and developmentally appropriate and positive eating behaviours. Most important, these primary intervention efforts need to be empirically tested to determine whether or not children and families benefit from such support and education in terms of a lowered rate of child feeding problems.
For children who are already experiencing feeding problems, secondary and tertiary prevention efforts need to focus on preventing (secondary) or controlling (tertiary) the negative and costly complications (e.g. naso-gastric or gastrostomy tube dependence) of the feeding problems. Given the complex causes of child feeding problems, children and families must have access to an interdisciplinary team of experts trained in the area of pediatric feeding assessment and treatment so that physiological as well as developmental and behavioural components can be assessed and addressed. The importance of interdisciplinary team care has been well described in the literature6-7. Unfortunately, such interdisciplinary assessment and treatment can be costly to provide and may not be available to all children and families, depending on where they live and the resources available. Therefore, to expand availability of services, health-care systems need to support the training of health-care providers to help them learn to identify feeding problems early as well as help them to understand and teach basic feeding and mealtime management strategies to caregivers of children with feeding and growth concerns. For children who require intensive feeding treatment, additional models of treatment need to be explored. Albeit effective, behavioural feeding treatment is highly individualized, labour-intensive and requires staff with specialized training to carry out the intervention8. Additional research needs to be conducted to determine whether the treatment of choice (i.e. intensive behavioural interventions) can be tailored for implementation within a group format, for example, rather than on an individual treatment basis to reduce health- care costs and expand the availability of treatment services.
If we can help caregivers and health-care providers understand how feeding problems develop in children and the most effective manner of addressing specific acute and chronic feeding problems, more children will likely be able to avoid progressing down the pathway to maladaptive feeding patterns.
- Fledelius HC. Inhibited growth and development as permanent features of low birth weight. A longitudinal study of eye size, height, head circumference, inter-pupillary distance and exophthalmometry, as measured at age 10 and 18 years.Acta Paediatrica Scandinavica 1982;71(4):645-650.
- Douglas JE, Byron, M. Interview data on severe behavioural eating difficulties in young children. Archives of Disease in Childhood 1996;75(4):304-308.
- Hawdon JM, Beauregard N, Slattery J, Kennedy G. Identification of neonates at risk of developing feeding problems in infancy. Developmental Medicine & Child Neurology 2000;42(4):235-239.
- Drotar D. Failure to thrive (growth deficiency). In: Roberts MC, ed. Handbook of Pediatric Psychology. 2nd ed. New York, NY: Guilford Press; 1995:516-536.
- Skuse D, Reilly S, Wolke D. Psychosocial adversity and growth during infancy. European Journal of Clinical Nutrition 1994;48(Suppl 1):S113-S130.
- Lefton-Greif MA, Arvedson JC. Pediatric feeding/swallowing teams. Seminars in Speech & Language 1997;18(1):5-11.
- Miller CK, Burklow KA, Santoro K, Kirby E, Mason D, Rudolph CD. An interdisciplinary team approach to the management of pediatric feeding and swallowing disorders. Children’s Health Care 2001;30(3):201-218.
- Kerwin ME. Empirically supported treatments in pediatric psychology: severe feeding problems. Journal of Pediatric Psychology 1999;24(3):193-214.
How to cite this article:
Burklow K. [Archived] Feeding Behaviours and Very Young Children: Comments on Piazza and Carroll-Hernandez, Ramsay and Black . In: Tremblay RE, Boivin M, Peters RDeV, eds. Faith MS. Encyclopedia on Early Childhood Development [online]. https://www.child-encyclopedia.com/ch