Diagnosis of disorders eating behavior Children are usually treated by a pediatrician, and only in rare cases by a pediatric nutritionist or occupational therapist. First of all, the specialist must find out the characteristics of the baby’s oral motor skills. He will research them on his own, but will first ask parents about their child’s skills.
In doing so, he will ask the following questions:
Can the baby wrap his lips tightly around the nipple or spoon? Can he keep his lips closed when he sucks from the breast or bottle or chews?
How would you describe your child's eating skills? Does the child know how to chew a bitten piece and gather food into a ball for swallowing? (If your child is unable to do this, you may notice that after swallowing, food remains in the recesses of the mouth or between the gums and cheeks).
Have you noticed that your child loses control of food and liquids before or during swallowing?
Can you describe how a child chews? There are two types of chewing: chomping and rotating. The clucking type means that the jaws move up and down, but the child does not make rotational movements with the jaws. This type of chewing is primitive, but rotational chewing is mature. Rotational chewing helps move food between the teeth and more efficiently collect it from the molars to the tongue before swallowing.
Can the child move his tongue to the sides of his mouth to move food around the mouth?
Can a child raise his tongue to the roof of his mouth?
Can a child form a dimple in the tongue when swallowing liquid?
The doctor uses this information to select foods that best suit the child's motor skills. He will also determine the type of therapy program your baby needs to strengthen the muscles of the face and mouth and improve their function. Your answers to these questions will also help determine whether your child may have a swallowing disorder.
It is also important for the doctor to ask about your child's breathing before, during, and after meals:
Does your child experience hasty swallowing while eating? Does it happen that he choke?
Does it happen that while swallowing a child chokes, coughs and gags?
Is there something about your baby's swallowing that worries you?
Is the baby breathing freely before he starts to eat?
Does his breathing become gurgling when he eats?
Does the child have wet breathing? (Wet breathing means your baby is breathing normally, but when he starts to eat, you can literally hear liquid and food pooling in his throat and causing a gurgling sound. Newborns may also experience wheezing in their chest.)
Does your child cough while eating?
What kind of breath does the child have after eating: clear, gurgling or moist? Does he have shortness of breath after eating?
This information, as well as what you have learned previously, will help you figure out whether your child's swallowing is appropriate and safe.
Sometimes a child plays by stuffing chew toys into his mouth, this is normal. Thus, the baby reduces his vomiting reflex, which gives him the opportunity to move to the next stage of nutrition. The gag reflex is triggered by irritation of the receptors on the surface of the tongue, its purpose is to protect the child from pushing objects into the throat that he could choke on. When a child plays, stuffing toys into his mouth, and hiccups at the same time, the trigger zone for this reflex moves further and further to the root of the tongue. This is why the gag reflex in adults is triggered only by irritation of the receptors in the throat.
The pediatrician will also ask you about the following:
How efficiently does your child swallow food and liquids?
Does your child need to swallow several times to clear their throat? If so, how many sips does it take?
Can you hear your baby breathing after swallowing?
Ultimately, the doctor will determine whether your child has mastered certain feeding skills and whether the following skills are causing you concern:
Drinking from a bottle;
Drinking from a cup (what type of cup do you use - open or with a lid and tip?);
Drinking through a straw;
Eating from a spoon (what type of spoon do you use?);
Eating with your hands;
Eating with appropriate items (spoon, etc.).
Each eating habit is based on those that the child mastered earlier, therefore, it is important for the expert to find out when the normal course of this process was interrupted. Your answers to the questions will help him understand this, and will also allow him to make appropriate recommendations for bottle, cup and spoon (if necessary).
Many children go through the picky stage at one age or another. Either they don’t want to try something new, then they refuse their once favorite food, or they don’t want to eat anything at all, turning their nose up at the plate and driving their parents crazy. This is normal and it doesn't last long. And although certain food cravings or aversions to a particular product may remain for a long time, most children outgrow pickiness by the age of 6. Most, but not all.
Matvey was one of those children whose picky eating never stopped. Moreover, over the years it became even more extreme. In fact, it is easier to list what he agreed to eat than what he refused, because he only ate five dishes. “At three years old,” says Matvey’s mother, “he only ate pancakes with condensed milk, mashed potatoes, cod, black bread and drank cocoa. He did not agree to any fruits, any cereals, any vegetables except potatoes, and no other methods of preparation. For example, fried potatoes he did not eat, just as he did not eat condensed milk separately from pancakes. Of course, we complained to the pediatricians. But they either thought that we had spoiled him and forbade us to feed him his favorite food, or they assured us that this was normal for his age and that he would eat himself if he was hungry."
All pediatricians love to repeat the mantra “A child will not starve himself to death” to the unfortunate parents of picky little ones. But Matvey almost managed to starve himself to death. When his parents, on the advice of pediatricians, began to limit him in his favorite foods, Matvey ate practically nothing for a whole week, and by the end of it he was so exhausted that he lay without getting up all the time. This is a classic case eating disorder, which most people haven't even heard of, but which actually exists and is called avoidant/restrictive food intake disorder (ARFID).
ARFID has little research yet, but experts warn that this extremely restrictive eating disorder can lead to serious health problems if a child is not treated promptly. In 2013, avoidant-restrictive eating disorder was officially added to the list of diseases in new edition Diagnostic and statistical manuals mental disorders(USA). Because the disorder is only recently recognized, few pediatricians recognize it and even fewer know how to treat it properly. Meanwhile, the problem is not as far-fetched as it might seem.
Potential consequences of avoidance-restrictive disorder
One of the symptoms of avoidance-restrictive disorder is the child's constant stress from the mention of food. Around these children, too much revolves around food in one way or another. So much so that any mention of food begins to make them anxious, cause stress and hinder their social life. They begin to communicate less because they cannot easily go with friends to the school canteen, to a cafe, to a birthday party, to a party, or just chat without the topic of food coming up. Thus, an eating disorder inhibits a child's social skills.
Another classic sign This disorder is an extremely limited diet. It is a constantly repeating set of 20-30 or less products, a categorical refusal to try anything new, even to the point of fear of new food. Many parents perceive this only as a feature of the child’s character, harmless pickiness, or even the beginnings of gourmetism, but the problem is that over time, more and more products begin to disappear from this already restrictive list. There are many cases where, as the child grew, this list gradually narrowed to ten or fewer “points.”
Physical health problems necessarily follow psychological ones. Even if a child does not appear malnourished or overweight, he is still suffering from malnutrition. Symptoms of such malnutrition include: fast fatiguability, dizziness, sensitivity to temperature changes and extreme temperatures(for example, the so-called freezing), headaches, numbness of the limbs, random pain of unknown origin. Often in such children due to a deficiency of vitamins, minerals and nutrients anemia, osteoporosis, insufficiency develops muscle mass, problems with the heart and blood vessels begin.
What is the cause of avoidance-restrictive disorder?
Unlike other eating disorders, ARFID has no connection with body image or the desire to lose weight. Often it is based on some traumatic situation from early childhood food related. For example, fear of choking if you have already had a similar experience. Fear of death from poisoning if any meal was followed by indigestion. Or even being in a prematurity cuvette with all those tubes inserted into your nose and mouth. On subconscious level the psyche rejects any food that somehow does not seem absolutely safe. The fear of death turns out to be stronger than fear hunger.
Is ARFID treatable?
Fortunately, despite the extreme manifestations, avoidance-restrictive disorder is quite treatable. The only problem is to find a doctor who would take this disorder seriously.
Since the basis is trauma, therapy must be approached with caution. What works for bulimia, anorexia, and binge eating disorder may be unhelpful and harmful for avoidant-restrictive disorder. If you go too far and force things, you can aggravate existing fears and even start a chain of new symptoms, creating a kind of vicious circle.
At the same time, with the right approach, ARFID can be easily overcome. Therapy is especially successful in adolescents who are most motivated to overcome the disorder that prevents them from fully communicating with peers. This is also a fundamental difference between ARFID and other eating disorders, in which adolescents are the most difficult group for therapy.
What should parents do if they suspect avoidance-restrictive disorder?
It is useless and even harmful to make your child feel guilty or ashamed in order to get him to eat more or try new foods. If your child is a picky child, don't tell him how much he's missing out on or how frustrating it is that he doesn't eat the same things as everyone else. Most likely, he himself already takes the current situation to heart and on a subconscious level feels guilty about it. While parents tend to emphasize the aspect physical health picky eating, its psychological consequences are often overlooked. Meanwhile, constant preoccupation with food can develop into a real mania if psychological stress the child himself is not taken into account.
And although it is difficult to cope with particularly advanced cases of pickiness without the help of professional nutritionists, a large share of success depends on the parents themselves. From their delicacy, unobtrusiveness and ability to recognize the problem in time. In the end, who else but they can understand their child. The main thing is not to rush and not give up.
What about Matvey? Now, at 13 years old, he is grateful to his mother for taking action in time and finding a child psychologist who was sympathetic to the problem. He himself hardly remembers the time when he ate only pancakes. Yes, he still loves them, but he doesn’t eat them every day or even every week. After all, there are still so many delicious things in life!
If we talk about the causes of eating disorders in children (not including newborns), there may be several of them:
- presence or beginning of development colds, rotavirus infection;
- presence of other pathological processes in organism;
- defects in the structure of the face and jaw;
- stressful conditions.
But the reasons listed indicate a decrease in appetite and the child’s refusal to eat. However, an eating disorder can also manifest itself as overeating. The manifestations of this form of eating disorder include: nervous and mental disorders.
Besides, similar violations may be associated with changes that have occurred in the brain and metabolic abnormalities.
Symptoms
Symptoms of a child having an eating disorder include:
- refusal of food;
- binge eating;
- change in taste preferences (perverted taste);
- decrease in summer weight or increase in body weight.
Signs of an eating disorder may be accompanied by other symptoms that may more clearly indicate the presence of a dysfunction of the organ or the whole system, or the presence of mental disorders in the child.
Diagnosis of an eating disorder
First of all, the doctor listens to the child and his parents, studying existing complaints about the patient’s eating behavior. Often a child, especially a teenager, does not see any problem, so it is important to talk with parents. Important information is how the child’s behavior changes during the day (maybe he eats at night), how long ago problems with eating behavior began and after what events.
- Next, the doctor analyzes the child’s life history. In a conversation with the parents, the doctor finds out whether there were any similar cases(hereditary factor), whether the child has had head injuries, whether he plays sports.
- An essential step if available warning signs is to perform a physical examination of the patient, during which the doctor determines the change in the child’s body weight. With prolonged lack of nutrition, the doctor notes such signs as pallor and dryness skin and mucous membranes. When overeating, the patient becomes obese, which can be at different stages.
- Among laboratory tests You may need to donate blood, feces, urine, often in connection with eating disorders called biochemical analysis blood, and a test to determine blood glucose.
You may also need the help of a neurologist, psychotherapist, dentist, jaw surgeon and other specialized specialists.
Complications
The presence of consequences of eating behavior in a child is due to a variant of this disorder.
- So, for example, if there is a decrease in appetite, a permanent decrease in body weight can occur, this complication can lead to cachexia (a state of serious exhaustion that is life-threatening), with increased appetite Obesity may occur.
- The integrity of the skin may be compromised; due to a lack of nutrients, cracks form on the skin with decreased appetite; when overeating, scars may appear on the skin due to quick stretch with a strong increase in the patient's body weight.
- The body's protective functions suffer (immunity weakens).
- Everyone's activities are disrupted internal organs due to lack useful substances or excess adipose tissue.
- Violated mental activity, for example: memory decreases, learning ability deteriorates, the speed of thinking slows down due to a lack of nutrients when refusing to eat.
- Feeling psychological discomfort, including sleep disturbance.
With timely medical care consequences and complications can be avoided.
Treatment
What can you do
If you notice unusual eating behavior in your child, you should consult a doctor. Is it not possible to force him to persuade him to eat something or, on the contrary, to abstain from food? Maybe the problem is not in his character, adolescence or personal taste, but much deeper?
Parents should be alerted to changes in the child’s weight, fixation on a certain idea related to nutrition, and aggressiveness when they try to convince him.
What does a doctor do
The main principle of getting rid of an eating disorder is to treat the cause of the disease.
Therefore, in each individual case, different methods are used. So, when refusing food, look at what reasons led to this. At physiological problems shown drug therapy, surgery may be prescribed.
If a child has a disability endocrine system, then the treatment is prescribed by an endocrinologist.
In case of psychogenic symptoms, the child must be observed and corrected by a psychiatrist or neurologist.
In case of overeating, diet therapy may be prescribed.
Prevention
Preventive measures They cannot completely eliminate the occurrence of this problem, but they will reduce the risk of their occurrence. It is necessary to ensure that the child sleeps properly, walks a lot, spends time on fresh air, healthy moderate physical exercise, it's important not to have bad habits teenagers All this can affect the child’s appetite and improve his eating behavior. An important aspect is stability psychological background. After all, sometimes eating disorders arise as a kind of protest against something.
Articles on the topic
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Show allArm yourself with knowledge and read a useful informative article about the disease of eating disorders in children. After all, being parents means studying everything that will help maintain the degree of health in the family at around “36.6”.
Find out what can cause the disease and how to recognize it in a timely manner. Find information about the signs that indicate you are feeling unwell. And what tests will help identify the disease and make a correct diagnosis.
In the article you will read everything about methods of treating such a disease as eating disorders in children. Find out what effective first aid should be. How to treat: choose medications or traditional methods?
You will also learn what can be dangerous untimely treatment the disease of eating disorders in children, and why it is so important to avoid the consequences. All about how to prevent eating disorders in children and prevent complications.
And caring parents will find on the pages of the service full information about the symptoms of eating disorders in children. How do the signs of the disease in children aged 1, 2 and 3 differ from the manifestations of the disease in children aged 4, 5, 6 and 7? What is the best way to treat eating disorders in children?
Take care of the health of your loved ones and stay in good shape!
In modern culture, such phenomena as healthy eating and lack of physical activity. Children are also susceptible to this. Experts say today's children are the first generation to have poorer health than their parents.
Moreover, when unhealthy eating is combined with a sedentary lifestyle and a culture that values thin bodies, it can lead to eating disorders. According to statistics, 23% of modern girls and 6% of boys suffer from them. Therefore, eating disorders pose a danger to the younger generation. Fortunately, parents are able to prevent them, but to do this it is necessary to intervene as early as possible. Intervention in adolescence, when children assert their right to independence, is less effective.
What can you do to prevent eating disorders in your child? First of all, help him develop healthy body and a healthy attitude towards it.
1. Help your child develop the right attitude towards his body
You should love your body, no matter what you see in the mirror. But under the influence of modern culture, many of us have obsession be thin. We judge ourselves greatly for not living up to this ideal image. So when we see a child begin to gain weight, all of our self-judgment kicks in and we project it onto the child, worrying that they will struggle with this for the rest of their lives. overweight. Unfortunately, children take on our fears and conclude that something is wrong with them. Parents should develop a healthier attitude towards their own bodies to avoid passing on feelings of shame and inferiority to their children.
2. Explain to your child how the media promotes an ideal body image that has nothing to do with reality.
Explain that images of models on the covers of glossy magazines are always processed in Photoshop and are simply unrealistic. Tell us how the modern beauty industry sets unrealistic beauty standards that people subsequently begin to focus on. Talk to your child about how good looks alone do not make a person happy.
3. Show your child an example of good nutrition.
Recognize that your child follows your example in everything. If you drink soda, your kids will too. If you prefer to nibble on carrots rather than chips for a snack, your kids will too. Children take over all your bad and good habits from you. Do you want to change your child and protect him from bad habits? Change your habits. Health, good vitality And appearance will be an additional reward for you in addition to good habits your children.
4. Don't talk about diets
Don't follow any diet, just eat healthy food. Do physical exercise permanent part Everyday life in your family. Research shows that diets do not give the desired results, but only lead to overeating later on. In addition, diets can change chemical composition body, which is why a person can gain weight again, and losing it the next time will be much more difficult. Only constant healthy eating and physical activity helps preserve optimal weight bodies.
If you want to teach your child self-control, start by teaching him to listen to his own body. Is he hungry or does he eat a lot just out of habit? If your child asks you for sweets, instead of saying “no,” tell your child that you will buy them for him next time: “The candy store will always be here. We will come here on special occasions, not every day.” Research shows that this approach teaches the child to make better decisions, while simply refusing leads to the fact that the child has a strong desire for sweets and, as a result, overeats when you buy them for him.
5. Don’t make fun of your child if he has gained excess weight - this will hurt his self-esteem
Instead, get him into regular physical activity and reduce the amount of sugar in his diet. If you decide that your child needs to lose weight, everyone in the family should follow a special diet. Changing eating habits is difficult for everyone, so don't expect your child to refuse treats that the rest of the family will eat.
6. Learn more about nutrition
Over the last century, the number of people who are overweight has increased, and this percentage continues to rise. At the same time, the percentage is growing various diseases. The reasons are a sedentary lifestyle, constant stress, overeating and an evolutionary tendency to eat more during periods of abundance.
However, nutritionists say that main reason overweight - processed foods. IN Lately people eat less saturated fat and more processed foods. Modern Products have a long shelf life. They are tasty, but less healthy. Their preparation uses hydrogenated fats, preservatives, corn syrup and carbohydrates, deprived of their nutritional properties. All this is very harmful to the body and leads to chronic diseases as we get older. But even from childhood they are addictive and inflammatory processes in organism.
And of course, most processed foods contain sugar. Research shows that more than 10% of our daily calories come from added sugar, which has negative effects on the entire body. As a result, more fat is deposited in the body than under the influence of other carbohydrates.
7. Avoid junk food and stock up on food.
Don't eat junk food or stock up on food unless special occasions. The whole family can suffer from this. If children see adults eating unhealthy food, they will follow suit. They will eat anything, sometimes in secret. Many teenage girls develop bulimia when they secretly eat ice cream and then start vomiting.
8. Encourage your child to eat vegetables
Children usually don't like new foods the first time. But sooner or later they get used to it. Research shows that children are more willing to eat foods that are already familiar to them.
9. Involve your child in sports
Every child needs regular physical activity. When girls play sports, they begin to feel positive about their bodies, and these attitudes continue throughout their lives. When children find a sport they enjoy, there is a high chance that this hobby will stay with them for many years. Instead of telling your child that exercise is necessary to lose weight, tell him that sports changes the body's biochemistry and makes us healthier and happier. Encourage your family to play sports together as a family every weekend.
10. Never comment on other people's appearance.
If you focus on how thin or fat people, then the child concludes that appearance is important and begins to think that people always pay attention to his appearance.
11. If you leave your child with a nanny, tell her what the child can and cannot eat.
Too strict an attitude towards a child causes him
a strong desire to secretly eat unhealthy foods. On the other hand, if the nanny allows him to eat chips and drink soda every day, this will negate all your attempts to teach him to eat healthy.
12. Raise your child
Raising your child can help you reduce the likelihood of your child becoming overweight as an adult.
13. Reduce stress
Children who have high level stress hormones, less physically healthy. They are also prone to overweight.
14. Watch less TV
Children who watch TV for 2 hours or more every day are more likely to be overweight and increased level cholesterol. Probably the reason is not only a sedentary lifestyle associated with watching television, but also advertising harmful products. Researchers say that children are highly susceptible to advertising, which is why many countries have banned advertising aimed at children (including television).