Departments of Pediatric Gastroenterology, Hepatology, and Nutrition, and
Pediatric Nutritional Consultant, Geneva, Illinois;
Pediatrics. 2015 Feb;135(2):344-53. doi: 10.1542/peds.2014-1630. Epub 2015 Jan 5.
Many young children are thought by their parents to eat poorly. Although the majority of these children are mildly affected, a small percentage have a serious feeding disorder. Nevertheless, even mildly affected children whose anxious parents adopt inappropriate feeding practices may experience consequences. Therefore, pediatricians must take all parental concerns seriously and offer appropriate guidance. This requires a workable classification of feeding problems and a systematic approach. The classification and approach we describe incorporate more recent considerations by specialists, both medical and psychological. In our model, children are categorized under the 3 principal eating behaviors that concern parents: limited appetite, selective intake, and fear of feeding. Each category includes a range from normal (misperceived) to severe (behavioral and organic). The feeding styles of caregivers (responsive, controlling, indulgent, and neglectful) are also incorporated. The objective is to allow the physician to efficiently sort out the wide variety of conditions, categorize them for therapy, and where necessary refer to specialists in the field.
许多家长认为自己的孩子饮食不良。尽管这些孩子大多数都受到轻微影响，但仍有一小部分孩子患有严重的进食障碍。然而，即使是受影响较小的孩子，如果他们焦虑的父母采取了不适当的喂养方式，也可能会产生后果。因此，儿科医生必须认真对待所有家长的担忧，并提供适当的指导。这需要一个可行的喂养问题分类和系统的方法。我们所描述的分类和方法结合了医学和心理学专家的最新考虑因素。在我们的模型中，孩子被归为以下 3 种主要的父母关注的进食行为：食欲有限、选择性摄入和进食恐惧。每个类别都包括从正常（误解）到严重（行为和器质性）的范围。照顾者的喂养方式（反应性、控制性、纵容性和忽视性）也被纳入其中。目的是让医生能够有效地梳理各种不同的情况，对其进行治疗分类，并在必要时向该领域的专家转诊。
