Eating Concerns
NURTURE INFORMATION HUB
Evidence
https://naspghan.org/files/documents/pdfs/cme/jpgn/jpgn%20cme%202019/March%202019%20Article%20B.pdf
Jinhee Park, Suzanne M. Thoyre, Britt F. Pados, and Matt Gregas
Preterm infants are at high risk for oral feeding difficulties during the neonatal period. Early feeding difficulties can persist into childhood for children who were born preterm. Between the ages of 6 months and 7 years, both very preterm and moderate to late preterm children have greater symptoms of feeding problems compared to full-term children regardless of their current age or sex.
Education
Feeding problems in early childhood may impact a child’s growth and development and eating is a very social activity and this would make some children feel different and worry about what their peers think, as well as their family’s well-being especially at mealtimes.
There can be several concerns related to eating and feeding. These concerns may include:
Feeding difficulties: Oral motor difficulties, such as sucking, swallowing, and chewing. Some pre-schoolers may struggle with coordinating these movements, leading to difficulties in eating and drinking.
Sensory issues: Sensitive to sensory stimuli, including texture, taste, and temperature of foods. They may exhibit aversions to certain textures or foods, leading to challenges in mealtime behaviour and acceptance of a varied diet.
Oral aversions: Oral aversions due to negative experiences with feeding tubes, intubation, or medical procedures during their NICU stay. These aversions can impact their willingness to eat orally and may require specialized feeding interventions.
Growth and nutritional concerns: Growth delays or nutritional deficiencies due to feeding difficulties or medical complications.
Gastrointestinal issues: Preterm infants are at increased risk of gastrointestinal issues, such as reflux, gastroesophageal reflux disease (GERD), or gastrointestinal motility disorders. These conditions can affect feeding tolerance and may require medical management or dietary modifications.
Developmental delays: Feeding difficulties may be associated with developmental delays or sensory processing issues. Early intervention services, such as speech therapy or occupational therapy, may be beneficial in addressing these concerns.
Behavioural challenges: Mealtime behaviours, such as food refusal, tantrums, or mealtime battles, may arise because of feeding difficulties or sensory sensitivities. Positive mealtime strategies and a supportive feeding environment can help address these challenges.
Parental stress: Managing feeding difficulties can be stressful for parents. It's essential for parents to seek support from healthcare providers, feeding specialists, and other parents who have experienced similar challenges.
Feeding concerns in pre-schoolers requires a multidisciplinary approach, including close monitoring by healthcare providers, early intervention services, and support for both the child and their family. Early identification and intervention can help improve feeding outcomes and promote healthy growth and development.
One helpful tool that is available and helps to diagnosis these problems is, ‘The Paediatric Eating Assessment Tool (Pedi EAT).’ This Tool is a parent-report assessment of symptoms of problem feeding in children ages between 6 months and 7 years. This tool is used in assessments and for research studies, it helps to identify the symptoms of feeding problems in children born very preterm.
Empowerment
Firstly, if you feel that your child’s problem with eating is causing your child and you worry and anxiety it might be time to have this addressed by the healthcare professionals. Sometimes this will take more than one type of healthcare provider and there are a few things that you can do at home that are helpful until you have the support you need.
Create Small Short-Term Goals
You may be worried and pressured to fix this situation and when helping your child you may run the risk of pushing too hard or too fast. So small achievable goals are needed. If we set expectations too high, it can ultimately make everyone involved think that treatment is failing when it actually isn’t. Change can take time, small changes in behaviour over a period of time can help keep the child and yourself motivated.
Stay Focused as This Will Take Time
Slowly Exposing your child to new foods is not easy. It can cause some strong reactions to your child and yourself. It could be 15 exposures before your child even try’s a new food. Repeating this process will help to increase the familiarity and show your child that you believe in their ability to try this new food.
Take the Pressure Off
It is extremely important not to pressure your child to eat. This can cause anxiety around mealtimes and family stress and then may have the opposite effect of your child not wanting to eat. Try to follow the Elyn Satter Division of Responsibility at all mealtimes, where it is the parent’s job to decide what, where and when of eating and the child’s job to decide how much they would like to eat and if they would like to eat. Aim to make mealtimes fun so that your child wants to come to the dinner table.
Expose your Child to a Variety of Foods, even if they refuse it
Make sure your child always sees and is offered a variety of foods. Repeated exposure to a variety of foods is an important step to accepting new foods. Once a new food becomes accepted, it is important to keep that food in the in the mix of mealtime choices.
Involve Your Child in Food Preparation
Did you know there are 32 steps to eating and only one of them is actually putting it in your mouth and eating! One of the major steps to eating is interacting with food. Involve your child in growing food, preparing food, cooking food and playing with food. These are all positive steps towards the process of eating new foods.
Take Care of Yourself
It’s important to take the time to care for yourself making sure you are eating balanced diet, getting enough rest, and having your own support, when you are taking care of yourself some of the challenges will be easier to handle.
Useful Links
Raising Children
Better Health
https://www.betterhealth.vic.gov.au/health/healthyliving/eating-tips-for-preschoolers
Health Direct
https://www.healthdirect.gov.au/healthy-eating-for-children
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Disclaimer: This publication by Miracle Babies Foundation is intended solely for general education and assistance and it is it is not medical advice or a healthcare recommendation. It should not be used for the purpose of medical diagnosis or treatment for any individual condition. This publication has been developed by our Parent Advisory Team (all who are parents of premature and sick babies) and has been reviewed and approved by a Clinical Advisory Team. This publication is not a substitute for professional medical advice. Miracle Babies Foundation recommends that professional medical advice and services be sought out from a qualified healthcare provider familiar with your personal circumstances.To the extent permitted by law, Miracle Babies Foundation excludes and disclaims any liability of any kind (directly or indirectly arising) to any reader of this publication who acts or does not act in reliance wholly or partly on the content of this general publication. If you would like to provide any feedback on the information please email [email protected].
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