HealthWatch: Picky Eaters

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2517. Picky Eaters
MIAMI, Fla. (Ivanhoe Newswire) — Does your child create chaos at mealtime? Refusing to eat or only eating certain foods? Thousands of parents struggle with picky eaters. What should you do and when is it time to get professional help? 
Amir Similien absolutely loved pizza and pb and j, but something changed at the age of two. 
“The only thing he would take was PediaSure. That’s all that he would want. That’s all he ate for about a year,” Amir’s mom, Tashara, explained.
His parents frantically tried everything to get him to eat. Nothing worked. 
Amir’s dad, Schiller, continued, “We didn’t know where to go with it and we just felt confused.” 
Roseanne Lesack, PhD, BCBA-D, ABPP, Clinic Director, Psychology, Nova Southeastern University, Mailman Segal Center for Human Development, Unicorn Children’s Foundation Clinic, told Ivanhoe, “I would say most children go through some sort of picky phase. Similar to how children at that stage also have a same shirt that they really like or dress that they love.”
Dr. Lesack  says the biggest and most common mistake parents make is giving up too easily.
Dr. Lesack shared, “Parents get in this cycle, oh they don’t like it so I’m not going to offer it, and then they don’t get the exposure, so they’re not going to like it.”
She says you should keep offering new foods, but start small. Really small. 
Dr. Lesack continued, “Have them take literally the size of a bite of rice, just to get them over that fear of the unknown.”
If your child refuses to eat anything from an entire food group, or just one thing, it may be time to call in a professional. 
Dr. Lesack stated, “If you really can count on your two hands the ten foods that your child will accept, that’s concerning.” 
Amir is making progress at a pediatric feeding disorders clinic at Nova Southeastern University.
Schiller, Amir’s dad, said, “We’ve seen a change once he allowed her to put the spoon in his mouth.” 
Amir’s parents are encouraged. He’s eating applesauce and yogurt. Now they worry about other parents facing the same dinner table disasters.  
“First and foremost, it’s not your fault. Don’t blame yourself and seek professional help,” Tashara, Amir’s mom, told Ivanhoe.
If a child is extremely picky, Dr. Lesack purées their food in the clinic. She says it’s harder for kids to spit out and they get some exposure to the flavor. 
Contributors to this news report include: Janna Ross, Producer; Roque Correa, Editor and Judy Reich, Videographer.


PICKY EATERS
REPORT #2517

BACKGROUND: About 25 percent of children are reported with some form of feeding disorder. This number increases to 80 percent in developmentally delayed children. Consequences of feeding disorders can be severe, including growth failure, susceptibility to chronic illness, and even death. Feeding disorders can occur in children who are healthy, who have gastrointestinal disorders, and in those with special needs. Most feeding disorders have underlying causes and should be conceptualized on a continuum between psycho-social and organic factors. Assessment and treatment are best conducted by an interdisciplinary team of professionals. At a minimum, the team should include a gastroenterologist, nutritionist, behavioral psychologist, and occupational and/or speech therapist. Intervention should be comprehensive and include treatment of the medical condition, behavioral modification to alter the child’s inappropriate learned feeding patterns, and parent training in appropriate parenting and feeding skills. 
(Source: https://www.ncbi.nlm.nih.gov/pubmed/10636208) 

EFFECTS AND SYMPTOMS: Children classified as having a feeding disorder do not consume enough calories and nutrients to promote healthy growth and development. It is important to differentiate between a picky eater, who may consume a restricted but still nourishing diet, from a child who consumes, for example, only three to four types of foods, eliminating entire food groups and compromising healthy growth. “The difference between a fussy eater and a child with a feeding disorder is the impact the eating behavior has on a child’s physical and mental health,” says Peter Girolami, Ph.D., Clinical Director of the Pediatric Feeding Disorders Program at the Kennedy Krieger Institute in Baltimore. Early diagnosis and treatment is extremely important when it comes to feeding disorders. The longer it is left untreated, the more complex it can become. In extreme cases, children can even require feeding tube assistance. Feeding disorders can also lead to serious complications from nutritional deficiencies such as anemia. Some common symptoms of a pediatric feeding disorder are an abrupt change in eating habits lasting longer than 30 days, delayed development of skill set necessary to self-feed or consume higher textures, weight loss or failure to gain appropriate weight, and even choking or coughing during meals. Unexplained fatigue and loss of energy can also be a symptom. 
(Source: https://www.news-medical.net/news/20110920/Common-symptoms-of-pediatric-feeding-disorder.aspx) 

TREATMENT ADVANCES: A new study suggests the existing drug, D-cycloserine, may enhance recovery for children during treatment for pediatric feeding disorders, by changing their brain’s reaction to food. The results came from researchers at the Marcus Autism Center, Children’s Healthcare of Atlanta, Emory University School of Medicine and Yerkes National Primate Research Center. Children with feeding disorders who received behavioral intervention and D-cycloserine experienced more rapid treatment gains, with a 76 percent improvement in feeding after five days of treatment. This was compared to a 37 percent rate of improvement for children who received behavioral intervention and a placebo. “While a growing body of research indicates D-cycloserine may improve outcomes for children undergoing cognitive behavior therapy for anxiety, this is the first clinical trial focusing on the use of this medication as an adjunct to feeding intervention for severe food refusal,” says co-author William Sharp, PhD, director of the Pediatric Feeding Disorders Program at Marcus Autism Center and assistant professor in the Department of Pediatrics at Emory University School of Medicine. “Our results suggest that D-cycloserine may play a similar role in augmenting the effectiveness of intensive behavioral intervention targeting chronic food refusal, which holds potential to reduce treatment time and cost to affected families.”~~
(Source: http://news.emory.edu/stories/2017/06/sharp_dcycloserine/)  

For More Information, Contact:

Roseanne Lesack, PhD, BCBA-D, ABPP            Marla Oxenhandler, Media Relations
Nova Southeastern University                Nova Southeastern University
rlesack@nova.edu, (954)     262-2273    Marla.Oxenhandler@nova.edu,     (954) 770-9204

Free weekly e-mail on Medical Breakthroughs from Ivanhoe. To sign up: http://www.ivanhoe.com/ftk

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