Feeding disorder is a common early-onset disorder in the pediatric population. The estimated prevalence ranges from 5-35% in healthy infants and toddlers (Benoit, 2000). It is more frequent in children with chronic medical conditions or developmental disabilities (Reilly et al., 1996; Rommel et al., 2003). Feeding disorder can be defined as a disturbed oral intake that cannot be explained by a medical diagnosis. Frequent symptoms include food refusal, regurgitation, gagging, or swallowing resistance.
Feeding disorder should be distinguished from feeding problems. Feeding problems are a common and to some extent normative behavior in most children. Most children refuse to eat, gag or even resist swallowing some food during some period of their lives. In most cases these symptoms can be explained by dislike of a certain taste, temperature or texture of food.
Criteria for a feeding disorder:
- Symptoms are present in more than three feeding situations per day for more than four weeks.
- The feeding situation is stressful for the parents and the infant.
- After a period of problematic feeding for which there is a known cause (e.g. after infections), the feeding behavior does not normalize, even after full medical recovery.
- A calm and satisfying feeding routine cannot be established.
- The feeding situation is otherwise extremely disturbed, resulting in symptoms such as: failure to thrive, growth retardation, oral motor apraxia, and a disturbed parent-child relationship.
For further criteria see DC: 0-3/R (Zero to Three, 2005 or Chatoor, 2002).
If a feeding disorder is present and the feeding situation remains stressful for months or even years, special treatment is recommended (Wilken & Jotzo, 2007, Wilken & Jotzo, 2008, Dunitz-Scheer et al. 2001). For these cases, a treatment program has been developed.