Academic journal article The Journal of Early and Intensive Behavioral Intervention

Behavioral Intervention and Prevention of Feeding Difficulties in Infants and Toddlers

Academic journal article The Journal of Early and Intensive Behavioral Intervention

Behavioral Intervention and Prevention of Feeding Difficulties in Infants and Toddlers

Article excerpt

Abstract

Although eating is considered an automatic physiologic process, many children experience feeding difficulties. The purpose of this paper is to provide a framework for assessment, treatment and prevention of feeding difficulties in children. Identification and treatment of any factors actively interfering with feeding success is a critical cornerstone for effective behavioral interventions for feeding. Using variables that comprise the structure of a meal, this paper discusses how these variables might be manipulated in behavioral interventions for feeding problems. Recommendations for prevention of feeding problems are also presented.

Keywords: Behavioral assessment, Feeding Problems, Behavioral Interventions, pediatric

Behavioral Intervention and Prevention of Feeding Difficulties in Infants and Toddlers

The term "feeding" traditionally refers to the ingestion of food that occurs in the context of a relationship between a child and adult, usually mother; whereas the term "eating" refers to an individual ingesting food. Feeding issues and problems are relatively common among infants and toddlers. Parents of infants often report colic around meals, spitting up, vomiting, and lack of weight gain (Mathieson, Worrall, Masel, Wall, & Shepherd, 1999). In contrast, parents of toddlers are more likely to report picky eating; eating only a few foods while rejecting the majority of other foods and/or eating only a little bit at each meal. Estimates suggest as many as half of parents of toddlers report feeding issues at some time during the early years, with children with special needs (medical, developmental, and physical) being even more at risk for developing feeding problems that require intervention. This paper provides brief background on the factors underlying feeding problems in infants and toddlers, describes how behavioral interventions can be used to treat feeding issues, and provides some guidelines for preventing feeding issues from becoming feeding problems.

Background

Eating is a complex process involving neurologic control of refined and coordinated muscle movements operating in structures next to and part of the respiratory and gastrointestinal tracts. As a result, a multitude of factors may impact the eating process. First, the child must have an intact swallowing reflex and adequate neurological function to successfully manage food and liquid boluses (bites or sips) orally. Second, muscle tone, control, and coordination are necessary components of successful feeding. Children who are feeding themselves need to be able to grip the utensil or cup and move it to their mouth successfully. Appropriate positioning and tone are also important for feeding success.

A third factor is oral-motor skill and function. Oral-motor development follows a stepwise progression from suckling, the most primitive oral motor pattern, to the more complex oral-motor milestones of suck, munch, and chew (Bosma, 1986). Infants are born with a suckling reflex that works involuntarily whenever something enters the child's mouth. As the infant matures, the reflex fades and is replaced with the voluntary act of sucking in which the tongue moves up and down within the mouth. This increased control in tongue movement enables successful spoon feeding; food placed on the tongue will no longer ride out of the mouth with tongue movement as it did when the baby used the suckling reflex. The next skill in the oral motor developmental sequence is munching. Munching is the rhythmical bite-and-release pattern that allows small pieces of food to be broken off, flattened and then collected by the tongue in preparation for swallowing. Chewing, or shredding food into smaller pieces does not occur until the child acquires a rotary component to jaw movement. This can be seen as early as 9 months but is modified gradually until an adult pattern is attained, typically around 3 years of age. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.