatric feeding / eating disorder?
A pediatric feeding disorder is a condition in which a child does not eat enough to provide adequate nutrition, calories or hydration. Feeding problems are considered to be pediatric feeding / eating disorders only if a child is safe to eat by mouth. If the child is experiencing physiological issues, which make eating or drinking unsafe, the feeding problem is not considered to be a pediatric feeding disorder, rather a medical issue unto itself.
A feeding disorder can be placed into three main categories: complete food refusal, selective (or picky) eating, or tube dependency. Each category can present different sets of symptoms or unique clusters of behavior.
Some children drink only water, will not open their mouth at mealtimes, and turn their heads when a spoon is presented at mealtime; while other children gag, cry and spit out food. Children do different combinations of behaviors (such as those listed in the feeding disorders symptom checklist below).
In these clusters or distributions of behavior, behavior deficits (e.g. not opening mouth enough during meal) or excesses (e.g. spitting food out) inhibit proper intake.
This makes it an imperative to treat each child with a feeding or eating problem as a unique case. Approaching all feeding/ eating problems with one protocol is inefficient and ineffective.
Etiology of pediatric feeding disorders
Pediatric feeding disorders originate from both organic and environmental variables, although in most occurrences the actual cause of the eating disorder is unknown or undeterminable.
Prevalence of pediatric feeding disorders
Recent statistics (source) reveal that one in four children have some sort of feeding disorder. This is reflective of a continuum of feeding problems. Not all problems are severe enough to warrant therapy. Some children will eat all kinds of food, but only three items from the vegetable group, while children on the other end of the spectrum will not consume anything at all.
Checklist of possible pediatric feeding disorder symptoms:
Spitting food out
Not opening mouth during feedings
Gagging during mealtimes
Coughing during mealtimes
Retching during mealtimes
Vomiting during mealtimes
Rumination during mealtimes
Not acting hungry
Drinking only water
Baby refuses to take significant amounts of formula through the bottle
Packing solids (keeping food in the mouth)
Pooling liquids (keeping liquids in the mouth)
Eating non-food items
Problems in eating chunkier textures
Refusal behaviors (turning the head, pushing away the spoon) during mealtimes
Throwing food, bowls, spoons from a table or highchair tray
Crying during mealtimes
Child is unusually picky in what he/she will eat
Child or toddler not drinking or not drinking enough
Baby or toddler only eats or drinks from a bottle
Child or toddler only eats or drinks from a syringe
Baby or toddler won't sit in high chair