The parents have the responsibility to care for the child with feeding difficulties. The development of appropriate and healthy eating behaviors in the child depends largely on the attitude of the parents in the act of feeding: their interaction with the child shapes this behavior.
And is that feeding involves an interaction of two: the caregiver, usually the mother, and the child. At the beginning, this is ideally achieved through breastfeeding, when a communication is established between the two based basically on the child's crying and the mother's timely response, who soon learns to differentiate in her child a pattern for each need: affection, food, sleep, defecation-urination. This way of communicating little by little is enriched with the presence of smiles, glances and the first words that the child emits.
Complementary feeding (solid or liquid food other than breast milk) begins from 4 to 6 months. The healthy interaction between the child and his caregiver in these stages will lead him in the near future to become independent and to eat (to feed himself and without the help of another). But at every stage parents have a great influence on the eating behavior of their children. In the neonatal period, a varied diet guarantees the fetus wide exposure to flavors through the amniotic fluid; after birth, breast milk also allows it because it correlates with the mother's diet. Parents also determine the environment in which feeding takes place, where and when it occurs.
A responsible eating style where the child is guided, establishing behavioral limits and where adequate responses are given to his hunger signals, diminishes the possibility of developing them. In the same way, encouraging the child to feed herself, at first with her hands despite the fact that she “makes things dirty” and then with cutlery according to her age, despite the fact that “she does not do it correctly”, is. important.
The prevention and management of feeding difficulties is based on responsible caregiver behavior. Feeding the child according to their real needs of appetite and satiety, responding positively to their attempts to feed themselves, knowing the different stages and difficulties they go through, from "being fed" to being able to "eat by themselves", are crucial points .
Feeding difficulties are defined as any situation that represents a negative interference on the normal feeding process of the child. One of the main drawbacks is poor appetite or hyporexia, which can be secondary to an organic disease, occur in depressed children or, more commonly, very active children, more aware of play and interaction with their environment than eating, who also they do not clearly identify the feeling of hunger and satiety.
In these cases, while the child learns to identify these sensations and under the supervision of the pediatrician, it is useful to use nutritional supplements specially formulated for the pediatric population, which provide calories and have an adequate balance of carbohydrates, proteins, fats, vitamins and minerals. It may also happen that parents consider their child with little appetite, due to overestimation of their real needs; In this case, the opportune advice of the pediatrician will make it possible to correct said error of assessment. In children with little appetite it is important:
• Always feed them at the same time and distance meals and snacks for 3-4 hours. If the child does not eat in the scheduled time, she will not be able to receive any food except water until the next meal.
• Serve small portions.
• The child should remain at the table until “mommy and daddy's belly” are full even though he is no longer eating or does not want to eat.
• Meals should last a maximum of 30 minutes.
• Maintain a neutral attitude.
• Do not use food as an expression of affection.
• If the child does not behave well, give him a single warning, if he does not correct the behavior, place him in time out.
WHEN IT'S QUICKY
Another common difficulty is highly selective children also called "picky eaters" at mealtime. They are children who reject foods or complete groups of foods due to their characteristics (colors, textures, flavors, smells).
Between 18-24 months of age, a stage known as "neophobia" is passed, when there is an innate fear and refusal to try new foods, which over time is overcome. Sometimes, to achieve acceptance of a new food, up to 10 exposures to it are necessary. Therefore, it is important at the beginning of complementary feeding to guarantee maximum exposure to flavors and textures. In this case, and if there is a rejection of complete food groups, the use of the nutritional supplements already mentioned may be useful. Consistently offering new foods without putting pressure on the child is the key, understanding that accepting them takes time but with patience is achieved. Food preferences must also be respected within the same group (for example, that they accept some vegetables and others do not) and avoid making "points of honor" with foods preferred by parents as this, together with the pressure they can exert at the time eating tends to increase rejection. Some of these children also describe a greater sensitivity to taste perception of bitter flavors and certain food textures, which would make them more likely to reject them.