Not just picky

When a child is highly se­lec­tive about his food, it’s more than just a be­havioural woe.

The Star Malaysia - Star2 - - FAMILY -

MANY par­ents be­lieve that a child who is a picky eater will even­tu­ally out­grow his be­hav­iour. This is not al­ways true, how­ever. Some­times, the un­will­ing­ness to eat new food is a sign of a se­ri­ous feed­ing dif­fi­culty, highly se­lec­tive in­take, which can af­fect a child’s growth and de­vel­op­ment.

Four-year-old Adam’s highly se­lec­tive in­take started when his par­ents As­ree and Atie tried to in­tro­duce him to solid food. He re­fused to eat any­thing other than milk, mush­room soup and ce­real. He would even vomit at the sight of cer­tain food such as rice.

“At first, we thought that Adam just needed more time to learn how to eat solid food. But when he turned three and still re­fused to eat solid food, we de­cided to seek med­i­cal help,” said Atie.

As­ree and Atie con­sulted some doc­tors, and even­tu­ally they were re­ferred to pae­di­a­tri­cian Dr Nazrul Neezam.

“Pre­lim­i­nary tests showed that there was noth­ing wrong with Adam’s di­ges­tive sys­tem or his abil­ity to swal­low food,” said Dr Nazrul. Fur­ther in­ves­ti­ga­tion sug­gested that Adam had highly se­lec­tive in­take.

Highly se­lec­tive in­take is one of the feed­ing dif­fi­cul­ties com­monly af­fect­ing chil­dren. Di­ag­no­sis and man­age­ment of th­ese con­di­tions were dif­fi­cult in the past be­cause of a lack of of­fi­cial di­ag­nos­tic frame­work for health­care pro­fes­sion­als. Things are start­ing to change, how­ever. In 2012, the Malaysian Pae­di­atric As­so­ci­a­tion, in col­lab­o­ra­tion with Ab­bott Nu­tri­tion, in­tro­duced Even­tu­ally the boy be­came used to eat­ing with his par­ents and the tears stopped.

To­day, Adam could fin­ish a scoop of rice all on his own. He has also de­vel­oped a lik­ing for noo­dles and a few other dishes, much to his par­ents’ joy.

“I would say that Adam is now 70% on the road to re­cov­ery,” said Atie. As­ree ad­vised par­ents to seek med­i­cal help if their child has a feed­ing dif­fi­culty. Atie added that pa­tience is very im­por­tant when it comes to help­ing the child. “There were many times when I broke down and cried, but I re­fused to give up on Adam,” she said. Iden­ti­fi­ca­tion and Man­age­ment of Feed­ing Dif­fi­cul­ties (IMFeD), a tool that al­lows for ac­cu­rate di­ag­no­sis of childhood feed­ing dif­fi­cul­ties.

Ac­cord­ing to Dr Nazrul, who uses IMFeD in his prac­tice, the rec­om­mended in­ter­ven­tion mea­sures in IMFeD are use­ful for chil­dren like Adam.

“In this sit­u­a­tion, the par­ents should eat with the child at least once a day,” said Dr Nazrul. Par­ents should eat nor­mally in front of their child, and of­fer a small por­tion only af­ter the child asks for a taste.

“Forc­ing the child to eat may make him more re­luc­tant to try new food,” Dr Nazrul ex­plained.

If the child’s growth is sig­nif­i­cantly af­fected by his feed­ing dif­fi­culty, a nutritional sup­ple­ment may be nec­es­sary.

As­ree said it took a while for Adam to get used to eat­ing at the din­ing ta­ble. He and Atie prac­tised the “time out method” rec­om­mended by IMFeD. When Adam mis­be­haved, they sent the boy to sit in a cor­ner for a few min­utes.

Iden­ti­fi­ca­tion and Man­age­ment of Feed­ing Dif­fi­cul­ties (IMFeD) is a tool that al­lows for ef­fi­cient and ef­fec­tive di­ag­no­sis of childhood feed­ing dif­fi­cul­ties. Since 2012, the Malaysian Pae­di­atric As­so­ci­a­tion has col­lab­o­rated with Ab­bott Nu­tri­tion Malaysia to pro­mote the use of IMFeD among health­care pro­fes­sion­als in Malaysia. For more in­for­ma­tion, visit www.imfed.my. This ar­ti­cle is con­trib­uted by the IMFeD pro­gramme, spear­headed by the Malaysian Pae­di­atric As­so­ci­a­tion in col­lab­o­ra­tion with Ab­bott Nu­tri­tion Malaysia.

Red sig­nal: When a child is overly picky about food, it could be a sign that he needs help.

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