Addressing Pediatric Eating Disorders in Infants
Grace Weatherby
/ Categories: WELLNESS, 2024

Addressing Pediatric Eating Disorders in Infants

As parents, one of our greatest joys is nourishing our little ones and watching them grow and thrive with each passing day. However, for some families, the journey of feeding their infants can be fraught with challenges and uncertainties in the form of pediatric eating disorders (PFDs).

PFDs encompass a range of challenges related to feeding and nutrition in the earliest stages of life. They may manifest as difficulties with breastfeeding or bottle-feeding, refusal to eat, aversions to certain textures or tastes, or challenges with weight gain and growth. It’s estimated that more than 1 in 37 children under the age of 5 in the United States  have PFDs. For these infants and children, every bite of food can be painful, scary, or impossible, potentially impeding nutrition, development, growth, and overall well-being.

Some common indicators of PFDs may include:

Leaking food: Whether they’re on the bottle or the breast, milk or formula regularly  leaks from your baby’s mouth during feeding. 

Blisters on the lips: Persistent blisters on an infant’s lips may be a sign of a latching issue.

Persistent refusal to eat: Your baby consistently turns away from the breast or bottle, displaying disinterest or distress during feeding attempts.

Limited weight gain: Your baby is not gaining weight at a healthy rate or is falling behind on growth charts.

Frequent spitting up or vomiting: Your baby experiences frequent episodes of spitting up or vomiting, which may indicate underlying feeding difficulties or reflux.

Excessive crying or irritability: Your baby becomes fussy, agitated, or inconsolable during or after feeding sessions.

Avoidance of certain textures or flavors: Your baby shows aversions to specific textures, tastes, or feeding utensils.

Worried about your child’s eating habits?
Click here for a questionnaire that will help you better understand your child’s feeding habits and identify any areas of concern regarding your child’s feeding that you should address with your child’s physician.

 

While the exact cause of disorders varies from one infant to another, some common factors that often contribute to the issue include:

Oral Motor Development: Difficulties with oral motor skills, such as sucking, swallowing, and chewing, can impact an infant's ability to breastfeed or bottle-feed effectively. Conditions such as tongue tie, cleft palate, or muscle weakness can interfere with the coordination necessary for successful feeding.

Gastrointestinal Issues: Infants may experience discomfort or pain related to gastrointestinal issues such as reflux, gastroesophageal reflux disease (GERD), or gastrointestinal infections. These conditions can affect their appetite, feeding patterns, and overall feeding experience.

Sensory Sensitivities: Some infants may have sensory sensitivities to certain textures, tastes, or temperatures of food. These sensitivities can lead to aversions or refusal to eat certain foods, making feeding a challenging experience for both the infant and the caregiver.

Medical Conditions: Underlying medical conditions, such as allergies, gastrointestinal disorders, metabolic disorders, or congenital anomalies, can affect an infant's appetite, digestion, and nutrient absorption. These conditions may require specialized medical management and dietary interventions.

Developmental Delays: Infants with developmental delays or neurological conditions, such as autism, may experience delays in the development of feeding skills, leading to difficulties with breastfeeding or bottle-feeding. These infants may require additional support and interventions to promote feeding success.

If you suspect that your infant is struggling with feeding issues, it's crucial to seek support from healthcare professionals promptly.

Members of SVMC’s Early Intervention and Children’s Integrated Services team can help assess your child’s situation and direct you to the most appropriate resources.

In many cases, a speech pathologist can identify oral motor issues and provide exercises that help overcome weakness that are limiting eating or otherwise negatively impacting the eating experience.  They are also able to recognize issues, such as a lip or tongue tie, and advise on next steps.

Many families also benefit from working with a nutritionist and/or dietician to ensure their child gets the nutrition needed to keep their growth and development on track.

Regardless of the type of help or support needed, the key is to reach out as soon as you recognize or suspect an issue.

Above all, remember that feeding your baby is a journey filled with love, patience, and understanding. Stay patient and positive and remember that you're doing your best to support your child's health and well-being. Seeking support can help your child thrive and develop a healthy relationship with food that can last a lifetime.

For questions about pediatric eating disorders or services, contact Jennie Moon at SVMC’s Early Intervention and Children’s Integrated Services at (802) 447-2768 ext. 5841.

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The Latest Testing Information

The world of COVID-19 testing is very complex and changing rapidly. But gratefully, unlike early on in the pandemic, tests are available for everyone who wants one, whether they have symptoms or not. Below is a list of common questions, along with answers from SVMC’s Laboratory Services Director Karen Bond and SVMC’s Director of Perioperative Services Tanya Cowder, MSN, RN, CNOR.

What are the reasons someone may get tested for COVID-19, even if they don't have symptoms? People without symptoms of COVID-19 are being tested when they are admitted to SVMC, before being discharged to other facilities, before scheduled surgeries, or because they may have been exposed to the virus. Primary care providers are also able to order a test for those who need to return to work or school or to end quarantine or isolation. And anyone can be tested through the Vermont Department of Health's Pop-Up Clinics.

What types of tests are available for detecting active cases of COVID-19? SVMC offers Polymerase Chain Reaction (PCR) testing that is processed at both outside labs and our own lab, depending on how quickly results are needed. PCR, which was pioneered by American biochemist Kary Mullis in 1983, actually amplifies and detects the presence or absence of small gene sections. In this case, it determines whether or not COVID-19 is present.

The specimen is most often taken from deep in the nose-throat passageway (nasalpharyngeal). Patients experience eye watering and a burning sensation for 30 seconds or less. The test can also be taken from inside the nose (anterior nares), depending on the patient population. The most common type of test, like those administered both at SVMC’s drive-up testing station and at the Vermont Department of Health’s Pop-Up Clinics, is greater than 90% sensitive (meaning that the test picks up the virus, if it is present) and greater than 90% specific (meaning the test detects the COVID-19 virus, as opposed to other viruses).

How do I get my results and what should I do? Results are usually provided by a primary care provider within 48 hours. Your primary care provider will share specific directions regarding what you should do next. The Centers for Disease Control and Prevention is sharing this table, which provides a synopsis of tests, what results mean, and guidance for what to do. If the test is positive, the Vermont Department of Health may call before the primary care provider to initiate contact tracing.

Are all of the tests sufficiently available? Yes. Anyone with an order from their primary care provider can be tested at the drive-up testing site at SVMC. Anyone can be tested at the Vermont Department of Health's Pop-Up Clinics. Visit https://humanresources.vermont.gov/popups for times, dates, and locations. Tests for inpatients at the hospital are also in adequate supply.

Important Note: Remember test results offer a snap shot of the current active viral load. A negative test result doesn’t reveal whether you have been exposed in the past or predict whether you will be infected in the future. Whether or not the result is positive, we should all continue to wash our hands frequently, wear masks when in public and in proximity to those outside of our household, and stay 6 feet from others.

What about antibody tests? Antibody tests (serology) are also available. It does not tell you if you have active disease. Antibody tests check for antibodies that appear in the blood between about 1 – 3 weeks after symptom onset and may remain as long as a lifetime. Antibody tests may be positive while a person is infected. It is not yet known whether these antibodies protect against reinfection with the COVID-19 virus. For many other similar viruses, antibodies are protective for years or longer, but we do not yet have adequate data to know for COVID-19. Patients who would like the test would get a referral from their primary care provider and come to the SVMC Lab to have blood drawn. Results are delivered by the primary care provider.

Those who receive a positive antibody test or who have recovered from COVID-19 may qualify to donate plasma with the American Red Cross. The plasma, which includes antibodies, may help those fighting the disease. Learn more at https://www.redcrossblood.org/donate-blood/dlp/plasma-donations-from-recovered-covid-19-patients.html.

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