PE5.1 | Feeding Problems — Summary & Reflection

KEY TAKEAWAYS

Feeding problems in children range from normal appetite variation to significant organic disease. The key diagnostic step is distinguishing organic from behavioural causes through careful history, growth monitoring (weight-for-height, MUAC), and targeted physical examination. Red flag features (projectile/bilious vomiting, dysphagia, aspiration, growth faltering, blood in stool) prompt urgent investigation. Organic causes — GORD, pyloric stenosis, CMPA, structural and neuromuscular disorders — require specific treatment: conservative/pharmacological management for GORD, surgical pyloromyotomy for pyloric stenosis after metabolic correction, and dietary elimination for CMPA. Behavioural feeding problems, the majority, are managed through structured mealtime strategies, parental education, and the division-of-responsibility model. Never force-feed a child. Children with nutritional compromise require micronutrient supplementation or therapeutic feeding per SAM/MAM protocols.

REFLECT

Think about the last time you witnessed a mealtime struggle — in your own experience or a clinical setting. What messages were being communicated to the child about food and eating? How might a paediatrician counsel a family where the parents have taken on the child's role (deciding how much the child eats) and the child has lost their own hunger cues? Kolb's concrete experience invites you to connect the physiological drivers of appetite (ghrelin, satiety signals) with the psychological overlay of mealtime dynamics, and to reflect on what 'good feeding practice' really means from the child's perspective.