Whether at breakfast, lunch or dinner. In almost all families with young children episodes of tension during meals are the order of the day. Either the children do not like what is offered to them, or they prefer to play at sitting at the table, so getting them to eat sometimes becomes an all-out fight. But it is estimated that between 20% and 40% of healthy children have some feeding difficulty, because the child always rejects some foods, refuses to try new foods or eats few amounts and incorrect perceptions by parents are included in that percentage. And of that percentage, between a 1% to 5% of cases there is a true disorder of feeding (TA). It is a problem that has nothing to do with the desire to meet the canons of beauty that generate anorexia or bulimia, usually in adolescents. These are disorders that usually appear between 0 and 6 yearsbeing more frequent under 3 years of age, especially when it is passed from nursing to spoon or from ground to solid food.
In 1994, these problems were first introduced in a manual as part of the mental disorders and since then there have been several attempts at classification by the scientific community. However, specialists currently use a division that groups difficulties andn three big groups: First of all, the children who they eat littleThey are hardly ever hungry and have zero interest in food. Sometimes the reason is not found and others it is caused by an organic disease or psychological problems.
Second, minors with selective intake, that is, they only eat certain foods and reject the rest. Sometimes the rejection does not have to do with being offered vegetables, fruit or fish, the foods that children generally eat worse, but rather that they usually reject the food for its texture, smell, temperature or appearance. Autism sometimes causes this type of selective eating. Third, there are children with fear of eating or that generates anxietya problem usually caused by a traumatic experience related to feeding such as choking or because they have been forced incorrectly.
But how do you know if a child has a problem or disorder of this type if these behaviors appear mildly or intermittently? “You should always consult the pediatrician”, answers Samuel Héctor Campuzano, a member of the gastroenterology working group of the SEPEAP medical society. The specialist acknowledges that a few years ago pediatricians used to “play down” these problems but now, thanks to periodic and regulated check-ups, which allow contrasting the child’s evolution, “more are diagnosed” and health professionals place more emphasis on finding a solution to difficulties that in almost 90% of cases they are cured “with the appropriate therapy”.
Pain when swallowing, cough when eating
Campuzano explains that there are some “alarm” indicators that parents or paediatricians should call attention to, such as when “meals are hell, the child has an extreme fixation on food, has pain when swallowing, coughing when eating, or vomiting frequently or when, after a serious event, he stops eating well.” In most cases, the problem can be resolved at the pediatrician’s office with a treatment for the disease that causes the eating difficulty; either a treatment or nutritional advice, as well as behavioral patterns to reduce the stress caused by the situation in the parents or children and gradually manage to redirect the situation. To do this, it is recommended time stamps and avoid snacking between meals, in order to stimulate appetite and use “individualized positive and negative reinforcement”. Sometimes families resort to having the child eat in front of him.to television or mobile. “It’s easy, but it’s counterproductive”, says the pediatrician. As for giving them prizes if they have eaten well, “it can be useful in certain cases, such as giving them a food that they like as a reward but a toy is not a good idea.”
the emotional problem
And for them to try new foods, there is nothing else to do “multiple attempts, go little by little, present the foods that they do not like in pleasant formats, that they participate in the preparation, use sauces, suggestive names…”. But it is important that parentsdon’t yell, don’t get angry and always show a pleasant attitude towards food”, he points out. However, if the problems persist, the case has to be referred to a specialized unit in eating disorders, in which interdisciplinary teams made up of speech therapists, psychologists and specialized paediatricians work and where individual or group therapies are carried out. Pediatrician Elvira Cañedo works in one of these reference units, located in the Niño Jesús Hospital in Madrid, and explains that there is a disorder that requires specialized care when it is detected in a child “malnutrition or alteration in psychomotor development”, but also when the situation generates a “emotional problem” important for parents or minors. And there are parents who can “force feeding so inappropriately” that can generate anxiety and fear of food in the child. Dr. Cañedo explains that in the case of children who eat little, parents should not be obsessed with quantity, but with “quality”, that is, “allow them to eat little but insist, not force, on offering variety and that they eat of everything”. “If you act precociously, it is not necessary to go to a specialized unit”, he concludes.