Feeding and eating difficulties in early childhood – Characterization of a child psychiatry consultation
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v32.i3.26966Keywords:
child psychiatry, feeding difficulty, early childhood, eating disorder, mental healthAbstract
Introduction: Feeding difficulties in early childhood are among the most common problems reported by parents and may reflect the child’s own characteristics or a relational problem. They are associated with problems in later life, such as behavioral disorders, cognitive deficits, and eating disorders.
Materials and Methods: This study was a retrospective, descriptive analysis of sociodemographic and clinical data of children under six years of age with feeding or eating problems evaluated at a first consultation in a child psychiatry unit of a tertiary hospital between January 2019 and May 2021. Children with a diagnosis or suspected diagnosis of autism spectrum disorder were excluded.
Results: Of a total of 647 children evaluated, 57 (8.81%) were classified as having feeding difficulties. Their median age was 24.5 months. Food selectivity was the most frequently reported problem (45.6%), followed by difficulties in self-regulation at mealtimes (43.9%) and decreased appetite (33.3%). Among the mothers, 21% had a history of depressive disorders and 7% had a history of anxiety disorders. Forty-nine percent of children had patterns of interaction with their primary caregiver that were considered worrisome or disruptive. Fifty-four percent of the therapeutic interventions provided were child-parent psychotherapy.
Conclusions: Early identification and intervention are needed for children with feeding problems. Feeding problems are common in early childhood and a multidisciplinary approach must always be considered as they can affect several domains of the child’s health and development.
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References
Zero to Three. DC:0–5TM: Diagnostic classification of mental health and developmental disorders of infancy and early childhood. Washington, DC. 2016. p.99-109.
Borowitz KC, Borowitz SM. Feeding Problems in Infants and Children: Assessment and Etiology. Pediatr Clin North Am. 2018;65(1):59-72.
Kerzner B, Milano K, MacLean WC Jr, Berall G, Stuart S, Chatoor I. A practical approach to classifying and managing feeding difficulties. Pediatrics. 2015;135(2):344-53.
Chatoor I. Feeding disorders in infants and toddlers: diagnosis and treatment. Child Adolesc Psychiatr Clin N Am. 2002;11(2):163-83.
Zeanah C H Jr. Chapter 23: Eating and Feeding Disorders in Early childhood. In: The Guilford Press. Handbook of Infant Mental Health, Fourth Edition. The Guilford Press; 2018. p392-406.
Chatoor I, Ganiban J, Colin V, Plummer N, Harmon RJ. Attachment and feeding problems: a reexamination of nonorganic failure to thrive and attachment insecurity. J Am Acad Child Adolesc Psychiatry. 1998;37(11):1217-24.
Chatoor I, Egan J, Getson P, Menvielle E, O’Donnell R. Mother-infant interactions in infantile anorexia nervosa. J Am Acad Child Adolesc Psychiatry. 1988;27(5):535-40.
Chatoor I. Infantile anorexia nervosa: a developmental disorder or separation and individuation. J Am Acad Psychoanal. 1989;17(1):43-64.
Lucarelli L, Ammaniti M, Porreca A, Simonelli A. Infantile Anorexia and Co-parenting: A Pilot Study on Mother-Father-Child Triadic Interactions during Feeding and Play. Front Psychol. 2017;8:376.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. American Psychiatric Publishing; 2013.
Ainsworth MDS., Blehar MC, Waters E, Wall S. Measures and methods of attachment. In: Ainsworth MDS, Wall S, editors. Patterns of attachment: Psychological study of the strange situation. Hillsdale, New Jersey: L. Eerbaum Ass. Inc.; 1978.p.45–64
Benjasuwantep B, Chaithirayanon S, Eiamudomkan M. Feeding problems in healthy young children: prevalence, related factors and feeding practices. Pediatr Rep. 2013;5(2):38-42.
Sdravou K, Fotoulaki M, Emmanouilidou-Fotoulaki E, Andreoulakis E, Makris G, Sotiriadou F, et al. Feeding Problems in Typically Developing Young Children, a Population-Based Study. Children (Basel). 2021;8(5):388.
Machado BC, Dias P, Lima VS, Campos J, Gonçalves S. Prevalence and correlates of picky eating in preschool-aged children: A population-based study. Eat Behav. 2016;22:16-21.
Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth?. Pediatrics. 2007;120(4):e1069-e1075.
Carruth BR, Ziegler PJ, Gordon A, Barr SI. Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food. J Am Diet Assoc. 2004;104(1 Suppl 1):s57-s64.
Samuel TM, Musa-Veloso K, Ho M, Venditti C, Shahkhalili-Dulloo Y. A Narrative Review of Childhood Picky Eating and Its Relationship to Food Intakes, Nutritional Status, and Growth. Nutrients. 2018;10(12):1992.
Cheng TS, Loy SL, Toh JY, Cheung YB, Chan JK, Godfrey KM, et al. Predominantly nighttime feeding and weight outcomes in infants. Am J Clin Nutr. 2016;104(2):380-8.
Nakagawa M, Ohta H, Shimabukuro R, Asaka Y, Nakazawa T, Oishi Y, et al. Daytime nap and nighttime breastfeeding are associated with toddlers’ nighttime sleep. Sci Rep. 2021;11(1):3028.
Chatoor I, Ganiban J, Hirsch R, Borman-Spurrell E, Mrazek DA. Maternal characteristics and toddler temperament in infantile anorexia. J Am Acad Child Adolesc Psychiatry. 2000;39(6):743-51.
Yi SH, Joung YS, Choe YH, Kim EH, Kwon JY. Sensory Processing Difficulties in Toddlers With Nonorganic Failure-to-Thrive and Feeding Problems. J Pediatr Gastroenterol Nutr. 2015;60(6):819-24.
Davis AM, Bruce AS, Khasawneh R, Schulz T, Fox C, Dunn W. Sensory processing issues in young children presenting to an outpatient feeding clinic. J Pediatr Gastroenterol Nutr. 2013;56(2):156-60.
Milano K, Chatoor I, Kerzner B. A Functional Approach to Feeding Difficulties in Children. Curr Gastroenterol Rep. 2019;21(10):51.
Steinsbekk S, Bonneville-Roussy A, Fildes A, Llewellyn CH, Wichstrøm L. Child and parent predictors of picky eating from preschool to school age. Int J Behav Nutr Phys Act. 2017;14(1):87.
Dovey TM, Staples PA, Gibson EL, Halford JC. Food neophobia and ‘picky/fussy’ eating in children: a review. Appetite. 2008;50(2-3):181-93.
Aldridge VK, Dovey TM, Martin CI, Meyer C. Identifying clinically relevant feeding problems and disorders. J Child Health Care. 2010;14(3):261-70.
Cortés-García L, McLaren V, Vanwoerden S, Sharp C. Attachment, mentalizing, and eating disorder symptoms in adolescent psychiatric inpatients and healthy controls: a test of a mediational model. Eat Weight Disord. 2021;26(4):1159-68.
Cortés-García L, Takkouche B, Seoane G, Senra C. Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis. PLoS One. 2019;14(3):e0213099.
Eggert J, Levendosky A, Klump K. Relationships among attachment styles, personality characteristics, and disordered eating. Int J Eat Disord. 2007;40(2):149-55.
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