Come riconoscere un feeding disorder

Abstract

Feeding disorders (FDs) are a large group of behaviours characterized by selectivity, inadequate intake and refusal of food. These disorders are frequent in children (10-15% < 3 years old) and their causes are multiple and variably combined. FDs have a significant impact in everyday life for the child, their family and caregivers inside or outside the school environment. In the last few years in the Department of Paediatric Dysphagia in Bologna (Italy) an increase in the number of healthy children with insufficient oral intake or extremely selective food behaviour, due to selecting in type, texture, smell or appearance of food, has been observed. These children tend to develop dysfunctional or oppositional behaviours during mealtime. This growing need requires the implementation of a network with local paediatricians that focalize the feeding disorder and refer the family to a multidisciplinary assessment. The multidisciplinary team identifies behavioural strategies, structural changes to the mealtime and at the same time introduces intervention for the sensorial normalization. The primary goal is the caregivers’ training: parents and school staff are constantly supported as they offer the child new, different, pleasant and adequate food proposals, avoiding to stop at first refusal. Parent training plays a significant role during such intervention, as it reduces mealtime stress and improves child-parent relationship. The introduction of new strategies during mealtime in a playful, positive and cheerful setting encourages the child’s willingness to taste new foods or new textures. Moreover, their peer and parent modelling improves the outcome.