Observation of feeding in the diagnosis of posttraumatic feeding disorder of infancy

Objectives: To delineate diagnostic criteria for posttraumatic feeding diso rder (PTFD) of infancy and to differentiate PTFD from infantile anorexia (I A) via observation of feeding interactions. Method: Three groups of infants (aged 6-32 months) participated: PTFD (n = 30), IA (n = 30), and healthy e ater controls (n = 30). The three groups were matched with regard to age, g ender, ethnicity, and socioeconomic status. Child psychiatrists used infant s' medical and feeding histories and observed 20-minute mother-infant feedi ng interactions to determine diagnoses and group placement. Feeding interac tions were also videotaped, and two raters assessed infants' resistance to feeding situations and to swallowing, as well as specific qualities of moth er-infant feeding interactions. Results: Overall, the clinical groups (PTFD and IA) demonstrated more problematic feeding interactions than did the co ntrol group. However, the PTFD group exhibited more resistance during feedi ng interactions than did the other two groups. In particular, the PTFD grou p displayed the most resistance to swallowing food. Conclusions: Infants' m edical and feeding histories, as well as observations of feeding, are impor tant to making the diagnosis of PTFD and differentiating it from other feed ing disorders. Implications for treatment of PTFD are discussed.