[Early restrictive feeding disorders: Quantitative assessment of parent/infant feeding interactions]. / Troubles du comportement alimentaire restrictif du nourrisson et du jeune enfant : évaluation quantitative des interactions parent/nourrisson pendant le repas.

INTRODUCTION: Interest in the study of early feeding disorders (FD) has steadily increased during recent decades. During this period, research described the importance of the transactional relationships and the complex interplay between caregiver and child over time. On the basis of the previous studies, our study tried to explore the associations between the characteristics of the parents and the temperamental characteristics of the infants with early FD. GOALS: A first aim of the present study was to show if parental perception of child temperament (including ability for arousal self-regulation) and parental characteristics (emotional and eating attitudes) are associated with early FD. A second aim was to identify emotional/behavioral difficulties in children with early FD by comparing children with a normal development and children with a diagnosed FD, and to investigate whether there are any correlations between parental emotional and feeding characteristics and a child's eating and emotional-behavioral development. A final aim was to explore if feeding conflict is bound to both infant ability for arousal self-regulatation and caregiver emotional status during meals. METHOD: Participants: 58 clinical dyads (children aged 1-36 months) and 60 in the control group participated in the study. The sample of 58 infants and young children and their parents was recruited in a pediatric hospital. They were compared to healthy children recruited in several nurseries. PROCEDURE: all parent-child pairs in the clinical sample were observed in a 20-minute video-recording during a meal using the procedure of the Chatoor Feeding Scale. After the videotaping, parents completed a battery of self-report questionnaires assessing their child's and their own psychological symptom status. MEASURES: Child's malnutrition assessment was based on the Waterlow criteria. The Child Behavior Checklist (CBCL 1½-5) was used to assess a child's emotional/behavioral functioning. The Infant Behavior Questionnaire-Revised (IBQ-R), a widely used parent-report measure of infant temperament, was used to identify the structure of infant temperament. The Eating Attitude Test-40, a self-report symptom inventory, was used to identify concerns with eating and weight in the adult population. The Chatoor Feeding Scale was used to assess mother-child feeding interactions during a meal based on the analysis of the videotaped feeding session. RESULTS: Analyses revealed that children with FD did not have a difficult temperament, especially no disability for arousal of self-regulatation, but their emotional-behavioral functioning is characterized by internalizing problems. Analyses of the EAT-40 showed that mothers of the children diagnosed with FD had significantly higher scores than mothers of the control sample; it means these mothers showed more dysfunctional eating attitudes. In addition, meals were characterized by negative effects in parents in the clinical group. When compared to the control sample, the feeding interactions between children with FD and their parents were characterized by low dyadic reciprocity, high maternal non-contingency, great interactional conflict and struggles with food. However, no significant correlation emerged either between the severity of malnutrition in infants or the conflict during feeding. CONCLUSION: Our study confirms the relations established in previous research. Finally, future longitudinal studies are needed to further clarify and investigate others factors that may be involved in early feeding disorders.

[Feeding disorders in infants and toddlers: At-risk situations and predisposing factors]. / Troubles du comportement alimentaire restrictifs du nourrisson et du jeune enfant : situations à risque et facteurs favorisants.

Feeding disorders and food refusal can be found in 25% of infants, with a minority of them having an organic explanation. Failure to thrive and/or severe malnutrition are found in 3-5% of infants in this population. The objective of this study was to analyze the risk factors of feeding disorders in infants and children less than 3 years of age. This study was conducted from January 2011 to December 2014 and included 103 children, 57 with feeding and/or eating disorders and 46 healthy children considered to be normal eaters. Parents participated in a structured interview and completed a data sheet to record the mode of delivery, neonatal status, medical history, milk feeding, and medical treatment. Statistical analysis indicated that cesarean delivery, prematurity, neonatal diseases, history of eating disorders in the family, consumption of protein hydrolysates, and treatment with proton pump inhibitors were highly significant risk factors in children with eating disorders. In the present study, we showed that several prenatal and postnatal conditions or interventions were associated with the development of eating disorders in young children. Recommendations for future studies include identifying environmental risk factors and implementing prevention programs focused on family, caregivers, as well as healthcare professionals. The objective is to allow physicians to efficiently sort out the wide variety of conditions, categorize them for therapy, and when necessary refer patients to specialists in the field.

[Feeding disorders in infants and toddlers: advantages of a joint consultation with pediatrician and psychologist]. / Troubles alimentaires restrictifs du nourrisson et du jeune enfant : avantages d'une consultation conjointe entre pédiatre et psychologue.

Feeding disorders and food refusal can be found in 25% of infants, a minority of these disorders has an organic explanation. Failure to thrive and/or severe malnutrition is found in 3-5% of infants in the general population. The authors describe the various phases of the interdisciplinary therapeutic intervention by underlining the advantages and the objectives to integrate therapeutic approaches across professional boundaries. Caregiver-infant relationship disturbances are certainly the most important factor, but the induced psychosomatic conditions also have a multifactorial etiology. This article points out the specificities of the disorders of infant feeding behaviors and explains the advantages of a joint pediatrician-psychologist consultation compared to separate consultations in pediatrics and child psychiatry.

[Mourning a chronic disease: diagnostic error experienced by two families]. / Faire le deuil d'une maladie chronique : vécu de l'erreur diagnostique par deux familles.

We report on two pediatric cases with a diagnosis of hereditary metabolic disease established for several years and secondarily disproved. Retrospective interviews conducted 1 year after the announcement of the absence of the illness, the psychological reactions were analyzed. Through this clinical experience, the authors suggest that the traumatism caused by the announcement of the diagnosis may be similar to that which occurred when invalidation of the disease is pronounced. Four steps predominate: relief, anger, guilt, and problems mourning the disease experienced in solitude.