Kk&s Ch.45 Feeding And Eating Ds Of Infancy Or Early Childhood

Front 1

pica definition?

Back 1

pica is described as persistent eating of nonnutritive substances for at least 1 mont

Front 2

geophagia=?
amylophagia?
seen in?

Back 2

Among adults, certain forms of pica, including geophagia (clay eating) and amylophagia (starch eating), have been reported in pregnant women

Front 3

A survey of a large clinic population reported that ? percent of 12-month-old infants and ? percent of 2- to 3-year-old toddlers placed nonnutritive substances in their mouth

Back 3

75
15%

Front 4

Pica is most often a transient disorder that typically lasts for several ? and then remits. In younger children, it is more frequently seen among children with ? and ?.

Back 4

Pica is most often a transient disorder that typically lasts for several months and then remits. In younger children, it is more frequently seen among children with developmental speech and social developmental delays.

Front 5

is pica higher in relatives?

Back 5

yes

Front 6

pica and nutritional deficiences?

Back 6

For example, cravings for dirt and ice are sometimes associated with iron and zinc deficiencies, which are corrected by their administration

Front 7

is pica associated with neglect?

Back 7

yes

Front 8

Eating nonedible substances repeatedly after ? months of age is usually considered abnormal

Back 8

18

Front 9

DSM criteria ... how long must pica occur for?

Back 9

1. Persistent eating of nonnutritive substances for a period of at least 1 month.
2. The eating of nonnutritive substances is inappropriate to the developmental level.
3. The eating behavior is not part of a culturally sanctioned practice.
4. If the eating behavior occurs exclusively during the course of another mental disorder (e.g., mental retardation, pervasive developmental disorder, schizophrenia), it is sufficiently severe to warrant independent clinical attention.

Front 10

Lab exams for pica?

Back 10

Levels of iron and ZINC in serum should always be determined; in many cases of pica, these levels are low and may contribute to the development of pica. Pica may disappear when oral iron and zinc are administered.
Hb to rule out anemia
level level to rule out poisoning

Front 11

pica ddx?

Back 11

anemia
iron, zinc def
lead poisoning
neglect

Front 12

?, a dramatic but reversible endocrinological and behavioral form of failure to thrive, children often show bizarre behaviors, including ingesting toilet water, garbage, and other nonnutritive substances.

Back 12

In psychosocial dwarfism

Front 13

tx pica?

Back 13

improve parental relationship with child if neglect
fix nutritional defiency
link pica to aversion (i.e. lemon drop)

Front 14

rumination disorder ... should rule out what?

Back 14

reflux

Front 15

key features of rumination disorder

Back 15

DSM-IV-TR notes that the essential feature of the disorder is repeated regurgitation and rechewing of food for a period of at least 1 month after a period of normal functioning. Partially digested food is brought up into the mouth without nausea, retching, disgust, or associated gastrointestinal disorder. This activity can be distinguished from vomiting by the clear, purposeful movements the infant makes to induce it. The food is then ejected from the mouth or reswallowed. A characteristic position of straining and arching of the back, with the head held back, is observed. The infant makes sucking movements with the tongue and gives the impression of gaining considerable satisfaction from the activity. Usually, the infant is irritable and hungry between episodes of rumination

Front 16

DSM rumination ds criteria

Back 16

1. Repeated regurgitation and rechewing of food for a period of at least 1 month following a period of normal functioning.
2. The behavior is not due to an associated gastrointestinal or other general medical condition (e.g., esophageal reflux).
3. The behavior does not occur exclusively during the course of anorexia nervosa or bulimia nervosa. If the symptoms occur exclusively during the course of mental retardation or a pervasive developmental disorder, they are sufficiently severe to warrant independent clinical attention.

Front 17

Usual emergence age of rumination ds?

Back 17

3 months and 1 year of age

Front 18

Rumination work up

Back 18

rule out reflux, hernia, pyloric stenosis

laboratory measures of endocrinological function
- thyroid function test
- dexamethasone-suppression test),
serum electrolytes, and a

hematological workup help determine the severity of the effects of rumination disorder.

Front 19

Tx of rumination ds?

Back 19

mother-child relation
behav mod: lemon, reduce atten
surgery

Front 20

Criteria for feading disorder of infancy or early childhood?

Back 20

# Feeding disturbance as manifested by persistent failure to eat adequately with significant failure to gain weight or significant loss of weight over at least 1 month.
# The disturbance is not due to an associated gastrointestinal or other general medical condition (e.g., esophageal reflux).
# The disturbance is not better accounted for by another mental disorder (e.g., rumination disorder) or by lack of available food.
# The onset is before age 6 years

Front 21

Children with feeding disorders have been found to show what? than children without feeding problems

Back 21

problems with touch
display less affectionate touch,
more negative touch, and
more rejection of mother's touch
In addition, more rejecting maternal responses to the child's touch have also been observed, and children with feeding disorders are more often positioned out of reach of their mothers' arms.

Front 22

DDX of feading ds?

Back 22

Feeding disorder of infancy must be differentiated from structural problems with the infants' gastrointestinal tract that may be contributing to discomfort during the feeding process

Front 23

Most interventions for feeding disorders are aimed at

Back 23

optimizing the interaction between the mother and infant during feedings, and identifying any factors that can be changed to promote greater ingestion.