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A Functional Approach to Feeding Difficulties in Children

  • Pediatric Gastroenterology (S Orenstein and S Khan, Sectior Editor)
  • Published:
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Abstract

Purpose of Review

This review provides an approach for resolving a variety of feeding difficulties in children, ranging from normal eating behavior that is misperceived as a problem to substantial feeding disorders.

Recent Findings

Criteria to identify pediatric feeding disorders have been thoroughly addressed in the newly established designations of avoidant restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD). These diagnostic criteria improve the accuracy of identifying, classifying, and managing significant feeding disorders in young children.

Summary

While recent definitions of feeding difficulties are particularly appropriate in multidisciplinary settings, in this paper, we advocate for a progressive approach of managing feeding problems in all clinical settings. It begins by identifying red flags indicative of serious threats to the child, screening for oral motor dysfunction, stabilizing nutrient intake, and eliminating aversive feeding practices. The next step, if eating behavior does not improve, involves strategies that target specific eating behaviors and parental feeding styles. In severe or resistant cases, referral to specialists or interdisciplinary feeding teams is advised.

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Authors and Affiliations

  1. College of Health & Human Sciences, Northern Illinois University, DeKalb, IL, 60115-2828, USA

    Kim Milano

  2. Department of Psychiatry, Children’s National Medical Health System, The George Washington School of Medicine and Health Sciences, Washington, DC, USA

    Irene Chatoor

  3. Department of Pediatric Gastroenterology, Hepatology and Nutrition, Children’s National Medical Health System, Professor of Pediatrics, The George Washington School of Medicine and Health Sciences, 111 Michigan Ave. NW., Washington, DC, 20010, USA

    Benny Kerzner

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  1. Kim Milano
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  2. Irene Chatoor
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  3. Benny Kerzner
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Correspondence to Benny Kerzner.

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Conflict of Interest

Kim Milano and Irene Chatoor report receiving honoraria from Abbott Laboratories for speaking at conferences related to feeding difficulties and disorders. The other author declares that there is no conflict of interest. Benny Kerzner carried out a clinical study 5 years ago to assess the ability of pediatricians to correctly classify young children with feeding problems in the office setting. The study was funded by Abbott Laboratories.

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Milano, K., Chatoor, I. & Kerzner, B. A Functional Approach to Feeding Difficulties in Children. Curr Gastroenterol Rep 21, 51 (2019). https://doi.org/10.1007/s11894-019-0719-0

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