HEALTH EDUCATION, HYGIENE

AND FOOD
THEME II
 Feeding disorders in children

 Nº visits for feeding problems

✓ANOREXIA ✓BULIMIA ✓PICA ✓RUMINATION

✓“FOOD JAGS”

CAUSES
• Family disintegration → the child feels unsure of himself
• Attention seeking
• Existence of unhealthy behaviors at home
• Undefined limits from the parents’ side
 Feeding disorders in children

✓ANOREXIA
The child, even if hungry, refuses to eat

✓BULIMIA
The child initiates a vomit habit
The child eats only those foods that he likes

Predisposing factors
Being teased about size and shape
Conflicts between the parents
A sibling birth
Vital events
 Feeding disorders in children

✓PICA Intake of non-nutritive substances:

hair, wood, chalk, paint, sand, …
Duration: at least 1 month 10-32%
from 18-24 mo 1-6 yo

Unknown cause
Factors involved:
hunger, nausea, vomit,
digestive disturbances,  salivation,
smell and/or taste alterations
lack of Fe and/or Zn

In many cases, spontaneous resolution

 Feeding disorders in children

✓RUMINATION
Regurgitation and repeated chewing of food
No feeling of nausea and vomit
Duration: at least 1 month
Starting age: 3-12 mo

Typical posture: stretching and arching of the back, head

holding backwards, mouth sucking movements

This disorder provokes repulsion and discouragement of

caregivers, particularly in child-institutions.
Child contact avoidance may complicate the resolution of
this disorder.
 Feeding disorders in children

✓“FOOD JAGS”:
REFUSAL TO EAT AND SELECTIVE EATING

The child systematically refuses some foods

This disorder may cause nutritional deficits, growth delay,

hypercholesterolemia, as well as social and emotional
consequences.

In many cases, refusal starts after choking or having bad

experiences with certain foods

“Programa de Tratamiento Intensivo de Trastornos de la

Conducta Alimentaria” (In Madrid: Hospital del Niño Jesús)
 Feeding disorders in children

DIFFERENTIAL DIAGNOSIS

✓Bad habits
✓Forcing the child to eat always what we want
✓Feeding the child, even when the child can do it
himself

✓Forcing the child to eat the amount of food we

want, within the time we establish and at the time
we want

✓Forcing the child to eat more because we think

he does not eat well, even though the child is
healthy and with adequate weight and height
 Feeding disorders in children

“How does my child eat?”

“Eats badly, doesn’t he?”
“He has never eaten well”

Umm…. He eats well here …. Are

we talking about the same child?
 Feeding disorders in children

CHILDREN SHOULD BE:

✓Taught to accept a wide range of body silhouettes

✓Guided in the development of success-aimed skills, but
not based upon the body image

✓Taught healthy habits regarding feeding and physical

exercise, highlighting the negative effects of dieting

✓Taught ways to resist jokes about their weight

✓ Informed about the fact that weight gaining is normal
and necessary for development