Exposure and practice with foods and feeding

The immediate impact of feeding difficulties in infancy is a slowing down of the rate at which infants learn to eat. This leads to less exposure to foods and feeding, and if prolonged, may lead to delays in age-related feeding skills.  There is a cross-over of cause and effect here,  with the time of greatest impact during the “sensitive window” of the first year, and in particular 6-12 months when learning how to eat solids.  Growth faltering and nutrient deficiencies can result, mainly due to the very high needs for calories and nutrients at this time. Limited exposure and practice eating a wide range of foods, textures, flavours in a structured way, may impact the reward-based system we think of as hunger and satiety.

Repeated illness during the first year

Feeding difficulties in infancy are often linked to repeated illness or hospitalisation during the first year. Food aversion may result, often also linked to an underlying medical condition such as cow’s milk allergy, which can affect appetite, food intake and/or absorption of nutrients.  Again, this will slow down the exposure and experience of a wide range of foods, with limited prospect of positive learning (reward. It is helpful to understand which factors are involved before addressing how best to support (re)learning these key feeding-skills. This is identified using dietary assessment methods, which elucidate how the particular feeding difficulties have arisen, how they have been managed and consideration of first steps towards addressing expanding the diet.

Growth Faltering and Nutrient deficiencies

The most common cause of growth faltering is lack of calories (energy) to meet the high calorie demands of growing infants, who need around 4 – 5 times the calories of an adult for their weight. Growth faltering is more common in the first year, and when addressed and resolved at an early point, has no adverse consequences.  Untreated growth faltering will impact on a child’s height growth going forward into childhood and may be associated with other nutrient deficiencies eg.  iron deficiency anaemia