Mechanistic feeding as cause for feeding difficulties

I am all for a child having a routine, in particular if this means children get all their nutrients and parents feel relaxed that they have had enough food.

The problem is, when feeding becomes so scheduled that it ignores the natural appetite and satiety of a child. If you were to perform a search on “Dr Google” on feeding schedules for babies, you will find anything from a 3 meal to a 9 meal schedule with breast or bottle feeds in between.

It is important to get to know your child’s appetite and satiety, instead of following a schedule that has been put together without taking your child’s appetite into account. Some children need only 3 meals per day and snacks reduce the meal volume and other actually do better with 3 smaller meals and 3 snacks. What is crucial is to listen to what your child is signalling. Trust your baby, they will signal hunger and satiety and show you when they are hungry.

Evidence has shown that if you “disrespect” the satiety of your child and feed just according to a schedule (i.e. “they must eat at a specific time”), that eating becomes a negative experience. In addition, we do not want to teach our children to override natural satiety as this has bearing on portion sizes in later life.

What I am certainly not saying is to through routine out of the window! Have a routine, but be flexible to adjust this, if your child is never hungry mid-morning for a snack, then do not force it on them. Cut it out and just provide lunch, they will signal if they get hungry in between and then you can bring in a snack. Equally, it may be on days that lunch is not such a successful meal, but dinner is great. This is fine, keep the routine but do not obsess about the success of the meal as most children will make up for poor intake in their next meal. Mechanistic feeding addresses feeding like a machine, which it obviously is not.

Please note: for those children with diagnoses affecting the gastrointestinal tract, hunger and satiety is often affected so the advice above, is for children without any underlying medical diagnoses.

 

When medical conditions cause feeding difficulties

Its been almost 3 months since my last post and I promised to go through the acronym STOMP as causes for feeding difficulties. This week in particular this entry seems important with the publication of a twin study from University College London on Fussy Eating and Neophobia, which has got the media going crazy.

Today’s entry is only about organic or medical causes of feeding difficulties. Those parents that have got children with food allergy, reflux of developmental delay (just to name a couple of medical diagnoses) will know that feeding difficulties are common when a child is not well. The question though is, when is your child’s feeding difficulty possibly a medical condition that has not been diagnosed.

There are a couple of “red flag signs” in regards to feeding difficulties that I would suggest requires a healthcare professional’s attention. These include:

  1. Dysphagia (difficulties in swallowing) – if you see your child has obvious difficulties in swallowing
  2. Coughing and spluttering every time your child has liquids (especially if you child has frequent chest infections)
  3. Gagging every time textured solid foods are given and this causing distress
  4. Apparent pain with feeding – in the young this often exhibits itself as refusing to drink breast milk or from the bottle
  5. Vomiting and diarrhea in association with feeding difficulties
  6. Growth faltering in association with feeding difficulties

If there is an underlying medical cause leading to the feeding difficulty, the problem is unlikely to be resolved without the medical condition being treated. It is therefore important to discuss feeding difficulties with somebody if they exhibit any of the above symptoms.

My next entry will be about mechanistic feeding as cause for feeding difficulties.