Feeding disorder of infancy and early childhood

Definition 
A feeding disorder of infancy or early childhood is the failure of a young child to obtain adequate nutrition, which is reflected by weight loss or a failure to gain weight appropriately for development.

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 chronic lung disease), or a mental condition (such as any disorder that causes mental retardation).

The cause of these disorders is often unknown, but they often 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 

     
  • Poor weight gain  
  • Weight loss  
  • Constipation  
  • Excessive crying  
  • Irritability  
  • Apathy

Signs and tests 

Physical examination is performed to evaluate for any medical illness that could cause or contribute to the problem. Evaluation of the growth curves for height, weight, and head circumference are 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. Instead, a multidisciplinary approach is required with pediatricians, outreach nurses, dietitians, social workers, behavior specialists, and parents working together 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.

Johns Hopkins patient information

Last revised: December 6, 2012
by Simon D. Mitin, M.D.

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