How to Tell If Your Child Has a Childhood Eating Disorder

For many families, meal timing can be a problem. Trying to get kids to try something other than the endless cycle of chicken nuggets, macaroni, and cheese can feel like endless negotiations. But while getting your kids to eat something healthy is just a stage for many families, some parents really go out of their way to feed their kids the right food.

Children diagnosed with Pediatric Eating Disorder (PFD) may feel painful when chewing and swallowing food. The Journal of Pediatric Gastroenterology and Nutrition defines this condition as “the inability to consume enough food and fluids to meet nutritional and hydration needs.”

One in 37 children under the age of five has PPF, but those born premature, on the autism spectrum, or with muscular dystrophy or cerebral palsy are at high risk. PFD can also hinder a child’s development and well-being. If you are unfamiliar with this condition, it is because it is just beginning to gain acceptance among pediatricians.

“There is some confusion in the medical community as well as in society in general about what an eating disorder is,” says Kyler Romeo, occupational therapist and pediatric nutritionist.

PFD versus fastidious eating habits

PFD is more than a child pushing food off a plate. This is a disruption in their feeding process, which prevents them from eating the same amount or types of foods as other children of their age. These symptoms can be associated with severe food allergies, reflux, or difficulty switching from breast milk to solid foods.

According to Romeo, there are signs that parents and caregivers can look out for while eating to help them distinguish fussy eating from something more serious:

  • Choking, vomiting, vomiting, or coughing while feeding
  • Refusing to eat or drink or showing strong food preferences
  • Difficulty maintaining nutritional levels or hydration
  • The child is dependent on one type of food, such as bottles, mashed potatoes, or snacks.
  • Fatigue while feeding
  • No weight gain or excessive weight gain
  • The child refuses to come to the table for eating.
  • Parents and caregivers feel stressed or depressed

If left untreated, symptoms can become disabling. Some cases of PFD are so severe that babies are tube-fed to get the nutrition they need to strengthen and grow . Feeding babies can still be challenging, Romeo said, despite treating PFO symptoms.

“If the swallowing was scary or associated with pain of any kind, the child might learn that the food is painful,” she says. “And once the symptoms have subsided and the baby can eat and swallow safely, it may have a delay in their feeding skills and it can be difficult to move on to the next set of foods to eat.”

How to get help

If you suspect your child is suffering from PFD, Romeo recommends starting with an online survey from the non-profit organization Feeding Matters. They worked with parents and doctors to develop an evidence-based tool to help caregivers identify which food choices or possibly PFO behaviors are.

After completing the questionnaire, send an email or bring the results to your provider to start a conversation about what your family’s next steps should be. And be patient with whoever you consult about your child’s symptoms, as both parents and doctors have only recently become more aware of the signs of PFD. However, Romeo urges parents not to be afraid to protect their child if they know something is wrong.

“The family can be people who bring new information,” says Romeo.

After your visit, Romeo encourages all parents to consider counseling. Ask yourself if your pediatrician heard and addressed your concerns. Did you both have a clear plan for moving forward? If the answer is no, keep asking questions or seek a different opinion.

“They may seek support from a dietitian or receive an assessment from a feeding therapist to determine if a child’s behavior is indicative of PFD,” she says. “The disorder spans the medical, nutritional and psychosocial areas. Families can talk to experts in any of these areas and express their concerns through a questionnaire. ”

She also emphasizes that it’s okay if your child has been diagnosed with PFO. Advocacy groups such as Feeding Matters offer resources and support to families, including coaching, webinars, and community events.


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