Eating behaviour in childhood week/lecture 4 virtual tutorial

Question 1

2. How are the disorders defined?

Answer 1

• Disorder of homeostasis: the infant cannot control the onset and termination of feedings as they are unable to regulate signals of hunger and satiety. Therefore they over or underheat. ✅ The parent is not aware of this and this exacerbates the problem
  
  • Disorder of attachment: defects in the mother-child attachment lead to feeding problems where regulation isn’t maintained. ✅ Leads to insensitivity and withdrawal at feeding/mealtimes, lack of pleasure in feeding leads to weight loss in child.
  • Disorder of separation and individuation: mother doesn’t let the infant develop properly as they still insist on feeding the infant themselves which doesn’t allow the motor skills of the infant develop.✅ Mother finds it hard to allow child to develop autonomous eating (what I said), battle for spoon leads to unhappy and difficult child at mealtimes.

Question 2

3. Are the causes of each of the disorders attributed to the child or the parent? Is it useful to attribute like this?

Answer 2

• Disorder of homeostasis: mainly infant as it is very biological however, the caregiver plays an important role in regulating the infants environment, interpreting the infants cues in order not to over or under stimulate the child. They must balance the external state to help maintain a constant internal environment within the infant. ✅ Irregular patterns and mother may misread cues.
  
  • Disorder of attachment: linked to the lack of affective engagement of the infant with caregiver. However, the mothers usually hold baby loosely and show little confidence or interest.✅ Infant may behave in similar way to withdrawn mother.
  • Disorder of separation and individuation: mother is overprotective at times and absent in others and the baby is yet to understand what these actions mean.✅ Child may want more control.
  • Doesn’t seem particularly useful to give diagnosis that attributes blame like this

Question 3

4. Can these case studies truly be described as non-organic?

Answer 3

• No because the mother and infant still act in a predetermined way. ✅ Only subtle potential links (Robert had colic and ADHD and Susan had a poor suck)

Question 4

5. A lot of people still use these names and terms today when working with children with feeding problems, are these types of classifications useful and appropriate or not?

Answer 4

• Babies develop at different stages and rates and it may not always be down to the infant and therefore it wouldn’t always be valid to use these terms. Also more research needs to be done as these case studies aren’t totally non-organic.
  
  • Given that the majority of cases of feeding problems are linked to factors related to children and in many cases to the ways that their caregivers respond to these (usually with the best intentions) it is a bit tricky to try and subdivide children like this. There are so many different names to different feeding problems and we are often talking about the same things with different names- these are problems of semantics that cloud diagnosis and treatment. All cases should be looked at individually with treatments geared towards individual children. For example in the case study on homeostasis there appears to be some break down in the attachment relationship between Robert and mother, in the case study on attachment it appears the mother has little awareness of the child’s hunger and satiety signals (homeostasis) and in the case study on separation it appears that the infant had a poor suck (homeostasis problems).
    Methodologically we also have to think about how the authors came to these diagnoses- if they are based on only 3 case studies then generalising these to large groups of children seems potentially inappropriate.