Interview data on severe behavioural eating difficulties in young children.

Abstract

Interview data from parents of 201 children under age 7 years with severe feeding and eating difficulties were analysed to describe features in the child's and parents' experiences that may have contributed to the development of the eating problem. Prematurity and low birth weight, distress during feeding in the first six months of life, and regular or frequent vomiting were common findings in the histories of the children. Aversive experiences during feeding may be the basis for early childhood eating difficulties. (Arch Dis Child 1996;75:304-308) Keywords: feeding, eating, behaviour.Feeding and eating difficulties in young children are common and it is important to recognise these at an early age and provide support for parents to help them cope with their child's eating.Attempts to classify these eating difficulties have tended to oversimplify the issues and focus on 'organic' and 'non-organic' failure to thrive. Several studies have identified serious behavioural eating difficulties in young children who have experienced ill health or tube feeding early in life.' Children can also be inaccurately diagnosed as having 'non-organic failure to thrive' when they have undiagnosed oral sensorimotor impairment from birth or early in life.8Young children and their parents may require psychological help to overcome eating difficulties that have become established during a period of medical or surgical treatment and which may continue long after the initial event has resolved.A psychological treatment programme has been established in Great Ormond Street Hospital for Children. A semistructured diagnostic interview was designed to collect standard information to aid classification and understanding of those referred and to identify any predictors of severe behavioural feeding problems. Methods SUBJECTSThis descriptive analysis is based on 201 patients seen over five years. The criteria for inclusion were that the child should be aged under 7 years and have had a severe eating difficulty for at least six months. Half of the sample were referred from within the hospital (51 %) while the rest were referred from paediatricians, general practitioners, and community health services. MEASURESEach child was assessed from a semistructured interview with parents by trained assistant psychologists who had either watched videos of previous interviews or sat in on interviews with other psychologists. Ten assistant psychologists or clinical staff conducted the interviews. No reliability measures were obtained. Uncertainties about any of the interviews were clarified during review between the parents and the senior author. In addition, a video was taken of parents and child eating lunch together in the unit, several questionnaires were given to the parents, and each child's height and weight were measured. We present here only the interview data obtained from questions which were designed with immediate scoring on predefined multiple choice and yes/no answers (available from the authors). Areas covered included family demog...

Factors affecting the introduction of complementary foods in the preterm infant

“…Weight as a measure of when to wean the preterm infant may be more appropriate. However, for the very preterm infants, this could delay the introduction of complementary foods for months and may subsequently lead to later feeding problems (Douglas & Byron, 1996). Twenty-one percent of infants in this study were weaned before 5 kg.…”

Caracterização do desenvolvimento da alimentação de crianças nascidas pré-termo entre três e 12 meses

“…Data collected in a study in London through interviews with parents of 201 children younger than 7 years with feeding difficulties analyzed what could have contributed to the development of eating problems. The authors report that prematurity, low birth weight and regular or frequent vomiting were commonly found in the children stories 25 .…”

Development of the Children's Eating Behaviour Questionnaire

“…On the basis of the literature on eating style and obesity, several aspects of eating behaviour have been implicated, including externality, emotional eating, satiety responsiveness, and speed of eating (Kaplan & Kaplan, 1957 ;Meyer & Pudel, 1972 ;Schachter, 1968 ;Slochower, 1976 ;Stunkard & Wolff, 1956). From the literature on underweight, issues of enjoyment of food, slowness, and fussiness appear to be important (Caruth et al, 1998 ;Douglas & Bryon, 1996 ;Harris, 1993 ;Marchi & Cohen, 1990 ;Reau, Senturia, Lebailly, & Christoffel, 1996 ;Rydell, Dahl, & Sundelin, 1995). In the first stage of this work, openended interviews with parents were used to determine which aspects of individual differences in eating style they were able to identify in their children.…”

“…Parents are already used as informants on eating behaviour in the clinical field (Vandereycken, 1992). Paediatric studies on eating problems often depend on parental reports of aspects of food refusal, choosiness, lack of interest in food, speed of eating, and appetite (Dahl & Sundelin, 1992 ;Douglas & Bryon, 1996 ;Harris, 1993 ;Stark et al, 1995). However, there have been few attempts to develop standardised measures of children's eating behaviours.…”