Eating Disorders, Food Aversion and Food Anxiety

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A great tip on increasing childs calories/fats if they are underweight

My dietician just gave me a great tip for my son - try putting some olive oil on any foods to increase their calories/fats. This works even on oven cooked food like fish fingers. It doesn't leave them soggy and my kids couldn't even tell I'd done it (which is important as they hate any change to their food).

She also recommended a supplement called WellKids. She said it contains most things except calcium so this has to be prescribed separately. The only place I could find information on the WellKids was on the Boots website:

http://www.boots.com/webapp/wcs/stores/servlet/CatalogSearchResultView?storeId=10052&catalogId=10551&langId=-1&pageSize=12&beginIndex=0&sType=SimpleSearch&resultCatEntryType=2&searchTerm=WellKid&x=30&y=3

We also recently found out that Seravit now do a flavoured version - pineapple. My kids much prefer this. You can get it on prescription if your childs diet is deficient in vitamins/minerals.

A teenagers own story about having a food phobia

The Children first website has a story written by a teenager who has a food phobia. It may help you understand what your child is feeling.

The link is:

http://www.childrenfirst.nhs.uk/teens/health/mental_health/book1/rs_phob_tal.htm

A useful leaflet on Fussy Eaters and food neophobia

This leaflet is produced by Candence Health and covers fussy eaters and food neophobia. it doesn't cover the more complicated eating problems like food aversion and food phobia.

http://www.cadencehealth.com.au/KidsE-FactSheet3-FussyEating.pdf

A useful website on food anxiety

http://www.anxietycare.org.uk/docs/eating.asp

do 'picky eaters' suffer from 'oral defensiveness' or sensory processing disorder?

this website talks about children who are picky eaters and whether or not this is realted to a sensory processing disorder / oral defensiveness.

To read the article visit:
http://www.sensory-processing-disorder.com/picky-eaters.html

Tips include:

- giving your child oral-motor activities daily
- allowing exploration and play with food
- grinding up real foods so texture is easier and allowing touch with hands first.
- let them play with and eat condiments
- once you find a food they like, try other similar foods.
- try distractions whilst eating
- use reward systems.
- give your child control and choice.
- pay attention to textures and temperatures.
- use positive reinforcement, not punishment.
- you could try giving a freeze pop before a meal to desensitize their mouth

Eating Disorders – NICE guidance (2004)

This NHS document is really useful for anyone who has a child suffering from an eating disorder including anorexia nervosa, bulimia nervosa and other eating disorders. This document is written in simple English and so could be useful for teenagers suffering from an eating disorder who want to read more about their illness and medical care.

The document covers:

Information about eating disorders – including Anorexia nervosa, Bulimia nervosa, binge eating disorders and other atypical disorders

How to care for someone with an eating disorder

Information and support within the NHS

Treatment, including medication and psychological treatments (such as cognitive analytic therapy (CAT), cognitive behaviour therapy (CBT), interpersonal therapy (IPT), focal psychodynamic therapy, family therapy

Inpatient care and care after being discharged

Care for children and young people and their families

Questions to ask about your childs care and treatment

To read the full guidance document visit -

http://www.nice.org.uk/nicemedia/pdf/cg009publicinfoenglish.pdf

Food-chaining - a treatment for food aversion and picky eaters?

Hi
I have been researching treatments for food aversions (my 2 sons have this problem) and came across a treatment called ' Food-Chaining' which sounds really interesting.

This is just a summary:

Food chaining involves a therapist analysing a childs food repetoire to see what similarities in taste and texture exist. They look at what kinds of foods are regularly rejected. Having looked at the childs 'core diet' they then link these foods to other very similar foods taste/texture foods and slowly try to expand the number of accepted foods. The idea is that a child is more likely to accept a food if it's selected on the childs own preferences. Food chains have to be individually designed and some therapists create 'calendars' for families to introduce the changes very slowly.

I found a really good article that you may like to read:

http://www.empoweredparents.com/pickyeating/pickyeating7.htm

Hope this helps someone.

Great Ormond Street Feeding Clinic

I came across this article which describes how they treat food aversions and food anxiety at Great Ormond Streets Feeding Clinic.

http://www.thepsychologist.org.uk/archive/archive_home.cfm/volumeID_15-editionID_82-ArticleID_429-getfile_getPDF/thepsychologist%5Cjuly02stuwriter.pdf

Information on Sitophobia in childhood (fear of eating or fear of food)

Sommerset and Wessex EAting Disorder Association

Information on lots of different kinds of eating fears/phobias and disorders including sitophobia

http://www.swedauk.org/disorders/other.htm

Sitophobia

a site aimed at adults but may give useful background information to the condition

http://www.sitophobia.info/phobia.htm

Need help for Food aversions / anxiety - try your local Speech Therapy Department (SALT)!

HI
My 2 sons hav e eating problems resulting from an undiagnosed gut condition where years of pain led them to develop an anxiety surrounding food.

Our eldest son couldn't eat anything but puree for years and used to vomit and gag. Our local speech therapy department had a speech therapist who specialised in oral problems and she was able to advise us. She arranged for us to go on a 'messy food play' course to ge tmy son used to different food textures. she also guided us on getting him used to oral stimulation so that he may come to tolerate lumps, finger foods, teeth brushing etc. She also did home visits to observe him eating to see if the problem was physical or psychological etc.

She was also able to refer on to more specialist teams (e.g. at Great Ormond Street) if things didn't improve - which she did for us.

If your child has eating problems then it may be worth consulting your local speech therapy department to see if they can help you.

New Research - Dietary baked milk accelerates the resolution of cow’s milk allergy in children

the research can be read at: http://www.jacionline.org/article/S0091-6749(11)00674-9/abstract. It is printed in the Journal of Allergy and Clinical Immunology and the summary is;

Background

The majority (approximately 75%) of children with cow’s milk allergy tolerate extensively heated (baked) milk products. Long-term effects of inclusion of dietary baked milk have not been reported.

Objective

We report on the outcomes of children who incorporated baked milk products into their diets.

Methods

Children evaluated for tolerance to baked milk (muffin) underwent sequential food challenges to baked cheese (pizza) followed by unheated milk. Immunologic parameters were measured at challenge visits. The comparison group was matched to active subjects (by using age, sex, and baseline milk-specific IgE levels) to evaluate the natural history of development of tolerance.

Results

Over a median of 37 months (range, 8-75 months), 88 children underwent challenges at varying intervals (range, 6-54 months). Among 65 subjects initially tolerant to baked milk, 39 (60%) now tolerate unheated milk, 18 (28%) tolerate baked milk/baked cheese, and 8 (12%) chose to avoid milk strictly. Among the baked milk–reactive subgroup (n = 23), 2 (9%) tolerate unheated milk, and 3 (13%) tolerate baked milk/baked cheese, whereas the majority (78%) avoid milk strictly. Subjects who were initially tolerant to baked milk were 28 times more likely to become unheated milk tolerant compared with baked milk–reactive subjects (P < .001). Subjects who incorporated dietary baked milk were 16 times more likely than the comparison group to become unheated milk tolerant (P < .001). Median casein IgG₄ levels in the baked milk–tolerant group increased significantly (P < .001); median milk IgE values did not change significantly.

Conclusions

Tolerance of baked milk is a marker of transient IgE-mediated cow’s milk allergy, whereas reactivity to baked milk portends a more persistent phenotype. The addition of baked milk to the diet of children tolerating such foods appears to accelerate the development of unheated milk tolerance compared with strict avoidance.

Oral Motor Play Ideas and Sensory Play Ideas

Reflux Rebels have some good ideas for oral motor play and sensory play to help children with problems that affect their willingness to feed, have their teeth brush, touch textures.

The link is:

http://www.refluxrebels.com/Oral_motor_play.html

The desensitisation for teethbrushing is particularly helpful as there's not much information about for this sort of problem. Some ideas are:

Use vibrating toothbrush
Count teeth using toothbrush or long food item
Make music by tapping food in between upper and lower teeth
Put vibrating toy on cheek

Possible causes of food refusal in children

You may want to look at this article:

http://www.keepkidshealthy.com/nutrition/food_refusal.html

It outlines possible causes of food refusal including:

gastroesophageal reflux
oral motor dysfunction
food aversion disorders
neuromuscular disorders
obstruction
achalasia
many other anatomical and neuromuscular disorders that cause dysphagia