What is Nutrition Disorder in Infancy and Childhood?
Manifestations of eating disorders are specific to infancy and early childhood. These include refusal of food, extreme choosiness in the presence of an adequate quantity and quality of food and a lactating person; in the absence of organic disease. As a concomitant disorder, chewing gum “Rumination” (repeated spitting up without nausea and impaired functioning of the gastrointestinal tract) may be noted. This group includes a regurgitation disorder in infancy.
Causes of Nutrition Disorders in Infancy and Childhood
Several etiological factors are suspected (various disorders in the relationship between mother and child). As a result of inadequate relationships with the mother, the child does not receive enough emotional satisfaction and stimulation and is forced to seek satisfaction himself. The inability to swallow food is interpreted as an infant’s attempt to restore the nutrition process and provide satisfaction that the mother is not able to provide. Excessive stimulation and stress are considered as possible causes.
In this violation, a dysfunction of the autonomic nervous system plays a role. A number of children with this disorder have gastroesophageal reflux or a hiatal hernia, sometimes frequent regurgitation is a symptom of intracranial hypertension.
Prevalence
It is rare. It is observed in children from 3 months. up to 1 year and in mentally retarded children and adults. It is equally common among girls and boys.
Symptoms of Eating Disorders in Infancy and Childhood
Diagnostic criteria
Repeated burping without vomiting or concomitant gastrointestinal disease, lasting at least 1 month, after a period of normal function.
Weight loss or inability to achieve the desired body weight.
With obvious manifestations, the diagnosis is not in doubt. Partially digested food or milk enters the mouth again without vomiting, or retching. The food is then swallowed again or thrown out of the mouth. Characterized by a posture with tension and an arched back, head backward. The child makes sucking movements with his tongue, and it seems that he enjoys his activities.
The baby is irritated and hungry in the intervals between burping periods.
Usually, with this disease there are spontaneous remissions, but severe secondary complications can develop – progressive malnutrition, dehydration, or decreased resistance to infections. There are deterioration in well-being, increased underdevelopment or developmental delay in all areas. In severe cases, mortality reaches up to 25%.
The disorder can manifest as abnormal picky, atypical malnutrition, or overeating.
Diagnosis of Eating Disorders in Infancy and Childhood
Differentiate with a congenital anomaly or infections of the gastrointestinal tract, which can cause belching of food.
This disorder should be distinguished from:
- conditions when the child takes food from other adults than nursing persons or caregivers;
- an organic disease sufficient to explain refusal of food;
- anorexia nervosa and other eating disorders;
- general mental disorder;
- nutrition difficulties or nutritional disorders (R63.3).
Treatment of Nutrition Disorders in Infancy and Childhood
Complications (alimentary dystrophy, dehydration) are mainly treated.
It is necessary to improve the psychosocial environment of the child, to conduct psychotherapeutic work with persons caring for the child. Behavioral therapy with aversive conditioning is effective (at the time of the onset of the disorder an unpleasant substance is given, for example, lemon juice), this has the most pronounced effect.
Several studies report that if patients are given what they want to eat, the severity of the disorder decreases.