Feeding Disorders
Basics
Description
- Feeding disorder:
- Inability to consume by mouth in quantity or quality the nutrition that is developmentally appropriate for that child
- Dysphagia:
- Disorder of swallowing characterized by difficulty in oral preparation for the swallow or in moving food or liquid from the mouth to the stomach
- Aspiration:
- Food or fluid enters the trachea and passes through the vocal cords to lungs.
- Penetration:
- Food or fluid enters the trachea but remains above vocal cord
- However, food or fluid can be cleared by patient through coughing to prevent aspiration.
- Oral motor disorder:
- Inability to manipulate an age-appropriate diet
- Often related to incoordination of facial muscles and/or tongue
- Pharyngeal dysphagia:
- Inability to protect airway during swallow
- May be due to anatomic abnormality or neurologic dysfunction
- Avoidant restrictive food intake disorder (ARFID):
- As defined by the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5): a voluntary food or fluid refusal associated with maladaptive interactions at mealtimes; associated with learned fear when foods or textures are advanced before a child is developmentally or medically ready to swallow without dysfunction
Risk Factors
- Anatomic deformities (i.e., Pierre Robin sequence, laryngomalacia, tracheotomy, cleft palate)
- Autism spectrum disorder
- Congenital heart disease
- Cystic fibrosis
- Developmental delay/cerebral palsy
- GI disorders: gastroesophageal reflux disease (GERD), eosinophilic esophagitis, celiac disease
- Metabolic disorders
- Neuromotor dysfunction
- Prematurity
- Prolonged tube feeders (>4 weeks)
- Tachypnea (respiratory rate >40 breaths/minute)
General Prevention
- Monitor weight, height, head circumference, weight for height, and BMI percentiles at regular interval office visits to identify changes in nutritional status early, especially in high-risk populations.
- Selective eater: Educate parents on age-appropriate portion sizes and foods.
- Provide vitamin and mineral supplementation or refer to nutritionist for complete assessment if patient is at risk for deficiencies.
- Developmental delay: Evaluate diet and feeding skills to manipulate nutrition provided.
- Ensure that foods offered are matched to developmental readiness rather than to chronologic age.
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Citation
Cabana, Michael D., editor. "Feeding Disorders." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617686/all/Feeding_Disorders.
Feeding Disorders. In: Cabana MDM, ed. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617686/all/Feeding_Disorders. Accessed November 13, 2024.
Feeding Disorders. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult (8th ed.). Wolters Kluwer. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617686/all/Feeding_Disorders
Feeding Disorders [Internet]. In: Cabana MDM, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2024 November 13]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617686/all/Feeding_Disorders.
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