Skip to main content

Abstract

Adequate feeding represents an important function of regulation during childhood. Early, transient feeding problems are common among normally developing infants. Paediatricians and child neuropsychiatrists should recognize enduring feeding difficulties, since they cause negative effects on children’s growth and development. Feeding disorders (FD) might be the result of a lack of balance among parents’ feeding style, organic causes and child behaviour. FD present a clinical spectrum from mild to severe. Among FD, avoidant/restrictive food intake disorder (ARFID) represents a newly introduced diagnosis in the DSM-5. Patients with ARFID present restrictive eating behaviour, persistent difficulty in meeting nutritional needs, in the absence of body image disturbances. FD, as selective or scarce feeding, may represent a warning early sign suggesting an autism spectrum disorder (ASD). Children with ASD are five times more likely to manifest FD than their peers. The management of children with FD requires collaborative care of a multi-professional team. At the present time, behavioural therapy is the mainly supported treatment for FD in childhood.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Parmeggiani A. Gastrointestinal disorders and autism. In: Patel VB, Preedy VR, Martin CR, editors. Comprehensive guide to autism. Diet and nutrition in autism spectrum disorders. London: Springer; 2014. p. 2035–46.

    Google Scholar 

  2. Martini MG, Barona-Martinez M, Micali N. Eating disorders mothers and their children: a systematic review of the literature. Arch Womens Ment Health. 2020 Aug;23(4):449–67.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Kabasakal E, Özcebe H, Arslan UE. Eating disorders and needs of disabled children at primary school. Child Care Health Dev. 2020;46(5):637–43.

    Article  PubMed  Google Scholar 

  4. Kerzner B, Milano K, MacLean W, Berall G, Stuart S, Chatoor I. A practical approach to classifying and managing feeding difficulties. Pediatrics. 2015;135(2):344–53.

    Article  PubMed  Google Scholar 

  5. Organic RA. Nonorganic feeding disorders. Ann Nutr Metab. 2015;66(5):16–22.

    Google Scholar 

  6. Academy Quality Management Committee and Scope of Practice Subcommittee of Quality Management Committee. Revised 2012 standards of practice in nutrition care and standards of professional performance for registered dietitians. J Acad Nutr Diet. 2013;113(6):S29–45.

    Article  Google Scholar 

  7. Goh L, How C, Ng K. Failure to thrive in babies and toddlers. Singapore Med J. 2015;57(06):287–91.

    Article  Google Scholar 

  8. Rommel N, van Wijk M, Boets B, Hebbard G, Haslam R, Davidson G, Omari T. Development of pharyngo-esophageal physiology during swallowing in the preterm infant. Neurogastroenterol Motil. 2011;23(10):e401–8.

    Article  CAS  PubMed  Google Scholar 

  9. Schieve LA, Tian LH, Rankin K, Kogan MD, Yeargin-Allsopp M, Visser S, Rosenberg D. Population impact of preterm birth and low birth weight on developmental disabilities in US children. Ann Epidemiol. 2016;26(4):267–74.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Oskoui M, Coutinho F, Dykeman J, Jetté N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2013;55(6):509–19. Erratum in: Dev Med Child Neurol. 2016;58(3):316.

    Article  PubMed  Google Scholar 

  11. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association; 2013.

    Book  Google Scholar 

  12. Wittenberg J. Feeding disorders in infancy: classification and treatment considerations. Can J Psychiatry. 1990;35(6):529–33.

    Article  CAS  PubMed  Google Scholar 

  13. Reilly S, Skuse D, Wolke D, Stevenson J. Oral-motor dysfunction in children who fail to thrive: organic or non-organic? Dev Med Child Neurol. 2007;41(2):115–22.

    Article  Google Scholar 

  14. Manikam R, Perman J. Pediatric feeding disorders. J Clin Gastroenterol. 2000;30(1):34–46.

    Article  CAS  PubMed  Google Scholar 

  15. American Psychiatric Association, & American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association; 2000.

    Google Scholar 

  16. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

    Google Scholar 

  17. Chatoor I. Feeding disorders in infants and toddlers: diagnosis and treatment. Child Adolesc Psychiatr Clin N Am. 2002;11(2):163–83.

    Article  PubMed  Google Scholar 

  18. Chatoor I. Diagnosis and treatment of feeding disorders in infants, toddlers, and young children. Washington, DC: Zero to Three; 2009.

    Google Scholar 

  19. DC: 0-5 Zero to Three (2016). DC:0-5. Diagnostic classification of mental health and developmental disorders of infancy and early childhood. Washington, DC, Zero to Three (tr. it.: Zero to Three (2018). DC:0-5. Classificazione diagnostica della salute mentale e dei disturbi di sviluppo nell’infanzia Roma, Giovanni Fioriti).

    Google Scholar 

  20. Zeanah CH, Carter AS, Cohen J, Egger H, Gleason MM, Keren M, Lieberman A, Mulrooney K, Oser C. Diagnostic classification of mental health and developmental disorders of infancy and early childhood DC:0-5: selective reviews from a new nosology for early childhood psychopathology. Infant Ment Health J. 2016;37(5):471–5.

    Article  PubMed  Google Scholar 

  21. Bryant-Waugh R. Feeding and eating disorders in children. Psychiatr Clin North Am. 2019;42(1):157–67.

    Article  PubMed  Google Scholar 

  22. Claudino A, Pike K, Hay P, Keeley J, Evans S, Rebello T, et al. The classification of feeding and eating disorders in the ICD-11: results of a field study comparing proposed ICD-11 guidelines with existing ICD-10 guidelines. BMC Med. 2019;17(1)

    Google Scholar 

  23. Hudson LD, Chapman S. Paediatric medical care for children and young people with eating disorders: achievements and where to next. Clin Child Psychol Psychiatry. 2020;25(3):716–20.

    Article  PubMed  Google Scholar 

  24. Zimmerman J, Fisher M. Avoidant/restrictive food intake disorder (ARFID). Curr Probl Pediatr Adolesc Health Care. 2017;47(4):95–103.

    Article  PubMed  Google Scholar 

  25. Eddy K, Thomas J, Hastings E, Edkins K, Lamont E, Nevins C, et al. Prevalence of DSM-5 avoidant/restrictive food intake disorder in a pediatric gastroenterology healthcare network. Int J Eat Disord. 2014;48(5):464–70.

    Article  PubMed  Google Scholar 

  26. Kurz S, van Dyck Z, Dremmel D, Munsch S, Hilbert A. Early-onset restrictive eating disturbances in primary school boys and girls. Eur Child Adolesc Psychiatry. 2014;24(7):779–85.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Zanna V, Criscuolo M, Mereu A, Cinelli G, Marchetto C, Pasqualetti P, Tozzi AE, Castiglioni MC, Chianello I, Vicari S. Restrictive eating disorders in children and adolescents: a comparison between clinical and psychopathological profiles. Eat Weight Disord. 2020;

    Google Scholar 

  28. Nicely T, Lane-Loney S, Masciulli E, Hollenbeak C, Ornstein R. Prevalence and characteristics of avoidant/restrictive food intake disorder in a cohort of young patients in day treatment for eating disorders. J Eat Disord. 2014;2(1):21.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Norris M, Robinson A, Obeid N, Harrison M, Spettigue W, Henderson K. Exploring avoidant/restrictive food intake disorder in eating disordered patients: a descriptive study. Int J Eat Disord. 2013;47(5):495–9.

    Article  PubMed  Google Scholar 

  30. Fisher M, Rosen D, Ornstein R, Mammel K, Katzman D, Rome E, et al. Characteristics of avoidant/restrictive food intake disorder in children and adolescents: a “new disorder” in DSM-5. J Adolesc Health. 2014;55(1):49–52.

    Article  PubMed  Google Scholar 

  31. Hartdorff C, Kneepkens C, Stok-Akerboom A, van Dijk-Lokkart E, Engels M, Kindermann A. Clinical tube weaning supported by hunger provocation in fully-tube-fed children. J Pediatr Gastroenterol Nutr. 2015;60(4):538–43.

    Article  PubMed  Google Scholar 

  32. Otasowie J, Paraiso A, Bates G. Pervasive refusal syndrome: systematic review of case reports. Eur Child Adolesc Psychiatry. 2020;27:1–13.

    Google Scholar 

  33. Ledford J, Gast D. Feeding problems in children with autism spectrum disorders. Focus Autism Other Dev Disabil. 2006;21(3):153–66.

    Article  Google Scholar 

  34. Sharp W, Berry R, McCracken C, Nuhu N, Marvel E, Saulnier C, et al. Feeding problems and nutrient intake in children with autism spectrum disorders: a meta-analysis and comprehensive review of the literature. J Autism Dev Disord. 2013;43(9):2159–73.

    Article  PubMed  Google Scholar 

  35. Jacopo Pruccoli, Altea Solari, Letizia Terenzi, Elisabetta Malaspina, Marida Angotti, Veronica Pignataro, Paola Gualandi, Leonardo Sacrato, Duccio Maria Cordelli, Emilio Franzoni, Antonia Parmeggiani. PREPRINT (Version 1) available at Research Square. https://doi.org/10.21203/rs.3.rs-122221/v1.

  36. Marí-Bauset S, Zazpe I, Marí-Sanchis A, Llopis-González A, Suárez-Varela M. Anthropometric measurements and nutritional assessment in autism spectrum disorders: a systematic review. Res Autism Spectr Disord. 2015;9:130–43.

    Article  Google Scholar 

  37. Parmeggiani A, Corinaldesi A, Posar A. Early features of autism spectrum disorder: a cross-sectional study. Ital J Pediatr. 2019;45(1):144–51.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Emond A, Emmett P, Steer C, Golding J. Feeding symptoms, dietary patterns, and growth in young children with autism spectrum disorders. Pediatrics. 2010;126(2):e337–42.

    Article  PubMed  Google Scholar 

  39. Schmitt L, Heiss C, Campbell EA. Comparison of nutrient intake and eating behaviors of boys with and without autism. Top Clini Nutr. 2008;23(1):23–31.

    Article  Google Scholar 

  40. Schreck K, Williams K. Food preferences and factors influencing food selectivity for children with autism spectrum disorders. Res Dev Disabil. 2006;27(4):353–63.

    Article  PubMed  Google Scholar 

  41. Allen S, Smith I, Duku E, Vaillancourt T, Szatmari P, Bryson S, et al. Behavioral pediatrics feeding assessment scale in young children with autism spectrum disorder: psychometrics and associations with child and parent variables. J Pediatr Psychol. 2015;40(6):581–90.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Cannell J. Autism and vitamin D. Med Hypotheses. 2008;70(4):750–9.

    Article  CAS  PubMed  Google Scholar 

  43. Dovey T, Kumari V, Blissett J. Eating behaviour, behavioural problems and sensory profiles of children with avoidant/restrictive food intake disorder (ARFID), autistic spectrum disorders or picky eating: Same or different? Eur Psychiatry. 2019;61:56–62.

    Article  PubMed  Google Scholar 

  44. Benoit S, Davis J, Davidson T. Learned and cognitive controls of food intake. Brain Res. 2010;1350:71–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Addison L, Piazza C, Patel M, Bachmeyer M, Rivas K, Milnes S, et al. A comparison of sensory integrative and behavioral therapies as treatment for pediatric feeding disorders. J Appl Behav Anal. 2012;45(3):455–71.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Peterson C, Becker C, Treasure J, Shafran R, Bryant-Waugh R. The three-legged stool of evidence-based practice in eating disorder treatment: research, clinical, and patient perspectives. BMC Med. 2016;14(1)

    Google Scholar 

  47. Arvedson J, Clark H, Lazarus C, Schooling T, Frymark T. The effects of oral-motor exercises on swallowing in children: an evidence-based systematic review. Dev Med Child Neurol. 2010;52(11):1000–13.

    Article  PubMed  Google Scholar 

  48. Edwards C, Walk A, Thompson S, Mullen S, Holscher H, Khan N. Disordered eating attitudes and behavioral and neuroelectric indices of cognitive flexibility in individuals with overweight and obesity. Nutrients. 2018;10(12):1902.

    Article  PubMed Central  Google Scholar 

  49. Morris N, Knight R, Bruni T, Sayers L, Drayton A. Feeding disorders. Child Adolesc Psychiatr Clin N Am. 2017;26(3):571–86.

    Article  PubMed  Google Scholar 

  50. Brewerton T, D’Agostino M. Adjunctive use of olanzapine in the treatment of avoidant restrictive food intake disorder in children and adolescents in an eating disorders program. J Child Adolesc Psychopharmacol. 2017;27(10):920–2.

    Article  CAS  PubMed  Google Scholar 

  51. Sant’Anna A, Hammes P, Porporino M, Martel C, Zygmuntowicz C, Ramsay M. Use of cyproheptadine in young children with feeding difficulties and poor growth in a pediatric feeding program. J Pediatr Gastroenterol Nutr. 2014;59(5):674–8.

    Article  PubMed  CAS  Google Scholar 

  52. Sharp W, Volkert V, Scahill L, McCracken C, McElhanon B. A systematic review and meta-analysis of intensive multidisciplinary intervention for pediatric feeding disorders: how standard is the standard of care? J Pediatr. 2017;181:116–124.e4.

    Article  PubMed  Google Scholar 

  53. Couturier J, Isserlin L, Norris M, et al. Canadian practice guidelines for the treatment of children and adolescents with eating disorders. J Eat Disord. 2020;8:4. Published 2020 Feb 1. https://doi.org/10.1186/s40337-020-0277-8.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Perrone A, Aruta SF, Crucitti G, et al. Pervasive refusal syndrome or anorexia nervosa: a case report with a successful behavioural treatment. Eat Weight Disord. 2020; https://doi.org/10.1007/s40519-020-00991-8.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Antonia Parmeggiani .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Parmeggiani, A., Pruccoli, J. (2022). Eating Disorders in Infants and Toddlers. In: Manzato, E., Cuzzolaro, M., Donini, L.M. (eds) Hidden and Lesser-known Disordered Eating Behaviors in Medical and Psychiatric Conditions . Springer, Cham. https://doi.org/10.1007/978-3-030-81174-7_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-81174-7_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-81173-0

  • Online ISBN: 978-3-030-81174-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics