Nutrition problems are seen in 3-11% of children. Not every eating problem should be considered a disorder. Because temporary eating problems in children are also common. Nutritional deficiency in developing countries, obesity in developed countries is seen as a common eating disorder.
Causes
1. Structural abnormalities (50-60%): cleft palate, esophageal stricture.
2.Neurological abnormalities (70-75%): mental disability, autism, muscle diseases, cerebral palsy.
3. Behavioral feeding difficulties (85%): Communication disorders between nurturer and nurturer, stubbornness, stimulus deficiencies, fears in children, depression in the child or caregiver, conditioned emotional reactions.
4. Circulatory and respiratory system problems (5-10%): Coordination in sucking/swallowing functions during feeding.
5. Metabolic problems (2-5%): Fructosentolerance.
In nutrition, the baby’s
capacity to recognize hunger, satiety and thirst, previous experiences in the feeding process, general health status, sensory structure and motor development characteristics are important. As environmental factors; The most important factor is the communication and attachment style of the baby with the individual who performs the feeding.
Feeding and eating disorders of infants or young children:
1. Rumination disorders
Repetitive removal and re-introduction of swallowed food for at least 1 month after a normal functioning period is chewing. There should be no biological factor explaining this behavior, and this should not occur during the course of anorexia nervosa and bulimia nervosa. In this disorder, stomach acid can cause serious damage to the oral mucosa, gums and cause pain. In this case, the course of treatment should be urgent.
2.Pica
It is the continuous consumption of non-edible food for at least 1 month. This edible substance should not be considered as a suitable substance to be eaten in that culture. It is common to accompany autism and especially severe, moderate and very severe mental disabilities. This disorder may also indicate that the child has been significantly neglected. It can cause important health problems such as parasitic infection, lead poisoning, growth and development retardation, anemia, intestinal obstruction.
WHAT SHOULD BE CONSIDERED AT THE DIAGNOSIS STAGE OF NUTRITIONAL DISORDERS IN BABIES OR YOUNG CHILDREN?
*Not gaining a significant weight or not eating enough continuously for at least 1 month with significant weight loss,
*No problem arising from the gastrointestinal tract (gastrointestinal reflux) to explain the eating disorder ,
*It must have started before the age of 6,
*The nutritional disorder must not have developed due to another mental disorder or food deprivation.
In the feeding problem seen in the baby in the first months (0-6 months) after birth; In addition to supporting existing biological problems, mother-infant communication should be focused on. If the mother has a mental problem such as depression, it should be treated, the mother’s self-confidence should be ensured in terms of providing care for the baby, and her concerns and thoughts of inadequacy should be eliminated. In this process, eating times should be fixed if possible with the person whose communication with the baby is more appropriate.
6-36 months babies; they start to gain autonomy on their own and try to eat with the spoon in their hands. In this period, it is important for the parents or primary caregivers to understand somatic sensations such as hunger and satiety and emotions such as anger and love. If the caregiver tries to feed him according to his own emotions and thoughts, other than his own somatic and emotional needs, problems begin to appear in his eating habits.
Childhood malnutrition may also develop after trauma. It usually has a sudden onset due to a drowning experience or illness/attempts. In this case, nutrition can also be associated with pain. Sometimes it takes liquid foods and rejects solids. Over time, the development of oral motor muscles slows down and the caregiver’s anxiety contributes to the development of additional eating and behavior disorders.
In children, aversion to food for sensory reasons develops around the age of 2 years.
