Sensory Based Feeding Intervention for Toddlers With Food Refusal: A Randomized Controlled Trial

Objective To investigate the effect of sensory-based feeding treatment for toddlers with food refusal compared with only providing nutrition education.Methods Thirty-two toddlers with food refusal were randomly assigned to an intervention group or the control group. Toddlers in the intervention group received the sensory-based feeding intervention and the duration was for 1 hour for 5 days per week for 4 weeks, and then 1 hour, once a week for 8 weeks. Subjects in both the intervention and control groups received nutritional education once every 4 weeks for 12 weeks. The participants were evaluated at their entry into the study and 12 weeks later based on height, weight, behavior at mealtime using the Behavioral Pediatrics Feeding Assessment Scale (BPFAS), and sensory processing ability using the Infant/Toddler Sensory Profile.Results Sixteen toddlers were included in each group. Two subjects in the intervention group and four toddlers in the control group were excluded from the final analysis. Significant improvements in child or parent subscales of the BPFAS were observed in the intervention group. In contrast, there were no significant improvements in any BPFAS scores in the control group.Conclusion Sensory-based feeding intervention was effective for improving mealtime behavior in toddlers with food refusal. Therefore, a sensory-based feeding intervention could be considered as an intervention approach to address feeding disorders in toddlers.

Development of a Scale to Measure Infant Eating Behaviour Worldwide

In order to create a short, internationally valid scale to assess eating behaviour (EB) in young children at risk of undernutrition, we refined 15 phrases describing avidity or food refusal (avoidance). In study one, 149 parents matched phrases in English, Urdu, Cantonese, Indonesian or Greek to videos showing avidity and avoidance; 82–100% showed perfect agreement for the avidity phrases and 73–91% for the avoidant phrases. In study two, 575 parents in the UK, Cyprus and Indonesia (healthy) and in Kenya, Pakistan and Guatemala (healthy and undernourished) rated their 6–24 months old children using the same phrases. Internal consistency (Cronbach’s α) was high for avidity (0.88) and moderate for avoidance (0.72). The best-performing 11 items were entered into a principal components analysis and the two scales loaded separately onto 2 factors with Eigen values > 1. The avidity score was positively associated with weight (r = 0.15 p = 0.001) and body mass index (BMI) Z scores (r = 0.16 p = 0.001). Both high and low avoidance were associated with lower weight and BMI Z scores. These scales are internationally valid, relate to nutritional status and can be used to inform causes and treatments of undernutrition worldwide.

Evaluation of feeding problems and food-refusal behavior in children with Autism Spectrum Disorders

A problem frequently reported by caregivers of children is food-refusal behavior. Evidence shows that this problem is exacerbated in children with a diagnostic of Autism Spectrum Disorders (ASD). In Mexico the prevalence of these problems on this population is unknown. The aim of this study was to conduct an exploratory and descriptive study of the prevalence and characteristics of eating behavior in children diagnosed with ASD. Parents or caregivers of children with a diagnosis of ASD were asked to answer a questionnaire, expressly prepared to obtain sociodemographic data of both parents and children, information of difficult and problematic behavior at mealtime, feeding practices, food preferences, medical information and food consumption by the family and children. It was found that 62.2% of children presented eating behavior problems at mealtime, the most frequent was leaving the table and food refusal. Children with behavior problems ate les food than children without behavior problems. Also a correlation between the number of foods consumed by the family and the child was found. The results of this study represent an initial approximation to the evaluation of pediatric feeding problems in children with ASD in a Mexican population.

Un bambino che non mangia… e non sta seduto

The Authors describe the case of an 11-month-old infant with severe vitamin B12 deficiency consequent to a strict vegan diet followed by the mother during pregnancy and to a strictly vegan weaning. The child presented with food refusal, somatic growth arrest and seriously compromised maturational patterns. The encephalic MR showed a marked white matter atrophy. Symptoms improved after vitamin B12 supplementation.

Food refusal in mentally ill patients and their management tactics

The paper presents generalized data on psychopathological symptoms that cause food refusal in mentally ill patients. It systematizes information about methods for preventing and supplying nutrient deficiencies in mentally ill patients who refuse to eat. The paper describes clinical cases of probe feeding in psychiatric inpatients when they refuse eat or cannot take food. It provides evidence for the rationality of describing food refusal in mentally ill people and the methods for symptomatic correction of this condition in the current fundamental guidelines on psychiatry.