Feeding problems of infants and toddlers.
OBJECTIVE
To propose a diagnostic and therapeutic approach to feeding problems in early childhood.


METHODS
Articles were retrieved through a MEDLINE search from January 1990 to December 2005 using the MeSH terms eating disorders, infant, and child. Recommended practice is based mainly on levels II and III evidence.


RESULTS
Feeding problems are classified under structural abnormalities, neurodevelopmental disabilities, and behavioural disorders, with overlap between categories. A medical approach also needs an evaluation of diet and an assessment of the interaction between parent and child. Treating medical or surgical conditions, increasing caloric intake, and counseling about general nutrition can alleviate mild to moderate problems. More complicated cases should be referred to multidisciplinary teams. Behavioural therapy aims to foster appropriate behaviour and discourage maladaptive behaviour.


CONCLUSIONS
Feeding problems in early childhood often have multifactorial causes and a substantial behavioural component. Family physicians have a key role in detecting problems, offering advice, managing mildly to moderately severe cases, and referring more complicated cases to multidisciplinary teams.
Bernard-Bonnin
Anne-Claude
AC
CHU Ste-Justine, University of Montreal, Quebec, Canada. ab.acbb@videotron.ca
D001521:Behavior Therapy; D002653:Child Behavior Disorders / Q000503:physiopathology; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000503:physiopathology; D004435:Eating / Q000502:physiology; D004947:Esophagus / Q000002:abnormalities; D001068:Feeding and Eating Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007830:Larynx / Q000002:abnormalities; D008487:Medical History Taking; D009056:Mouth Abnormalities / Q000503:physiopathology; D010808:Physical Examination; D014132:Trachea / Q000002:abnormalities