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Feeding disorder of infancy and early childhood

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Definition

A feeding disorder of infancy or early childhood is the failure of a young child to gain weight over time because he or she does not take in the proper amount of nutrients. However, no medical condition is causing the problem.

See also: Poor feeding in infants

Causes, incidence, and risk factors

Feeding disorders are diagnosed when the infant or young child appears malnourished and the problem is not caused by a medical condition (such as cleft palate, congenital heart disease, or long-term lung disease), or a disorder that causes mental retardation.

The cause of these disorders is often unknown, but they can result from a variety of factors such as poverty, dysfunctional child-caregiver interactions, or parental misinformation about appropriate diet to meet the child's needs.

Symptoms

  • Constipation
  • Excessive crying
  • Excessive sleepiness (lethargy)
  • Irritability
  • Poor weight gain
  • Weight loss

Signs and tests

The child will be evaluated for any medical illness that could cause or contribute to the problem. Evaluation of the growth curves for height, weight, and head circumference is important in any evaluation of feeding or weight problems.

Laboratory and imaging studies may be used to complete the medical workup but often are normal in children with growth problems.

Treatment

Depending on the severity of the condition, the following measures may be taken:

  • Increase the number of calories and amount of fluid the infant takes in
  • Correct any vitamin or mineral deficiencies
  • Identify and correct any underlying physical illnesses or psychosocial problems

A short period of hospitalization may be required to accomplish these goals.

Expectations (prognosis)

There is no quick cure for the majority of infants and children with feeding disorders. Most feeding disorders are mild and self-limited. A multidisciplinary approach involving pediatricians, outreach nurses, dietitians, social workers, behavior specialists, and parents is needed to improve the child's well-being and nutritional status.

Complications

Childhood malnutrition can permanently stunt mental and physical development if it is severe and long-lasting. Early treatment can prevent such complications.

Calling your health care provider

Call for an appointment with your pediatrician if you have concerns about your child's appetite, behavior, development, or growth.

Prevention

Following recommended guidelines for nutrition can help ensure adequate caloric and fluid intake for an infant. Regular well-child visits to your pediatrician can help identify any feeding and growth problems early and can prevent permanent damage related to malnutrition.

References

Moser SE, Bober JF. Behavioral problems in children and adolescents. In: Rakel RE, ed. Textbook of Family Medicine. 7th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 33.

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