Post by Laurel Chaisson on Mar 26, 2006 12:20:21 GMT -5
Eating and feeding difficulties occur on a continuum that begins at birth and that has the potential to follow us through our lives. Problems with feeding and weaning, fears and refusal, fads and selective patterns are the norm in pre-school children. In most instances the result of experimentation, stubbornness, imitation, food preferences, or benign phases, these behaviors will be outgrown, with or without parental intervention, and are not cause for concern. Some of these problems, however, may have adverse effects on the child’s physical and mental growth and development and have the potential to become lethal. Is your child in danger?
Not understanding what they see and experience in their child, parents are in danger of either catastrophizing problems that may not be overly serious, or ignoring problems that may need attention in order not to become a danger to the child’s health and well being. It is the child’s job to communicate feelings through symptoms; it is the parent’s to discern what these expressions mean in terms of the child’s needs, thereby heading off eating issues before they become problems.
In your very young child, the difficulties you see are most likely not the same type of eating disorder you have come to understand in the adolescent or the adult. Eating problems in the very young child generally bespeaks a degree of anxiety and compulsivity, as well as imitation of eating lifestyles modeled by parents and other adults. Eating disorders in adolescents and adults tend to be indicators of problems with identity and self-esteem, problem solving and coping, establishing controls and body image disturbances.
In the face of early childhood eating disorder, parents should beware of becoming involved with the dysfunctional behaviors rather than with the child and his or needs.
Parent’s Concerns
The following are excerpts from some letters I have received from concerned parents through www.empoweredparents.com who observe eating dysfunction in their young child.
• “In school, the kids are calling my six year old daughter a “cow” because she eats lunch. She won’t eat in front of other kids. She won’t wear shorts. I tell her she’s not fat but she says I “ have to say that” because I’m her mom. She used to be so outgoing. Now she is depressed and withdrawn.
• I have a six year old who has not eaten correctly for years. It’s not for lack of trying. We have tried many techniques, but to no avail. She takes over an hour to eat; she sits by herself at the table humming to herself averaging a bite every seven minutes. She also has developed a loud swallow, and she gags on dinner foods, but never on sweets.
• I have noticed my kindergartener throwing her lunch in the garbage and hiding some under her bed. She refuses to eat anywhere outside the house.
• Both my seven-year-old twins are off the charts for weight. They seem to have no self-control, so I feel it is my responsibility to monitor their quantities. My concern is that when they are older, my control over their intake could backfire, and they will develop some sort of disorder due to the limits set for them now. My husband was obese as a child.
• Our three-year-old granddaughter’s diet consists primarily of carbohydrates. She is a picky eater and won’t eat anything but pasta, fires and bread. She is crabby and cries about every little thing. I can’t calm her down and I know it’s because she hasn’t eaten anything all day.
• I am a second grade teacher and have concerns about a certain child who is losing weight quickly. I asked her if she was afraid to get fat and she said “yes,” and that “even her mom and grandmother were on diets.
The Childhood eating disorders
The following paradigm is taken from a book by Lask and Bryant-Waugh , called Anorexia Nervosa and Related Eating Disorders in Childhood and Adolescence.
• Food avoidance emotional disorder (FAED); An emotional disorder where food avoidance is the prominent feature. These are primarily mood, not food, disturbances. Food becomes the pathway through which the child expresses anxiety or depression.
• Functional dysphagia; fear of vomiting, swallowing or choking. An aversive event brings on this condition.
• Selective Eating. The child limits food intake to a very narrow range of preferred foods. Typically, these are foods that are high in carbohydrates. Weight is generally not adversely affected, and they do not share a preoccupation with weight and shape. Growth may be affected, and parental responses can lead to more problems.
• Restrictive Eating. These children eat little, don’t enjoy food, though show no mood disturbances. Though they do not actively avoid food, these children’s difficulties will be seen at puberty.
• Food refusal; refusal tends to be episodic, intermittent, or situational, affecting the quality of a child’s relationships
• Pervasive refusal syndrome; refusal to eat, drink, walk, talk, or care for themselves in any way over a period of months. Life threatening; requires hospital admission.
• Appetite loss due to depression
• Compulsive overeating
• Anorexia nervosa (and atypical and sub-clinical forms) Motivated by a fear of gaining weight, becoming fat.
• Bulimia nervosa (and atypical and sub-clinical forms.) Rare in childhood.
Feeding Disorders are seen in the infant or toddler’s refusal to eat. More information about feeding disorders may be obtained from contacting Dr. Cathleen Piazza 707N. Broadway, Baltimore, MD. 21205 or by checking out the www for Kennedy Krieger Institute or Marcus Institute.
Keep in mind that food preferences in children are normal. The key to dysfunction lies in the inflexible quality of the child and the refusal to consider change, not only in the area of food and eating, but in other areas of life as well. Oftentimes, obsessive compulsive behaviors in children that show themselves through food and eating are misconstrued as eating disorders.
© 2005, Abigail Natenshon
Not understanding what they see and experience in their child, parents are in danger of either catastrophizing problems that may not be overly serious, or ignoring problems that may need attention in order not to become a danger to the child’s health and well being. It is the child’s job to communicate feelings through symptoms; it is the parent’s to discern what these expressions mean in terms of the child’s needs, thereby heading off eating issues before they become problems.
In your very young child, the difficulties you see are most likely not the same type of eating disorder you have come to understand in the adolescent or the adult. Eating problems in the very young child generally bespeaks a degree of anxiety and compulsivity, as well as imitation of eating lifestyles modeled by parents and other adults. Eating disorders in adolescents and adults tend to be indicators of problems with identity and self-esteem, problem solving and coping, establishing controls and body image disturbances.
In the face of early childhood eating disorder, parents should beware of becoming involved with the dysfunctional behaviors rather than with the child and his or needs.
Parent’s Concerns
The following are excerpts from some letters I have received from concerned parents through www.empoweredparents.com who observe eating dysfunction in their young child.
• “In school, the kids are calling my six year old daughter a “cow” because she eats lunch. She won’t eat in front of other kids. She won’t wear shorts. I tell her she’s not fat but she says I “ have to say that” because I’m her mom. She used to be so outgoing. Now she is depressed and withdrawn.
• I have a six year old who has not eaten correctly for years. It’s not for lack of trying. We have tried many techniques, but to no avail. She takes over an hour to eat; she sits by herself at the table humming to herself averaging a bite every seven minutes. She also has developed a loud swallow, and she gags on dinner foods, but never on sweets.
• I have noticed my kindergartener throwing her lunch in the garbage and hiding some under her bed. She refuses to eat anywhere outside the house.
• Both my seven-year-old twins are off the charts for weight. They seem to have no self-control, so I feel it is my responsibility to monitor their quantities. My concern is that when they are older, my control over their intake could backfire, and they will develop some sort of disorder due to the limits set for them now. My husband was obese as a child.
• Our three-year-old granddaughter’s diet consists primarily of carbohydrates. She is a picky eater and won’t eat anything but pasta, fires and bread. She is crabby and cries about every little thing. I can’t calm her down and I know it’s because she hasn’t eaten anything all day.
• I am a second grade teacher and have concerns about a certain child who is losing weight quickly. I asked her if she was afraid to get fat and she said “yes,” and that “even her mom and grandmother were on diets.
The Childhood eating disorders
The following paradigm is taken from a book by Lask and Bryant-Waugh , called Anorexia Nervosa and Related Eating Disorders in Childhood and Adolescence.
• Food avoidance emotional disorder (FAED); An emotional disorder where food avoidance is the prominent feature. These are primarily mood, not food, disturbances. Food becomes the pathway through which the child expresses anxiety or depression.
• Functional dysphagia; fear of vomiting, swallowing or choking. An aversive event brings on this condition.
• Selective Eating. The child limits food intake to a very narrow range of preferred foods. Typically, these are foods that are high in carbohydrates. Weight is generally not adversely affected, and they do not share a preoccupation with weight and shape. Growth may be affected, and parental responses can lead to more problems.
• Restrictive Eating. These children eat little, don’t enjoy food, though show no mood disturbances. Though they do not actively avoid food, these children’s difficulties will be seen at puberty.
• Food refusal; refusal tends to be episodic, intermittent, or situational, affecting the quality of a child’s relationships
• Pervasive refusal syndrome; refusal to eat, drink, walk, talk, or care for themselves in any way over a period of months. Life threatening; requires hospital admission.
• Appetite loss due to depression
• Compulsive overeating
• Anorexia nervosa (and atypical and sub-clinical forms) Motivated by a fear of gaining weight, becoming fat.
• Bulimia nervosa (and atypical and sub-clinical forms.) Rare in childhood.
Feeding Disorders are seen in the infant or toddler’s refusal to eat. More information about feeding disorders may be obtained from contacting Dr. Cathleen Piazza 707N. Broadway, Baltimore, MD. 21205 or by checking out the www for Kennedy Krieger Institute or Marcus Institute.
Keep in mind that food preferences in children are normal. The key to dysfunction lies in the inflexible quality of the child and the refusal to consider change, not only in the area of food and eating, but in other areas of life as well. Oftentimes, obsessive compulsive behaviors in children that show themselves through food and eating are misconstrued as eating disorders.
© 2005, Abigail Natenshon