Feeding and FPIES

Abstract

Feeding skill development generally follows a predictable progression. When a child’s feeding experiences are atypical, then we expect that progression to be interrupted. Interruption anywhere along the child’s feeding progression can alter the child’s feeding trajectory and place the child at risk for developing a pediatric feeding disorder. Pediatric feeding disorders are associated with deficits in four primary areas: nutritional, medical, skill, and psychosocial. These may include slow weight gain and growth, micronutrient deficiencies, constipation, delays in the development of skills associated with eating and feeding, refusal to eat certain foods (picky eating), refusal to eat enough food to gain weight and grow, or other disruptive behaviors that are incompatible with eating. For the child with food allergy or FPIES, discomfort and pain associated with food reactions can adversely impact the child’s learning about feeding. As with any other pediatric feeding disorder, children with FPIES are ideally evaluated and managed using a multidisciplinary approach that allows for the identification of contributing factors in multiple domains (nutritional, medical, skill development, and psychosocial) and allows for intervention in all those realms.