Feeding problems in preschool children

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Feeding problems are remarkably common in pre-school children. The incidence of feeding problems has been estimated to vary from 16% to 75 %( Eppright et al, 1969; Minde & Minde, 1986). This is a time of growing individuality for children, a time when a child's personality and temperament is demonstrated. Most cases of food refusal and feeding problems are minor and have no effect on growth or the child's weight gain but occasionally the problems can be very severe. Feeding problems may relate to the choosing of foods, or to eating behaviors. Both of these may be accompanied with food refusal or food fads which have psychological and other underlying causes (Harrise & Booth, 1992).

Medical conditions must always be considered and excluded as a reason for a child failing to eat. In the absence of underlying disease, psychological problems should be considered. Many young children pass through a phase of being faddy about food and refusing to eat certain foods. Food faddiness tends to reflect the extremes of young children's food likes and dislikes and often has a psychological cause. Food like and dislikes are influenced by taste, familiarity, parents attitudes to food, and food appeal. In this respect, refusal to eat meat and vegetables and also refusal to drink milk have been reported in young children. Poor appetite, limited food appeal, emotional upset and manipulative behavior are said to be the most common reasons for food refusal in young children(Harrise & Booth, 1992).

Excessive intake of snacks, milk and drinks, particularly squash, may be a reason for poor appetite in young children (Houlihane & Rolls 1995). Snacks close to mealtimes may also suppress appetite (Sims & Morris, 1974). Irregular frequent meals are a common feeding pattern in young children. This behavior may influence both the appetite and dental health of children. In a study in 1991 Holt showed that between-meal snacking was prevalent in 4 year-old children (Holt, 1991). Small children may be over-whelmed by a large plate of food. Small portions, of colorful, attractively presented food are more tempting (Harrise & Booth, 1992).

Toddler behavior is strongly influenced by past experience. Any negative experience with food might result in future food refusal. Transient food refusal may occur after birth of a sibling or other event, in an attempt to redirect attention to themselves (Harrise & Booth, 1992). Refusal to chew due to failure to introduce texture and lumps before 6-7 months of age can result in children rejecting lumpy food later (K & R Minde, 1986).

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