What Are Feeding Disorders?
Infants and children with feeding disorders do not eat or drink enough, or
do not consume a wide enough range of foods to get a sufficient amount
of the nutrients they need to grow up healthy. This pattern often becomes
evident when children gain too little weight or even lose weight and
show signs that they are not developing properly. Medical professionals
often call this “failure to thrive.” Besides a slowing of or a stop in physical
growth, children with feeding disorders sometimes also develop other
problems, including difficulties with cognition, which includes learning,
reasoning, analyzing, and other thought processes.
Feeding disorders often are the result of difficulties in one of a number
of different areas of the digestive system that process food. These areas
include the following:
system. Examples are listed below.
Mouth-related feeding disorders
While many feeding disorders
are noticeable only after a baby begins to lose weight, cleft palate and
defects in which the two halves of the roof of the mouth, called the palate
(PAL-ut), did not join. The result ranges from a notch in the upper lip to
a large gap in the front of the face that runs from the upper lip to the nose.
Clefts are fairly common, affecting one in every 600 to 800 newborns.
A child may inherit the condition as a result from a genetic mutation, or
it may occur from other causes, such as the mother’s diet or use of drugs
during the pregnancy. Infants with a cleft palate and/or lip usually have
trouble eating, because they cannot make a good seal with their lips and
therefore have difficulty getting the suction necessary to draw milk from a
mother’s breast or from a bottle. The treatment for these problems is surgery.
Children who receive the surgery early in their lives usually do well.
Unfortunately, some children’s families, particularly those in developing
countries, cannot afford surgery, and these individuals must go through
their lives with the obvious facial defect. These children typically have
difficulties speaking and may become withdrawn, sometimes developing
behavioral problems.
Children may have other feeding disorders related to abnormalities
in the mouth. For instance, a child may have ankyloglossia (an-kih-lo-
GLOSS-ee-uh) (be tongue-tied). In this condition, the child’s tongue cannot
move normally because the piece of tissue (called a lingual frenulum)
that anchors it to the floor of the mouth holds the tongue down. Because
of this condition, the child may not be able to lift his or her tongue very
much. In infants, this can affect their ability to suck from a mother’s
breast or from a bottle. The condition affects from 4 to 10 percent of all
newborns. Sometimes children “grow out of it” because the anchoring
tissue may begin to allow more movement by the time the child reaches
six years of age. In other cases, the child can learn to live with the condition.
Sometimes when the tongue continues to be severely restricted in its
movement, however, surgery is necessary.
Pharynx- and esophagus-related feeding disorders
From the
mouth, food moves into the pharynx and toward the esophagus. A ring
of muscle at the top of the esophagus opens long enough for the food to
enter. The food travels down to the bottom the esophagus, where another
ring of muscle opens temporarily to allow the food to enter the stomach.
In some children, this process does not go smoothly. For example, the
ring of muscle at the top of the esophagus—known as the cricopharyngeus
(KRY-ko-fare-in-GEE-us) muscle—may not open enough for food
to move from the pharynx into the esophagus. This very rare birth defect
is called cricopharyngeal achalasia. Doctors sometimes prescribe drugs
to relax the muscles, and studies as of 2009 were under way on possible
other treatments.
A different feeding disorder may result from another birth defect:
the esophagus ends in a pouch instead of connecting to the stomach as
it should. This condition, called esophageal atresia (uh-TREE-zee-uh),
affects about one in 4,500 newborns. A telltale symptom of this disorder
is excessive drooling, sometimes accompanied by choking, coughing,
sneezing, and/or a bluish tint to the skin. The treatment for esophageal
atresia is surgery to connect the esophagus and stomach.
lip are evident immediately at birth. Cleft palate and cleft lip are birth
Disorders related to the stomach and intestines
Experienced
parents often slip a towel over their shoulder before laying their infant’s
head there, because they are so used to their infants spitting up. This frequent
regurgitation, which doctors call gastroesophageal reflux, is normal
among healthy babies. It occurs because the ring of muscle at the bottom
of the esophagus opens up after a baby has eaten so that gas in the stomach
can exit up through the esophagus and out of the mouth as a burp. In
infants, food in the stomach may also come up with the gas, which results
in regurgitation.
Sometimes, however, the regurgitation can become severe and is a
sign of a feeding disorder called pyloric stenosis (py-LOR-ik sten-O-sis),
which affects about three of every 1,000 babies born in the United States.
In this disorder, the infant not only vomits often but begins projectile
vomiting, which means that the vomit shoots out of the mouth, sometimes
for a distance of two or more feet. Other symptoms, all of which
typically begin when the baby is about three weeks old, may include a
noticeable decrease in the number and the size of stools, which occurs
because too little food is remaining in and being processed by the baby’s
digestive system; a decrease in the number of wet diapers; no weight gain
or an actual loss of weight; tiredness; noticeable rippling movements after
a feeding (resulting from contractions of the stomach); a dip or “soft
spot” on their heads; and wrinkly skin on the stomach, upper arms, and
upper legs.
Pyloric stenosis occurs when the muscles of the pylorus become thickened.
This condition results in a smaller opening between the stomach
and small intestine. Because of this narrower opening, food can no longer
easily progress through the digestive system, and the baby’s system ejects
it. As of 2009 medical experts were unsure of the cause of this disorder.
To diagnose the condition, a doctor asks the parent about the vomiting,
checks the baby’s weight history, and may press on the baby’s stomach to
feel for a small bump. The doctor also may order an ultrasound or blood
tests. The treatment is surgery that widens the opening through the pylorus.
After successful surgery, babies recover quickly, often returning home
within two days.
One especially dangerous condition involving the large intestine is
necrotizing enteritis (NEK-ro-ty-zing en-ter-I-tis), which can also cause
an infant to stop feeding. It occurs in fewer than five out of every 2,000
newborns, and the vast majority of its victims are premature babies. In this
condition, the tissue of the large intestine dies. The treatment typically
involves antibiotics and other medical care and sometimes includes surgery.
As of 2009 medical professionals were unsure what causes necrotizing
enteritis, but the occurrence of occasional outbreaks in the neonatal
intensive care units at hospitals suggests that an infectious agent, such as a
bacteria or virus, may be involved.
do not consume a wide enough range of foods to get a sufficient amount
of the nutrients they need to grow up healthy. This pattern often becomes
evident when children gain too little weight or even lose weight and
show signs that they are not developing properly. Medical professionals
often call this “failure to thrive.” Besides a slowing of or a stop in physical
growth, children with feeding disorders sometimes also develop other
problems, including difficulties with cognition, which includes learning,
reasoning, analyzing, and other thought processes.
Feeding disorders often are the result of difficulties in one of a number
of different areas of the digestive system that process food. These areas
include the following:
- Mouth
- Pharynx (FARE-inx; a short tube that extends from the mouth to
the esophagus) - Esophagus (a tube that connects the pharynx to the stomach)
- Stomach, including the pylorus (portion of the stomach that attaches
to the duodenum, the first part of the small intestine) - Small intestine (a long tube that completes digestion and moves
waste matter to the large intestine for elimination)
system. Examples are listed below.
Mouth-related feeding disorders
While many feeding disorders
are noticeable only after a baby begins to lose weight, cleft palate and
defects in which the two halves of the roof of the mouth, called the palate
(PAL-ut), did not join. The result ranges from a notch in the upper lip to
a large gap in the front of the face that runs from the upper lip to the nose.
Clefts are fairly common, affecting one in every 600 to 800 newborns.
A child may inherit the condition as a result from a genetic mutation, or
it may occur from other causes, such as the mother’s diet or use of drugs
during the pregnancy. Infants with a cleft palate and/or lip usually have
trouble eating, because they cannot make a good seal with their lips and
therefore have difficulty getting the suction necessary to draw milk from a
mother’s breast or from a bottle. The treatment for these problems is surgery.
Children who receive the surgery early in their lives usually do well.
Unfortunately, some children’s families, particularly those in developing
countries, cannot afford surgery, and these individuals must go through
their lives with the obvious facial defect. These children typically have
difficulties speaking and may become withdrawn, sometimes developing
behavioral problems.
Children may have other feeding disorders related to abnormalities
in the mouth. For instance, a child may have ankyloglossia (an-kih-lo-
GLOSS-ee-uh) (be tongue-tied). In this condition, the child’s tongue cannot
move normally because the piece of tissue (called a lingual frenulum)
that anchors it to the floor of the mouth holds the tongue down. Because
of this condition, the child may not be able to lift his or her tongue very
much. In infants, this can affect their ability to suck from a mother’s
breast or from a bottle. The condition affects from 4 to 10 percent of all
newborns. Sometimes children “grow out of it” because the anchoring
tissue may begin to allow more movement by the time the child reaches
six years of age. In other cases, the child can learn to live with the condition.
Sometimes when the tongue continues to be severely restricted in its
movement, however, surgery is necessary.
Pharynx- and esophagus-related feeding disorders
From the
mouth, food moves into the pharynx and toward the esophagus. A ring
of muscle at the top of the esophagus opens long enough for the food to
enter. The food travels down to the bottom the esophagus, where another
ring of muscle opens temporarily to allow the food to enter the stomach.
In some children, this process does not go smoothly. For example, the
ring of muscle at the top of the esophagus—known as the cricopharyngeus
(KRY-ko-fare-in-GEE-us) muscle—may not open enough for food
to move from the pharynx into the esophagus. This very rare birth defect
is called cricopharyngeal achalasia. Doctors sometimes prescribe drugs
to relax the muscles, and studies as of 2009 were under way on possible
other treatments.
A different feeding disorder may result from another birth defect:
the esophagus ends in a pouch instead of connecting to the stomach as
it should. This condition, called esophageal atresia (uh-TREE-zee-uh),
affects about one in 4,500 newborns. A telltale symptom of this disorder
is excessive drooling, sometimes accompanied by choking, coughing,
sneezing, and/or a bluish tint to the skin. The treatment for esophageal
atresia is surgery to connect the esophagus and stomach.
lip are evident immediately at birth. Cleft palate and cleft lip are birth
Disorders related to the stomach and intestines
Experienced
parents often slip a towel over their shoulder before laying their infant’s
head there, because they are so used to their infants spitting up. This frequent
regurgitation, which doctors call gastroesophageal reflux, is normal
among healthy babies. It occurs because the ring of muscle at the bottom
of the esophagus opens up after a baby has eaten so that gas in the stomach
can exit up through the esophagus and out of the mouth as a burp. In
infants, food in the stomach may also come up with the gas, which results
in regurgitation.
Sometimes, however, the regurgitation can become severe and is a
sign of a feeding disorder called pyloric stenosis (py-LOR-ik sten-O-sis),
which affects about three of every 1,000 babies born in the United States.
In this disorder, the infant not only vomits often but begins projectile
vomiting, which means that the vomit shoots out of the mouth, sometimes
for a distance of two or more feet. Other symptoms, all of which
typically begin when the baby is about three weeks old, may include a
noticeable decrease in the number and the size of stools, which occurs
because too little food is remaining in and being processed by the baby’s
digestive system; a decrease in the number of wet diapers; no weight gain
or an actual loss of weight; tiredness; noticeable rippling movements after
a feeding (resulting from contractions of the stomach); a dip or “soft
spot” on their heads; and wrinkly skin on the stomach, upper arms, and
upper legs.
Pyloric stenosis occurs when the muscles of the pylorus become thickened.
This condition results in a smaller opening between the stomach
and small intestine. Because of this narrower opening, food can no longer
easily progress through the digestive system, and the baby’s system ejects
it. As of 2009 medical experts were unsure of the cause of this disorder.
To diagnose the condition, a doctor asks the parent about the vomiting,
checks the baby’s weight history, and may press on the baby’s stomach to
feel for a small bump. The doctor also may order an ultrasound or blood
tests. The treatment is surgery that widens the opening through the pylorus.
After successful surgery, babies recover quickly, often returning home
within two days.
One especially dangerous condition involving the large intestine is
necrotizing enteritis (NEK-ro-ty-zing en-ter-I-tis), which can also cause
an infant to stop feeding. It occurs in fewer than five out of every 2,000
newborns, and the vast majority of its victims are premature babies. In this
condition, the tissue of the large intestine dies. The treatment typically
involves antibiotics and other medical care and sometimes includes surgery.
As of 2009 medical professionals were unsure what causes necrotizing
enteritis, but the occurrence of occasional outbreaks in the neonatal
intensive care units at hospitals suggests that an infectious agent, such as a
bacteria or virus, may be involved.
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