Feeding problems in children

for post basic b.sc. nursing

1. FEEDING PROBLEMS IN CHILDREN BY: MANISHA SHARMA NURSING TUTOR

2. INTRODUCTION Feeding problems in infants and young children are usually minor but sometimes have serious consequences . Common feeding problems include gastroesophageal reflux, gastroenteritis, too much food, too little food, and dehydration (fluid loss). Some feeding problems resolve without treatment, but others require medical attention or hospitalization. Proper nutrition and feeding techniques can alleviate some feeding problems.

3. FEEDING PROBLEMS Spitting up Spitting up (burping up) is the effortless return of swallowed formula or breast milk through the mouth or nose after feeding. Almost all infants spit up, because infants cannot sit upright during and after feedings. Also, the valve (sphincter) that separates the esophagus and stomach is immature and does not keep all of the stomach's contents in place. Spitting up gets worse when an infant eats too fast or swallows air. Spitting up usually stops between the ages of 7 months and 12 months.

4. CONTINUE Spitting up can be reduced by: Feeding infants before they get very hungry Burping them every 4 to 5 minutes Placing them in an upright position during and after feeding Making certain the bottle nipple lets out only a few drops with pressure or when the bottle is upside down

5. CONTINUE Spitting up that seems to cause an infant discomfort, interferes with feeding and growth, or persists into early childhood is called  gastroesophageal reflux and may require medical attention. If the material that is spit up is green (indicating bile) or bloody or causes any coughing or choking, medical attention is needed immediately.

6. CONTINUE Vomiting: Vomiting is the uncomfortable, forced throwing up of feedings. It is never normal . Vomiting in infants is most often the result of acute viral gastroenteritis . Infants between the ages of 2 weeks and 4 months of age may rarely have forceful (projectile) vomiting after feedings because of a blockage at the stomach outlet ( hypertrophic pyloric stenosis )

7. CONTINUE A child who is vomiting frequently may tolerate small amounts of solution given more often better than large amounts given less often. Older children can be given popsicles or gelatin, although red versions of these foods can be confused with blood if the child vomits again.

8. CONTINUE A child should be hospitalised if he/she: Has severe abdominal pain Is unable to drink and retain fluids Has a high fever Is lethargic or acting extremely ill or acting very different than usual Vomits for more than 12 hours Vomits blood or green material (bile) Does not urinate in 8 hours These symptoms may signal dehydration or a more severe condition.

9. Overfeeding: Overfeeding is giving more nutrition than a child needs for healthy growth. Overfeeding occurs when children are automatically fed as a response to crying, when they are given a bottle as a distraction or activity, or when they are allowed to keep a bottle with them at all times. Overfeeding also occurs when parents reward good behavior with food or expect children to finish their food even if they are not hungry. In the short term, overfeeding causes spitting up and  diarrhea. In the long term, overfed children can become  obese .

10. Underfeeding: Underfeeding is giving less nutrition than a child needs for healthy growth. It is one of many causes of failure to thrive and may be related to the child or the caregiver. Underfeeding may result when a fussy or distracted infant does not sit well for feedings or has difficulty sucking or swallowing. Underfeeding can also result from improper feeding techniques and errors in formula preparation.

11. CONTINUE Poverty and poor access to nutritious food are major reasons for underfeeding. Occasionally, abusive parents and parents with mental health disorders purposely withhold food from their children. In infants, underfeeding can result in dehydration and yellowing of the skin

12. CONTINUE Community services (such as RCH, ICDS) can help parents purchase formula and can teach them proper techniques for formula preparation and feeding. If an infant is so far below expected weight that supervised feedings are necessary, the doctor may admit the child to a hospital for evaluation. If the parents are abusive or neglectful, Child Protective Services (1098) may be called.

13. PARENTS EDUCATION Offer a variety of foods, even ones your child has rejected in the past. Keep healthy foods in the house. Limit high-calorie, low-nutrient foods. Let kids help make meals. Give them simple jobs, like tearing lettuce for a salad or helping set the table. Set regular mealtimes and snack times so kids don't graze all day long. Have regular family meals and make them pleasant times for the whole family to get together. Set a good example by eating healthy foods yourself. Let the child take control.

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