Feeding Disorder

The term "feeding disorder" refers to a condition in which an infant or child is unable or refuses to eat, or has difficulty eating, which can result in frequent illnesses, failure to grow normally, and even death.  Feeding disorders should not be confused with eating disorders, such as anorexia, which are more common in adolescence and adulthood. Some common types of feeding disorders in children include adipsia, which is the absence of thirst or the desire to drink; dysphagia, a real or imagined difficulty in swallowing; food refusal; inability to self-feed; taking too long to eat; choking, gagging, or vomiting when eating; inappropriate mealtime behavior; and picky eating according to food type and texture.

The cause of feeding disorders are varied in nature.  It can be a result of a medical condition, digestive issues, motor based difficulties and/or a sensory based feeding disorder.  A medical based feeding disorder is diagnosed by a physician.  Motor-based and sensory-based feeding disorders will be diagnosed by an occupational therapist or speech-language pathologist.

Treatment is dependent upon the basis of the feeding disorder.  The team for medical treatment can include a pediatrician, gastroenterologist, nutritionist, behavioral psychologist, occupational therapist and speech-language pathologist.  

When a child has a motor-based or sensory-based feeding disorder an extensive assessment and  therapeutic plan will need to be provided by the attending therapist.  A physician may or may not be involved with this type of feeding disorder.  

Symptoms
  • Constipation
  • Excessive crying
  •  Excessive sleepiness (lethargy)
  • Poor weight gain
  • Irritability 
  • Weight loss
Exams 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:
  • Videofluroscopy (an x-ray procedure done to evaluate the swallowing function)
  • Feeding plan by an OT or ST outlining specific goals and objectives
  • Feeding therapy and home program
  • Increase the number of calories and amount of fluid in take
  • Correct any vitamin or mineral deficiencies
  •  Identify and correct any underlying physical illnesses or psychosocial problems 
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