Feeding difficulties is a very broad term to cover many aspects of infant and childhood feeding and eating, encompassing many aspects of both normal childhood patterns through to pathological states.
A history for feeding difficulties needs to consider the various problems often encountered relative to the child's age:
- normal toddler eating patterns: grazing, refusal to eat many food types, tantrums, gagging and sometimes vomiting, establishing autonomy
- excessive milk intake (leading to poor appetite and iron deficiency)
- sensory problems, behavioural difficulties or autism spectrum disorders manifesting as eating difficulties
It remains important to exclude symptoms or signs that may suggest underlying organic disease, e.g. anatomical anomalies, peristaltic problems, gastrointestinal disease (celiac disease, IBD, etc.), malignancy.
- A history for feeding difficulties needs to consider the various problems often encountered relative to the child's age.
- Management is often multidisciplinary for feeding difficulties.
- It is critical to understand normal childhood eating patterns and difficulties, as well as reasonable nutritional information, in order to determine those children in whom abnormalities exist.
Investigation and management of feeding difficulties will be guided largely by the age of the child, underlying cause and severity of the problem.
Management is often multidisciplinary for feeding difficulties.
It is critical to understand normal childhood eating patterns and difficulties, as well as reasonable nutritional information, in order to determine those children in whom abnormalities exist (see Other Resources below).
- Many feeding difficulties in children can be adequately managed without the need for paediatric input.
- The Paediatric Feeding Clinic at Ballarat Health Services encompasses paediatrician along with dietitian and speech pathology.
- Referral to paediatric outpatient services can be considered in the management of feeding difficulties when underlying medical concerns are present, such as disability, failure to thrive, cow's milk protein intolerance, suspected eating disorders, etc.
- Dietitian and speech pathologist
- Severe feeding difficulties with strong emotional and behavioural components in infants and toddlers may require input from mental health services.
- Other resources