Developmental approach to feeding disturbances

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DEVELOPMENTAL APPROACH TO FEEDING DISTURBANCES Irene Chatqor, M.D., Sharon Schaefer, M.A., L.C._S.W.., LindaD!cksqn, M.S., L.C.S.W., James Egan, M.D. The authors propose a developmental classification for eating disorders in infancy and young children based on their work with the failure to thrive population at a pediatric hospital. They found that the construct of the developmental line allowed them to integrate the biological, psychological and social (or dyadic) elements in various cases Qf failure to thrive into one biopsychosocial model. Developmental subgroups of homeostasis, attachment, and separation were used in classifying infant feeding disturbances. Infants with selfregulatory difficulties belong in the group referred to as Prob%ems i_~nHomeos,tasis (birth to two months). An infant who has not achieved a good homeostasis can be a baffling child to feed. Work with the mother-infant dyad experiencing this feeding difficulty focuses on helping the mother compensate for the homeostatic imbalance and better interpret the infant's cues. The second group of infants is characterized by P;qblemsl o f Atftachment (two to eight months). Feeding problems at this stage can stem from inadequate stimulation (vocal, tactile, visual) by the mother. The third group of infants develop feeding problems during the developmental stage ~ of separation and indlviduation, between 6 months and 2 years of life. The child's autonomous eating behavior is met with ambivalence and inconsistency from mother. A battle of wills around eating results in the child's refusal to eat. This feeding disorder reflects a disturbance in somatopsychological differentiation during the developmental phase of separation and individuatlon.