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 cords and can be cleared by patient through coughing to prevent aspiration.
- Oral motor disorder: inability to manipulate 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
- 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
- Congenital heart disease
- Cystic fibrosis
- Metabolic disorders
- Autism spectrum disorder
- Developmental delay/cerebral palsy
- Prolonged tube feeders (>4 weeks)
- Prematurity
- Neuromotor dysfunction
- Anatomic deformities (i.e., Pierre Robin sequence, laryngomalacia, tracheotomy, cleft palate)
- GI disorders: gastroesophageal reflux, eosinophilic esophagitis, celiac disease
- Tachypnea (respiratory rate >40 breaths per 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 foods offered match developmental readiness rather than chronologic age.
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Citation
Cabana, Michael D., editor. "Feeding Disorders." Select 5-Minute Pediatrics Topics, 7th ed., Wolters Kluwer Health, 2015. Medicine Central, im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14075/all/Feeding_Disorders.
Feeding Disorders. In: Cabana MDM, ed. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14075/all/Feeding_Disorders. Accessed June 2, 2023.
Feeding Disorders. (2015). In Cabana, M. D. (Ed.), Select 5-Minute Pediatrics Topics (7th ed.). Wolters Kluwer Health. https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14075/all/Feeding_Disorders
Feeding Disorders [Internet]. In: Cabana MDM, editors. Select 5-Minute Pediatrics Topics. Wolters Kluwer Health; 2015. [cited 2023 June 02]. Available from: https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14075/all/Feeding_Disorders.
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