Eating disorders in children

Healthy eating provides a relationship between the child and the parent, in which the verbal and nonverbal signs are interpreted. This mutual relationship forms the basis of the emotional attachment between the child and his parents.

After the sixth month, the motor and cognitive development allows the baby to act more freely, both physically and emotionally. When the child takes up a spoon and begins to eat alone, the child’s “struggle for independence” begins. In other words, a conflict arises over who will take the spoonful from the child’s mouth at each meal. In these cases, meal times become a “battlefield” rather than an environment in which the child and the father communicate.

Nutrition development

It is a process in which the child and the parents actively participate 

The parent determines the food and advises the “where” and “when” to eat it, and the “how much” the child will eat.

As a child grows and matures, this distribution of tasks becomes more complex.

According to feeding skills and types of food, the child goes through some stages from birth;

The first 6 months: Breast milk is the main food source. No additional food items, including water, are recommended. In some special cases, food may be preferred, but the general diet is liquid foods

6-8 months: This is the period when juices, foods and semi-solid foods in the form of puree are added to the baby’s meals. This transmission may be in the fourth month in babies who are unable to consume breast milk or if they are fed a mixture of (breast milk + formula).

8-10 months: soft and lumpy food is used. As you transition to these different tastes, problems are reduced in the first six months compared to bottle-fed babies.

After the twelfth month: from bottle to spoon and self-feeding. A child can eat the same food as family members. Food preferences begin to emerge. Therefore, it is the period when nutritional problems occur most frequently .

Why is breast milk important? 

Breastfeeding gives the baby more control and the mother less control over time and quantity. The opposite is the case for those who are bottle-fed. It is reported that babies, who have control over their feeding, have no difficulty moving to the spoon.

The taste and smell of breast milk varies according to the content of the foods the mother eats. The baby can learn the flavors and aromas of different foods early through breast milk, the baby passes to foods of different taste and aroma more easily thanks to their previous experience. In newborns who started complementary food 6 months ago, fear of new food and restricted food consumption was 2.5 times higher than those who consumed breast milk; Results in studies determined that switching to breastfeeding and supplementary foods after 6 months reduced childhood food choice .

How often are feeding problems in infants and young children?

The frequency of feeding problems in infants and children with normal growth is 25-35%; This rate can increase to 33-80% in those with developmental delay.

Serious problems such as refusal to eat and vomiting occur in 1-2% of children.

What are normal and abnormal food behaviors and growth characteristics?

In the process of normal feeding, a decrease in appetite is observed after one year of life. Again in this period, an irregularity in the intake of nutrients during the day is normal. After the sixth month, especially after the age of 1 year, weight loss is expected. Given this, the family can feel anxious. Therefore the use of growth curves in the nutritional assessment is beneficial. A child’s growth curve is prepared by looking at the growth curves formed as a result of assessments of children who are developing normally for a specific age and gender. If the child goes along the same curve during the growth process, that is also normal.

Feeding problems that usually appear in infancy and early childhood; Refusal to eat (eating less / not eating at all), food choice (only a few types of food), less expected improvement in nutritional consistency (not switching to semi-solid / solid foods), lack of self-feeding, frequent vomiting, behavior Inappropriate during meal times (irritability, crying, outbursts of anger) can be summed up with problems swallowing or chewing.

In the research, data were obtained that girls have more problems eating, children who have eating problems have more siblings, and can focus less on their attention, and children who have eating problems have a higher percentage of working mothers. A history of eating problems in these families

What are the most common causes of feeding disorders in infants and children?

Reflection of problems in the relationship between mother and child; In the presence of a serious mental illness or an eating disorder in the mother or after the death of the mother

Post-accident food disorder: develops after an accident (during surgery or food leakage into the respiratory system) that may affect the mouth, throat or esophagus. Fear during breastfeeding in particular, of swallowing and choking.

Sensory rejection of eating: Against foods that have a specific taste, smell, appearance, or consistency. New food rejection attitudes and food selection behaviors are also common in these children.

Nutritional disorder associated with a medical condition (such as esophageal reflux or heart or lung disease)

Organic growth retardation: Delayed growth resulting from the direct effects of hormones that affect growth or hereditary causes

PICA syndrome (dust-and-sand intake syndrome)

It is the insistence on eating inedible substances. This behavior, which occurs at 12-24 months of age in normal development, causes various medical problems. It can cause intestinal obstruction most of the time due to malnutrition, anemia, diarrhea, constipation, infection, iron and zinc deficiency, and lead poisoning. This syndrome is found 5 times more frequently in individuals suffering from mental retardation. The following were identified as potential risk factors for gender: male, youthful age, mental retardation, autism, and schizophrenia. The severity of the disease is directly proportional to the severity of mental retardation. There are studies that have found a strong association with Pica syndrome in childhood and bulimia nervosa (bulimia) in adulthood.

Rumination syndrome

It is the frequent and voluntary repetition of stomach contents and chewing again. It is more common in boys than girls. It is rarely seen in normally developed children between the ages of 3 and 12 years. It can have mental retardation of any age. It can be seen with other eating disorders in adults without mental retardation. It may occur in the presence of an inappropriate psychosocial environment or in the first years of life in situations of inadequacy, limitations, lack of motivation and neglect in the relationships between the child and the mother. It can also be done for self-calming, fun, and grabbing mom’s attention. Ruminating is thought to stimulate the internal opioid system and provide relief in this way. In this respect, they are similar to stylized movements. There is a significant association with GERD. It is seen chronically in older children and adults. The main medical problems it causes are; Poor nutrition, mouth ulcers, tooth decay, esophagitis, choking, electrolyte loss, dehydration, weight loss and death. Death rates are reported to be 25%.