Eating behaviour in childhood

Question 1

What are common feeding problems in children?

Answer 1

Food refusal
Rejection of bitter tastes
Unhealthy food preferences
Many difficulties reflect natural developmental stages or learned behavior.

Question 2

What are some caregiver behaviors that can cause feeding problems?

Answer 2

Pressure to eat (can lead to overeating)
Using food as a reward
Using food to soothe
Restriction of food (especially high-calorie “treat” foods)

Question 3

What is food refusal characterized by?

Answer 3

Refusing new or previously liked foods
Rejection of bitter tastes, especially vegetables
Can generalize to same texture, colors, etc.

Question 4

Why does food refusal happen?

Answer 4

Neophobia (fear of new foods)
Developing cognition
Developmentally predictable

Question 5

Can non-food rewards be effective in encouraging children to try new foods?

Answer 5

Yes, incentives can help alter food choices and increase food consumption.
For example, offering a sticker for trying a new food.
Studies show sustained increases in liking for vegetables with praise and repeated tastings. Cooke et al (2011)

Question 6

What did Holley, Haycraft, and Farrow (2015) find about interventions for increasing vegetable intake?

Answer 6

A 14-day program of offering disliked vegetables with incentives and parental modeling increased consumption.
Parental modeling alone was not sufficient for disliked foods.
New foods can be accepted through modeling alone.

Question 7

What is the problem with overt food restriction?

Answer 7

Restricting access to desired foods can make them more desirable, leading to overconsumption when given access.
Restriction can lead to eating in the absence of hunger, especially if the child is overweight.

Question 8

What are some common outcomes of overt restriction in children?

Answer 8

Increased desire for restricted foods when they are made available.
Studies show that children consume more of restricted snacks when they are available for a limited time.
(Fisher and Birch, 1999)

Question 9

What is “growth faltering”?

Answer 9

Formerly “failure to thrive,” this is when a child grows more slowly than 95% of their peers.
It is often identified by 12-18 months and can persist into early childhood.
Can be caused by issues with food provision, intake, or calorie absorption.

Question 10

What are common causes of growth faltering in children?

Answer 10

Problems with food provision (e.g., poverty, not recognizing hunger signals)
Problems taking in food (e.g., low appetite, oral motor dysfunction)
Problems absorbing calories (e.g., gastrointestinal issues, chronic conditions)

Question 11

What is Avoidant/Restrictive Food Intake Disorder (ARFID)?

Answer 11

A clinically diagnosed eating disorder characterized by:
Avoidance or restriction of food types or amounts due to sensory-based avoidance, fear of consequences, or low interest in eating.
Affects physical health, growth, and psychological well-being.

Question 12

What are common signs of ARFID?

Answer 12

Short list of acceptable foods
Avoidance of entire food groups (e.g., vegetables, proteins)
Emotional stress around unfamiliar foods
Nutrient deficiencies and poor weight gain, though growth may be normal

Question 13

What are some causes and risk factors for ARFID?

Answer 13

Often related to sensory sensitivity, fear of eating consequences, or lack of interest.
Can be linked to anxiety disorders, autism, ADHD, or intellectual disabilities.
Severe picky eating that doesn’t improve can be a risk factor.

Question 14

What interventions are effective for ARFID?

Answer 14

A multidisciplinary approach tailored to the child and family.
Avoid blaming the child.
Involves the whole family, including parents and schools.

Question 15

What are the main causes of feeding problems in childhood?

Answer 15

Difficult temperament in children
Lack of maternal sensitivity or over-controlling parenting
Family dynamics, including mental health factors affecting parents

Question 16

Why are feeding problems in children important?

Answer 16

They can lead to poor diet habits that track into adulthood.
NHS costs related to diet-related illnesses are significant, with increasing projections for obesity-related costs.
Parents often experience high levels of stress over feeding concerns.

Question 17

What is the role of parents in managing children’s feeding problems?

Answer 17

Interventions should avoid blame and involve the whole family system.
A multi-level approach, considering family dynamics, is crucial for success.

Question 18

What did Orrell-Valente et al. (2007) find about incentives in children’s eating?

Answer 18

Incentives can effectively alter children’s food choices, leading to an increase in the consumption of targeted foods, especially with repeated exposure.

Question 19

What was the finding of Baer et al. (1987) regarding food incentives?

Answer 19

Incentives were shown to increase children’s consumption of certain foods, particularly when the incentive is tied to trying new or disliked foods.

Question 20

What did Cooke et al. (2011) discover about praising children for trying new foods?

Answer 20

Children who were praised for repeatedly tasting a vegetable over 12 days showed significant, sustained increases in liking for that vegetable.

Question 21

What did Holley, Haycraft, and Farrow (2015) conclude about parent-led interventions?

Answer 21

A 14-day program where parents offered a disliked vegetable outside of mealtime increased children’s consumption of that vegetable.
Parental modeling alone was not enough for disliked foods, but it was effective for new foods.
Combining modeling with incentives was more effective than modeling alone.

Question 22

What was the design of Holley, Haycraft, and Farrow’s (2015) study?

Answer 22

115 parent/child pairs (ages 2.5 to 4 years)
Experimental group: Parents offered a target disliked vegetable outside mealtime for 14 days.
Control group: No intervention, baseline and follow-up free-eating test.
Results showed that combining modeling and incentives increased vegetable intake.

Question 23

What did Fisher and Birch (1999) find regarding snack availability?

Answer 23

Children consumed more of a restricted snack when it was available for a limited time compared to when it was available for the entire snack period. This suggests that overt restriction increases desire for the restricted food.

Question 24

What were the findings of Birch et al. (2003) about food restriction and eating behaviour?

Answer 24

Restriction at age 5 led to eating in the absence of hunger at ages 7 and 9, particularly in overweight children.
Restricting food can lead to overconsumption when unrestricted access is allowed.

Question 25

What did Marchi & Cohen (1990) find about long-term consequences of feeding problems?

Answer 25

They found that feeding problems in childhood (e.g., picky eating) can persist into adulthood, potentially leading to eating disorders such as pica or bulimia, and issues like picky eating and digestive problems later in life.

Question 26

What did Reau et al. (2006) and Sdravou et al. (2021) report about the prevalence of feeding problems?

Answer 26

Approximately 25-45% of infants and toddlers experience feeding problems, with the rate being higher in children with developmental disabilities (70%–90%).

Question 27

What did the Office for National Statistics (2011) estimate about feeding problems?

Answer 27

Up to 289,266 children born in 2010 in England and Wales will experience some form of feeding-related problem.

Question 28

What did Scarborough et al. (2011) report about the NHS spending on diet-related illnesses?

Answer 28

In 2006-07, the NHS spent £5.8 billion on illnesses related to poor diet, with costs predicted to rise to £9.7 billion by 2050.

Question 29

What did Harris et al. (2019) and Inouye (2021) estimate about ARFID in children with autism?

Answer 29

They found that the co-occurrence of ARFID and autism spectrum disorder (ASD) ranges from 12.5% to 33.3%.

Question 30

What did the DSM-V describe about ARFID?

Answer 30

ARFID (Avoidant/Restrictive Food Intake Disorder) is characterised by sensory-based avoidance, low interest in eating, or concern about the consequences of eating. It can impact physical health, growth, and psychological well-being.

Question 31

What did the DSM-IV diagnose before ARFID became more recognized?

Answer 31

The DSM-IV used the diagnosis “Feeding Disorder of Infancy or Early Childhood,” which was later revised to ARFID in the DSM-V.