In the case of reflux, medications are usually prescribed. In the most severe cases a surgery is performed called a Nissen Fundoplication. This involves a repositioning of the stomach which results in a smaller opening into the organ. This allows for a greater probability of food going in without reflux or vomiting.
Allergy testing is essential because if a child ingests a food to which he or she is allergic, lesions or irritations can form in the GI track, which can make eating a very painful ordeal. There are several ways to test for allergies. Talk to your pediatrician for advice on the best test to administer to your child.
Aspiration occurs when liquids enter the lungs. This occurs when a ligament over the passage to the lungs, which usually closes during oral intake, remains open. This can be dangerous because the liquid in the lungs can cause pneumonia. A speech pathologist or occupational therapist can help determine if aspiration is occurring and which consistency of food will lower the probability of aspiration occurring.
Lastly, with motility issues food does not pass through the GI track at a normal rate. This can cause food to stay in the stomach too long, overfilling it, and causing vomiting, pain, and constipation. This can be treated with medications such as Reglan and Erythromycin.
Tips on things to do before seeking treatment to increase your child?s food/drink intake orally
1. Allergy testing
2. Upper endoscopy
3. Swallow study
Tips to try to increase food orally on your own when your child has been cleared of physical impediments to eating
1. Do not give any attention to any crying or negative behaviors (i.e. coughing or vomiting), which occur while eating.
2. Give praise or access to a special activity or toy when a food that is not normally consumed, or greater quantities than normal are eaten.
3. Try presenting a preferred food with a non-preferred food during a meal.
Ben Zimmerman, Senior Feeding Consultant
Los Altos Feeding Clinic~(650) 237-9111
www.pediatricfeeding.org
Recent statistics reveal that one in four children have some sort of feeding disorder. Food refusal can take the form of food selectivity, G-tube or NG-tube dependency, bottle dependency, texture selectivity, or poor oral intake in general.
Nutritionists, pediatricians, speech language pathologists, occupational therapists, and behavioral therapists all work in different ways to solve this growing epidemic. Behavioral therapists structure the environment and consequences during mealtime to facilitate healthy eating habits.
Of all the approaches behavioral management strategies have been proven to be the most effective. A significant amount of progress can be made within a 4-6 week period. One behavioral clinic in Baltimore, The Kennedy Krieger Institute, reports to have a 91% success rate at meeting their client?s feeding goals. Unfortunately most behavioral clinics are located on the East Coast.
While most feeding disorders are simple to treat, there may be medical complications which interfere with treatment possibilities. Any child with a feeding disorder should be carefully evaluated by a physician to determine whether he or she is physically safe to eat before starting treatment for a feeding disorder. These evaluations are done both to ensure the safety of the child and also to optimize the treatment effects.
