ABSTRACT
This chapter discusses the difficult decision of when to admit children with feeding disorders (FDs) into in-patient (IP) intervention programmes. Children with FDs may not respond to strategies that are commonly recommended for children with more transient problems. Such children are likely to require intensive multi-disciplinary intervention that may necessitate admission to hospital. The majority of children that present with feeding problems respond well to management strategies suggested by clinicians. Feeding is a complex dynamic process that requires a well integrated development of biological systems effectively interacting with the environment. For children who are tube-fed or have a tube-dependence, a frequent practice during IP intervention is to progressively reduce artificial feeding to the minimum daily nutritional needs and to deliver those calories at night during the child's sleep. Children with severe problems that develop into FDs can be at considerable risk of malnutrition and severe weight loss that may impact on their cognitive, emotional and physical development.
