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Feeding is a developmental skill. A multilevel approach—one that considers environmental, family, and individual factors—to interventions that promote healthy feeding patterns in children is perhaps the most effective strategy. Feeding difficulties call for the combined expertise of occupational therapists, speech therapists, behavioural psychologists, dieticians and a range of medical specialists that come together in multidisciplinary clinics.
At the environmental level, restaurants are encouraged to offer nutritious food choices for children. At the family level, guidelines exist to educate families on nutritional needs and provide strategies for healthy eating behaviour. To establish and change eating patterns in children, the participation and modelling of caregivers is key. They need to ensure that children are offered healthy food, on a predictable schedule and in a pleasant setting. Children who are raised with caregivers who model healthy eating behaviours will likely establish healthy food preferences and eating habits. Educational guidelines for teaching professionals, clinical practitioners and parents should include information on nutritional needs and strategies to promote healthy feeding behaviours (modelling positive eating behaviours, establishing consistent and predictable mealtime routines, and offering nutritionally balanced foods within a positive mealtime atmosphere).
Effective interventions for children with severe feeding problems, often associated with medical issues and poor growth, are contingency management treatments that use positive reinforcement for appropriate feeding responses and ignore or guide inappropriate responses. Screening instruments for problematic feeding behaviours help identify problems early on.
Moving forward, further research regarding physiological and environmental factors of problematic feeding behaviours would be desirable. As well, investigations on the individual, interactive and environmental determinants of feeding styles and the relationship between feeding styles and children’s eating behaviour and weight gain are needed.
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