Poor feed tolerance or slow weight gain
Some children have to take a mainly liquid diet, or are already on tube feeds and may suffer from vomiting, reflux or just discomfort preventing adequate weight gain. In these children we may change the type of feed given, reduce the volume and /or prescribe treatment to
- Control reflux
- Improve gastric emptying
- Stimulate appetite
- Refer to the complex feeding team in Paediatric Gastroenterology
High Energy Milk and Drinks
In practice these drinks and special milks are only really suitable for children who really cannot eat (or learn to eat) solid food.
There are a wide range of these products on the market, but while they sound as if they should helpful for increasing weight gain, there is little evidence that they are effective and we have seen many instances in our clinic where they have suppressed appetite for other foods and in some cases even slowed weight gain.
If these products are started it is important to monitor their effect over time. If they do not result in increased weight gain or have only a short term effect, they should be stopped and other strategies adopted.
Other help with eating and feeding behaviour
If you are worried about feeding problems and issues such as food refusal or picky variable eating, this leaflet may provide the answer to some of the issues that are worrying you.
Your health visitor (for preschool children) or your GP (for school age children) can usually offer helpful advice and support. If need be they may refer you on to:
- Dietitian – to assess whether their diet is good enough and give you advice on managing their eating behaviour
- Parenting support such as triple P, for support in managing their behaviour in general
- Paediatrician to investigate worries about their growth or possible nutrient deficiencies
- Speech therapist to investigate how they chew and swallow.
If these people are worried and you live in the Greater Glasgow health board area , they may refer on to us, but we do not accept referrals straight from primary care.
Simple approaches to managing feeding problems
Almost all families encounter feeding issues such as food refusal, picky eating and other problems at some stage. In order to cope with these it is important to understand what influences a child’s feeding behaviour for better or worse
The key factors that put a child off eating are:
- Not Being Hungry – help by avoiding snacking before meals and high energy drinks, offer small portions, leave at least 2 hours between meals or snacks
- Unhappiness or Stress – Help by trying to make mealtimes happy, keep meals short, praise food eaten and let child self feed.
- Short Term Illness – Help by waiting for it to pass, they will eat again when better.