98 Feeding Disorder of Infancy or Early Childhood (307.59)
98 Feeding Disorder of Infancy or Early Childhood (307.59)
DSM-IV-TR criteria
- A. Feeding disturbance as manifested by persistent failure to eat adequately with significant failure to gain weight or significant loss of weight over at least one month.
- B. The disturbance is not due to an associated gastrointestinal or other general medical condition (e.g., esophageal reflux).
- C. The disturbance is not better accounted for by another mental disorder (e.g., Rumination Disorder) or by lack of available food.
- D. The onset is before the age of 6.
Associated features
Infants with feeding disorders can be more irritable and difficult to console when feeding then others of their age. They appear withdrawn and apathetic and may also show developmental delays. Sometimes parent-child interaction problems may add to or exacerbate the infant’s feeding problems. Inadequate caloric intake can make associated features worse and further impact to feeding difficulties. Factors that may be associated with Feeding Disorder of Infancy or Early Childhood include temperamental characteristics or intrauterine growth retardation. Preexisting developmental impairments that make the child less responsive could also be factors. Some other associated factors include parental psychopathology and child abuse or neglect.
Child vs. adult presentation
- Due to the nature of the disorder, adults cannot present with feeding disorders. This disorder is primarily focused on the presentation in children from infants to early childhood.
- A later onset, during toddler years, is associated with developmental delay and malnutrition. Growth retardation may be observed.
Gender and cultural presentation
Feeding Disorder of Infancy or Early Childhood seems to be equally common in both males and females.
Epidemiology
Of all pediatric hospital admissions, 1%-5% are for failure to thrive, and up to one-half of these may reflect feeding disturbances without any apparent predisposing general medical condition. Data from community samples suggest a point prevalence of around 3% for failure to thrive.
Etiology
- Feeding problems often occur in infant and children who are tube fed for extended periods of time due to some other illness or disability. In premature infants, the underdeveloped sphincter muscle, between the stomach and esophagus, can cause the infant to spit up frequently during feedings. Because this is uncomfortable for the child, he or she may not want to eat.
- Disorders of the digestive system can also cause feeding problems, and include abnormalities of the throat and esophagus that cause pain during swallowing, inhaling food into the lungs, constipation, and celiac disease, a hereditary disorder in which a cereal protein called gluten, which is found in wheat, causes an allergic reaction that results in poor absorption of fats from the diet.
- Other digestive-type disorders that can cause feeding problems include necrotizing entercolitis, a condition seen mainly in premature