Feeding Problems in Pre-School Children
Feeding problems in pre-school children are extremely common. At any time, about 10% of young children will demonstrate some problem with food refusal, and studies have suggested that one third of five-year-olds have a mild to moderate eating problem. The majority of children who present with feeding disorders are physically normal and thriving, but a small percentage may have rare medical problems. It is important not to miss these few children who may be genuinely failing to thrive. Rumination is defined as the repeated regurgitation and re-chewing of food without associated gastrointestinal or other medical disorder, such as oesophageal reflux. It is rare but serious, because of its association with failure to thrive. It is often associated with developmental delay, particularly in older children. Referral to a paediatrician should be considered if the child's weight is below the third centile or there is a fall across centiles. The failure to thrive may have an organic cause.