Feeding Disorders

Are feeding disorders the same thing as eating disorders?

Not in young children, according the the DSM-IV. Feeding disorders are diagnosed in infancy or early childhood when there is failure in a young child to gain weight because the child not consume enough food or nutrients and when there is no medical condition causing the problem.

Examples of feeding disorders include pica (eating non-nutritive substances such as dirt, clay, paper or chalk), rumination disorder (regurgitating partially digested food before re-chewing the food or spitting it out), and failure to thrive (not growing and gaining weight at the rate expected for a child's age). Rumination disorder is not diagnosed if it occurs exclusively during the course of anorexia or bulimia. Failure to thrive may also be referred to as "feeding disorder of early childhood" and is only diagnosed in children when the onset of symptoms occurs before age six.

Failure to thrive has also recently been observed in older adults, but the National Institutes of Health is still seeking clarification about the nature of these symptoms in older populations.

According to the American-Speech-Language-Hearing Association, feeding disorders also include problems gathering food and getting ready to suck, chew, or swallow it. For example, a child who cannot pick up food and get it to her mouth or cannot completely close her lips to keep food from falling out of her mouth may have a feeding disorder.

The following are signs and symptoms of feeding and swallowing problems in very young children:

• arching or stiffening of the body during feeding
• irritability or lack of alertness during feeding
• refusing food or liquid
• failure to accept different textures of food (e.g., only pureed foods or crunchy cereals)
• long feeding times (e.g., more than 30 minutes)
• difficulty chewing
• difficulty breast feeding
• coughing or gagging during meals
• excessive drooling or food/liquid coming out of the mouth or nose
• difficulty coordinating breathing with eating and drinking
• increased stuffiness during meals
• gurgly, hoarse, or breathy voice quality
• frequent spitting up or vomiting
• recurring pneumonia or respiratory infections
• less than normal weight gain or growth

Be sure to call for an appointment with a pediatrician if you have concerns about your young child's appetite, behavior, development, or growth.