ABSTRACT
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.
Subject(s)
Feeding and Eating Disorders of Childhood/classification , Child , Child, Preschool , Cooperative Behavior , Diagnosis, Differential , Failure to Thrive/classification , Failure to Thrive/diagnosis , Failure to Thrive/therapy , Feeding Methods , Feeding and Eating Disorders/classification , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/therapy , Feeding and Eating Disorders of Childhood/diagnosis , Feeding and Eating Disorders of Childhood/therapy , Female , Humans , Infant, Newborn , Interdisciplinary Communication , Male , Mass Screening , Protein-Energy Malnutrition/classification , Protein-Energy Malnutrition/diagnosis , Protein-Energy Malnutrition/therapy , Referral and Consultation , Terminology as TopicABSTRACT
Nucleotides play a significant role in many physiologic functions, ranging from the encoding of genetic information to signal transduction. Accumulating evidence from recent animal and clinical studies supports the original notion that nucleotides are semi-essential dietary nutrients. The development of a new technique, total potentially available nucleosides, to accurately quantify the nucleotide content in various biological fluids has allowed investigators to properly assess the importance of nucleotide function and availability in various conditions. Data from animal studies indicate that exogenous nucleotides produce beneficial gastrointestinal and immunologic effects, especially during times of rapid growth, when nucleotide availability may be low. Infant studies confirm these findings and are presented in this review. Regulatory agencies are currently using this information collectively to support the rationale for the supplementation of infant formulas with higher amounts of nucleotides.
