Infant Mental Health for the Pediatric Nurse Practitioner

Feeding
Along with sleep concerns, feeding issues usually have great importance to parents. Since optimal nutrition is essential to brain development and physical health, addressing issues early on is essential. 

Review growth parameters. Learn about CDC recommended WHO growth charts for children under two:  http://www.cdc.gov/nccdphp/dnpao/growthcharts/who/index.htm

Poor or slow feeding in infants may indicate heart issues. New guidelines for pulse oximetry screening in newborns have been established: http://www.cdc.gov/ncbddd/pediatricgenetics/CCHDscreening.html Consider economic, cultural, parental history, and social factors that may be impacting feeding.

Pediatric undernutrition (failure-to-thrive) is just one issue. Feeding disorders may include issues of state regulation, issues of caregiver-infant reciprocity, infantile anorexia, sensory food adversions, posttraumatic feeding disorder, and feeding disorders related medical conditions (Chatoor, 2009). 

Infants born preterm can have underdeveloped sucking skills or unsynchronized suck-swallow-breathing (Dodrill, 2011). After extended NICU stays preterm infants may also exhibit oral tactile defensiveness that impacts feeding abilities.

Help is available from breastfeeding specialists, speech pathologists, and occupational therapists. But it is important to note that not all individual specialists and therapists have expertise in often complex feeding issues.

Reflection:

How do I coordinate care with speech pathologists and other therapists involved with an infant with feeding difficulties?

References and Resources:

Chatoor, I. (2009). Diagnosis and Treatment of Feeding Disorders in Infants, Toddlers, and Young Children. Washington, DC:  Zero To Three.

Dunitz-Schneer, M., Mischk, S., Ktatky, E., Hauer, A., & Scheer, P. (2011). Tube dependence: A reactive eating behavior disorder. ICAN: Infant, Child & Adolescent Nutrition 

Babies fed on demand have higher IQ: http://www.guardian.co.uk/society/2012/mar/17/babies-fed-demand-better-school