FACILITATING INTERNAL REGULATION OF EATING - A TREATMENT MODEL FOR INFANTILE ANOREXIA

Infantile anorexia is characterized by food refusal and failure to thr ive. It is defined as a transactional disorder that leads to a develop mental disturbance in internal regulation of eating. By this transacti onal model, the infant's temperament characteristics of emotional inte nsity, distractibility, and stubbornness evoke conflicts over control and limit setting in a vulnerable mother who becomes anxious and insec ure when faced with the infant's food refusal and oppositional behavio rs during feeding. Mother and infant become increasingly involved in m aladaptive interactions, each struggling for control, with food being the battleground. The infant's eating becomes increasingly externally controlled by the interactions with his or her caregivers instead of i nternally by hunger and fullness. The therapeutic intervention address es the three components of the model: (1) it serves to help the parent s understand and deal with the anorectic infant's temperament, (2) it addresses the difficulties the parents may have in setting limits, and (3) it provides parents with recommendations on how to structure meal times in order to facilitate internal regulation of eating.