Feeding problems of infants and toddlers

Background: Eating is a primary biological need. Feeding is of great import ance for the development and consolidation of the social relationship betwe en infant and the primary caretaker. A minority of children and their paren ts, however, have distressing experiences around feeding and eating that ca n lead to long-term problems in the parent-child relationship and the child 's health. Objective: To provide a review of the prevalence, etiological factors and c onsequences of feeding problems, and to describe a behavioral approach to t he treatment of feeding problems. Method: Literature review. Results: Major feeding problems in infancy are refusal to eat any food or s olid food, very selective eating, lack of appetite and failure to thrive wi th feeding problems. The prevalence of severe feeding problems has been est imated to be around 6-10%, and of failure to thrive to be between 3 and 4% in the general infant population. Feeding problems often lead to impaired g rowth and as a consequence have been found to affect the cognitive, behavio ral and social development of children. Disturbances of mother-infant inter action, both as an etiological factor and as a secondary problem, are often found. A developmental task-orientated biological-behavioral model of the etiology of feeding problems is introduced and an approach to treating food refusal and failure to thrive is described. Behavior modification techniqu es, modified for the treatment of feeding problems, are introduced. A multi -disciplinary behavioral treatment approach to feeding problems has been re ported in case series to be highly successful for treating feeding problems . Conclusions: Feeding problems are frequent and, if untreated, can have adve rse consequences on the child's development. There is evidence for the effe ctiveness of a multi-disciplinary behaviorally and developmentally orientat ed treatment approach in small case series. However, sufficiently large ran domized controlled trials of the effectiveness of behavioral treatment appr oaches in clinical practice are lacking.