Picky Eater or a Feeding Disorder?

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NURSE MONDAYS

published in KC Parent Magazine – May 2012 issue

by Stacey Hatton

Most kids are picky eaters at one time or another—but determining if their finicky behavior is severe enough to be classified a pediatric “feeding disorder” involves an expert’s diagnosis. According to the September 2011 National Institutes of Health (NIH) report, “Up to 10 percent of infants and children have a pediatric feeding disorder;” however, many children are missed in this study.

Symptoms

“Professionals working with children with feeding difficulties sometimes classify children as ‘picky eaters’ rather than a ‘problem eater’ or a child with a ‘feeding disorder,’” says Marci Chmielewski, M.S., OTR/L, and clinical coordinator of the Occupational Therapy Department at Children’s Mercy Hospitals & Clinics.

“A picky eater is a child that does not have a wide variety of foods, but will typically eat 30 or more foods,” reports Chmielewski. “The picky eater may also have times in which he won’t want to eat that food, but will generally add it back into his food repertoire after a couple weeks.”

These kids usually are able to touch, look at or taste new foods, even if they refuse to eat them. They also will try one food from each food group.

“The ‘problem feeders’ are the children we treat in occupational therapy and typically have 20 or fewer foods they eat,” says Chmielewski. “A child with a feeding disorder will often never eat a food once they have “burned out” on that food—even after a break from it. These children may cry, try to get away from the table, be unable to tolerate smells of food or become very upset when a new food is presented. The problem feeder also often eats foods in only one or two of the food groups.”

Treatment modalities

“The treatments vary depending upon the underlying causes of the child’s problem or picky eating,” Chmielewski says. “A feeding  therapist will typically take a history to help determine if there are underlying physiological problems causing discomfort with eating, as well as evaluate for oral motor problems (inability to properly chew or move food in the mouth), swallowing problems or oral sensory problems (difficulty with tolerating various textures of foods).”

Working along with the parents, caregivers and treatment team, a goal-oriented plan will be initiated for improving eating and feeding techniques for the child. The NIH recommends the earlier the diagnosis and beginning of treatment, the better the results. If left untreated, feeding disorders can become more complex.

Stacey Hatton is a pediatric RN and Overland Park freelance writer.

Erma Bombeck’s true gift

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The Kansas City Star – April 26, 2012

Stacey Hatton Commentary

It was another classic April day in 2010.

The cherry trees were blossoming. I was searching in Lady Google Land for the next writing topic to suction to my eyeballs while my children were quietly demolishing art projects. My youngest was creating her “new family” with her medium of choice — ball point pen — on the freshly painted hallway walls, while my eldest was applying various shades of lipstick to the protuberances of her face and our white bathroom surfaces. Just another day…

Until my life took a dramatic turn when I discovered on a humor writers’ website that there’s a small conference in Dayton, Ohio, that only a few hundred people are allowed to attend: The Erma Bombeck Writers’ Workshop.

“Well, smack my head with a window pane and call me Dorothy! I’ve got to be a part of that,” I yelped to my children, who were ignoring me as much as I was ignoring them.

I quickly scrolled through the website for the event date and — horror of all horrors — the workshop had filled up the previous week and I couldn’t attend for two more years. Who does that? Erma Bombeck’s people, that’s who, because they offer it every other year! The inhumanity of it all.

(Erma Bombeck, for my younger readers or those who grew up in a cave, wrote a syndicated column that ran in 900 newspapers and a dozen books — nine of which made the New York Times’ bestseller’s list. Not too shabby, so they gave her a conference after she sadly passed away in 1996.)

I spent those two years waiting with my head held high and carried on like she would have wanted me to. Every day I got out of bed, I fed and dressed my children, I bathed myself routinely — and sometimes even before school drop-off.

But friends, last week I attended my first Erma Bombeck conference. I’m not going to name drop, but there were some fancy schmancy folk there. A high-larious comedienne who wrote for Bill Cosby, Lily Tomlin and Jim Henson’s people, (OK, fine, her name is Adriana Trigiani and she is brilliant!) did a stand-up routine after dinner one evening and had the audience rolling with laughter. However, in mid-routine, something unexpected happened to me.

During a huge laugh, tears streamed down my face like I had been presented a Pulitzer prize. (I was actually sitting watermelon-seed-spitting distance from people who had won that award.) For 48 hours I had bathed in Erma’s words from guest speakers, listened to her children speak of their dearly missed mother and peacefully took in the lovely essence of the experience. Then during a laugh of all things, a menopausal whoosh came over me, accompanied by tears. A Technicolor flashback dropped me into my childhood, when I used to visit my grandmother’s home.

MeeMaw had a spare bedroom with one lone bookshelf that contained the Holy Bible, various paperback romance novels that I was forbidden to read and a hardcover copy of Erma’s, If Life Is a Bowl of Cherries, What Am I Doing in the Pits?

Every trip to MeeMaw’s house when I got bored, I sneaked away to that bookcase and grabbed Erma’s book, inhaled each joke and maked sure not to laugh so loud I would get forced to rejoin the family reunion. I knew at first read that Erma was the funniest writer I had experienced. I also knew it was the only hardcover MeeMaw had purchased, so it had to have been special to her, as well.

Sadly, while MeeMaw was alive, there never was any true bonding between us, but here I was years after her passing, with tears for the relative who first introduced me to my favorite writer. At that moment I knew MeeMaw and I shared common ground and apparently some genetic code. MeeMaw would have loved to have joined me at that workshop. Now I know, thanks to Erma Bombeck, what I have in common with my MeeMaw. The love of laughter and great writers. What a gift!

Good thing I didn’t grab for those trashy romance novels instead. I would have missed out on so much brilliant writing — and last weekend would have been the pits!

Stacey Hatton is a pediatric registered nurse, writer and public speaker. Her humor blog can be found at http://nursemommylaughs.com.

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6 Reasons Mama Kicks the Kids Out of her Bed

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1. The only drool on my pillow is going to be MINE!

2. If I’m getting early morning “action,” it’s NOT going to involve karate chops, eye gouging, pillow suffocation or repeated kicks to my stretched-out uterus.

3. I need more than 6.45 inches of sleeping space in a King size bed.

4. The doctor cut the cord at the hospital and that was terrific with me.  GET OUT!

5. Mama needs sleep or will turn Kardashian on her kids!

AND FINALLY…

6. No, I am NOT moving to college with you; and in a couple of years, this co-sleeping thang will be considered just plain creepy.

©2012, Stacey Hatton.  All rights reserved.

NATIONAL INFANT IMMUNIZATION WEEK: Buy your favorite nurse a shot!

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NURSE WEDNESDAYS:

NATIONAL INFANT IMMUNIZATION WEEK

It’s that time again. How time flies when you’re having fun giving immunizations to millions of screaming babies while pacifying the sobbing new moms!  As a nurse, it’s a challenging task giving pediatric immunizations; especially when they are either, holding their breath, kicking you in the crotch, or screaming so loud you know damage is occurring to your eardrums.  And sometimes the kids will do all this stuff too!

“BUT IT IS SOOOO NECESSARY TO IMMUNIZE YOUR CHILD!” ~Nurse Mommy

“This year marks the first time that National Infant Immunization Week, April 21-28, is joined by World Immunization Week,” reports the American Academy of Pediatrics (AAP)**  This shows you how more organizations are backing this urgent movement.

Check with your child’s provider to see if he or she is up-to-date and here is the current requirement list for go-getter parents:

http://www2.aap.org/immunization/IZSchedule.html

AAP is one of many partners with ONE campaign and The Million Moms Challenge. For additional information, check out these fabulous sites:

(Source:  AAP, April 23, 2012)

**The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org.

Pain Patches can be FATAL for children

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The FDA has released this press information which is pretty scary for  families who have Fentanyl (pain) patches in your home.  (Especially if you have an elderly person living with you or someone with chronic pain- the chance of these laying around is high and can be FATAL for your children! Lock these up and keep an eye on the elderly in your home.) ~ Nurse Mommy


Fentanyl Patch Can Be Deadly to Children

Read the Consumer Update to learn more about how to prevent accidental exposure to Fentanyl:

http://go.usa.gov/yTw

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm300803.htm

Young children have died or become seriously ill from exposure to a skin patch containing a powerful painkiller, and the Food and Drug Administration (FDA) is issuing an alert to warn patients, caregivers and health care professionals about the dangers of improperly using and disposing of the fentanyl patch.

The fentanyl transdermal system—the patch marketed under the brand name Duragesic and in several generic forms—contains fentanyl, a potent narcotic that is intended to treat patients in constant pain by releasing the medication over the course of three days. An overdose of fentanyl—caused when the child either swallows the patch or applies it to his or her own skin—can cause death by slowing breathing and increasing the levels of carbon dioxide in the blood.

(Source: FDA, April 19, 2012)