Lemons P K, Dodge N N
Riley Children's Hospital, Indiana University Medical Center, Indianapolis 46202-5210, USA.
J Pediatr Health Care. 1998 Jan-Feb;12(1):27-32. doi: 10.1016/s0891-5245(98)90026-8.
The inability to successfully feed a young infant or child is as worrisome to parents as it is to the health care provider. Early growth failures are likely to reflect difficulty with infant homeostasis and often respond to medical management of the physical problem that is temporarily interfering with the infant's ability to feed by mouth. In addition to medical management, however, treatment also necessitates investigation and management of behavioral problems that so universally accompany growth failure. This article presents a case study of a child who presented with poor growth and respiratory symptoms associated with nonregurgitant gastroesophageal reflux, a clinical entity that can be difficult to recognize. Although surgical management of this condition was successful, persistent failure-to-thrive continued and was seemingly recalcitrant to treatment. The use of cyproheptadine as an appetite stimulant to promote weight gain in this child is discussed with a review of the current literature regarding this pharmacologic approach to poor weight gain. A behavioral-based treatment plan is described as an alternate management method, avoiding the use of pharmacologic agents in general.
无法成功喂养婴幼儿，这让家长和医疗服务提供者一样忧心。早期生长发育不良很可能反映出婴儿体内平衡出现问题，通常可通过对暂时干扰婴儿经口喂养能力的身体问题进行医学处理来解决。然而，除了医学处理之外，治疗还需要对普遍伴随生长发育不良出现的行为问题进行调查和处理。本文介绍了一个病例研究，该患儿因非反流性胃食管反流出现生长发育不良和呼吸道症状，这是一种难以识别的临床病症。尽管对该病症的手术治疗取得了成功，但患儿持续存在发育迟缓，且似乎对治疗有抵抗性。本文讨论了使用赛庚啶作为食欲刺激剂来促进该患儿体重增加的情况，并回顾了有关这种针对体重增加不佳的药物治疗方法的现有文献。还描述了一种基于行为的治疗方案，作为一种替代管理方法，总体上避免使用药物。
