Hospitalization Can Correct Behavioral Feeding Disorders in Children by Resetting the Pedagogic Climate

Ellen van der  Gaag; Miriam  Münow

doi:10.4236/ojped.2014.42019

Ellen van der Gaag, Miriam Münow

Abstract: Background: Behavioral feeding disorders are common among children, which sometimes become progressive, and consequently, children may refuse to eat anything. Parents have lots of difficulties to reset such a disturbed eating pattern. The aim of this study was to perform an analysis of clinical intervention in behavioral feeding disorders in young children. Methods: We conducted a retrospective analysis of data of 28 children aged 1 - 9 years with behavioral feeding disorders. A pediatrician and pediatric social worker conducted the training in two groups: outpatient or inpatient setting. Both groups were treated with parental education and guidance. The inpatient group also had a temporarily (2 weeks) resetting of the pedagogic climate in a pediatric ward of a general hospital under guidance of a pediatric social worker. Results: Almost all parents were inconsistent in applying appropriate behavioral contingencies during meals. Eleven patients followed 8 months of outpatient treatment and 25 patients followed 2 weeks of inpatient treatment. The overall success rate of outpatient treatment after 2 weeks was 18%, and that of inpatient treatment after 8 months was 88%. The corrected relapse rates are 18% and 56% respectively after 6 months. Conclusion: Short clinical intervention in a structured pedagogic environment is a successful treatment in behavioral feeding disorders. Herewith, pediatricians have a powerful tool for treating behavioral feeding disorders by temporarily resetting and changing the pedagogic climate.

Keywords: Behavioral Feeding Disorder, Hospitalisation, Behavioral Contingencies, Pediatrics

Cite this paper: Gaag, E. and Münow, M. (2014) Hospitalization Can Correct Behavioral Feeding Disorders in Children by Resetting the Pedagogic Climate. Open Journal of Pediatrics, 4, 135-142. doi: 10.4236/ojped.2014.42019.

References

[1] Linscheid, T.R., Budd, K.S. and Rasnake, L.K. (2003) Pediatric Feeding Disorders. In: Robberts, M.C., Ed., Handbook of Pediatric Psychology, The guilford Press, New York, 481-498.

[2] Ramsay, M., Gisel, E.G., McCusker, J., Bellavance, F. and Platt, R. (2002) Infant Sucking Ability, Non-Organic Failure to Thrive, Maternal Characteristics, and Feeding Practices: A Prospective Cohort Study. Developmental Medicine & Child Neurology, 44, 405-414. http://dx.doi.org/10.1111/j.1469-8749.2002. tb00835.x

[3] Lindberg, L., Bohlin, G., Hagekull, B. and Thurnstrom, M. (1994) Early Food Refusal: Infant and Family Characteristics. Infant Mental Health Journal, 15, 262-277. http://dx.doi.org/10.1002/1097-0355 (199423)15:3<262::AID-IMHJ2280150303>3.0.CO;2-Q

[4] Satter, E. (1990) The Feeding Relationship: Problems and Interventions. Journal of Pediatrics, 117, S181-S189. http://dx.doi.org/10.1016/S0022-3476(05)80017-4

[5] Manikam, R. and Perman, J.A. (2000) Pediatric Feeding Disorders. Journal of Clinical Gastroenterology, 30, 34-46. http://dx.doi.org/10.1097/00004836-200001000-00007

[6] Singer, L. (1986) Long-Term Hospitalization of Failure-to-Thrive Infants: Developmental Outcome at Three Years. Child Abuse & Neglect, 10, 479-486. http://dx.doi.org/10.1016/0145-2134(86)90052-9

[7] Singer, L. (1987) Long-Term Hospitalization of Nonorganic Failure-to-Thrive Infants: Patient Characteristics and Hospital Course. Journal of Developmental & Behavioral Pediatrics, 8, 25-31. http://dx.doi.org/10.1097/00004703-198702000-00006

[8] Field, M. (1984) Follow-Up Developmental Status of Infants Hospitalized for Nonorganic Failure to Thrive. Journal of Pediatric Psychology, 9, 241-256. http://dx.doi.org/10.1093/jpepsy/9.2.241

[9] Goldstein, S. and Field, T. (1985) Affective Behavior and Weight Changes among Hospitalized Failure-to-Thrive Infants. Infant Mental Health Journal, 6, 187-193. http://dx.doi.org/10.1002/1097-0355 (198524)6:4<187::AID-IMHJ2280060402>3.0.CO;2-2

[10] Dahl, M., Rydell, A.M. and Sundelin, C. (1994) Children with Early Refusal to Eat: Follow-Up during Primary School. Acta Paediatrica, 83, 54-58. http://dx.doi.org/10.1111/j.1651-2227.1994.tb12952.x

[11] Dahl, M. and Sundelin, C. (1992) Feeding Problems in an Affluent Society. Follow-Up at Four Years of Age in Children with Early Refusal to Eat. Acta Paediatrica, 81, 575-579.
http://dx.doi.org/10.1111/j.1651-2227.1992.tb12303.x

[12] Marchi, M. and Cohen, P. (1990) Early Childhood Eating Behaviors and Adolescent Eating Disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 112-117.
http://dx.doi.org/10.1097/00004583-199001000-00017

[13] Kotler, L.A., Cohen, P., Davies, M., Pine, D.S. and Walsh, B.T. (2001) Longitudinal Relationships between Childhood, Adolescent, and Adult Eating Disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1434-1440. http://dx.doi.org/10.1097/00004583-200112000-00014

[14] Galler, J.R., Ramsey, F., Solimano, G., Lowell, W.E. and Mason, E. (1983) The Influence of Early Malnutrition on Subsequent Behavioral Development. I. Degree of Impairment in Intellectual Performance. Journal of the American Academy of Child and Adolescent Psychiatry, 22, 8-15.
http://dx.doi.org/10.1097/00004583-198301000-00002

[15] Galler, J.R., Ramsey, F., Solimano, G., Kucharski, L.T. and Harrison, R. (1984) The Influence of Early Malnutrition on Subsequent Behavioral Development. IV. Soft Neurologic Signs. Pediatric Research, 18, 826-832. http://dx.doi.org/10.1203/00006450-198409000-00004

[16] Galler, J.R., Bryce, C.P., Waber, D., Hock, R.S., Exner, N., Eaglesfield, D., Fitzmaurice, G. and Harrison, R. (2010) Early Childhood Malnutrition Predicts Depressive Symptoms at Ages 11-17. Journal of Child Psychology and Psychiatry, 51, 789-798. http://dx.doi.org/10.1111/j.1469-7610.2010.02208.x

[17] Reif, S., Beler, B., Villa, Y. and Spirer, Z. (1995) Long-Term Follow-Up and Outcome of Infants with Non-Organic Failure to Thrive. The Israel Medical Association Journal, 31, 483-489.

[18] Burklow, K.A., Phelps, A.N., Schultz, J.R., McConnell, K. and Rudolph, C. (1998) Classifying Complex Pediatric Feeding Disorders. Journal of Pediatric Gastroenterology and Nutrition, 27, 143-147.
http://dx.doi.org/10.1097/00005176-199808000-00003

[19] Bryant-Waugh, R., Markham, L., Kreipe, R.E. and Walsh, B.T. (2010) Feeding and Eating Disorders in Childhood. International Journal of Eating Disorders, 43, 98-111.

[20] Timimi, S., Douglas, J. and Tsiftsopoulou, K. (1997) Selective Eaters: A Retrospective Case Note Study. Child Care Health Development, 23, 265-278. http://dx.doi.org/10.1111/j.1365-2214.1997.tb00968.x

[21] Gentry, J.A. and Luiselli, J.K. (2008) Treating a Child’s Selective Eating through Parent Implemented Feeding Intervention in the Home Setting. Journal of Developmental and Physical Disabilities, 20, 63-70. http://dx.doi.org/10.1007/s10882-007-9080-6

[22] Chatoor, I. and Ganiban, J. (2003) Food Refusal by Infants and Young Children: Diagnosis and Treatment. Cognitive and Behavioral Practice, 10, 138-146. http://dx.doi.org/10.1016/S1077-7229 (03)80022-6

[23] Chatoor, I. (2002) Feeding Disorders in Infants and Toddlers: Diagnosis and Treatment. Child & Adolescent Psychiatric Clinics of North America, 11, 163-183. http://dx.doi.org/10.1016/S1056-4993 (01)00002-5

[24] The Dutch Nutrition Centre Foundation (2013) Age Appropriate Portions for Toddlers and Pre-Schoolers. https://www.voedingscentrum.nl/nl/schijf-van-vijf/schijf.aspx

[25] Braet, C., Tanghe, A., Decaluwe, V., Moens, E. and Rosseel, Y. (2004) Inpatient Treatment for Children with Obesity: Weight Loss, Psychological Well-Being, and Eating Behavior. Journal of Pediatric Psychology, 29, 519-529. http://dx.doi.org/10.1093/jpepsy/jsh054