Feeding and Eating Disorders of Infancy or Early Childhood: Pica, Rumination Disorder, Feeding Disorder of Infancy or Early Childhood

Essential Concepts

Pica, the eating of non-nutritive substances, may be normative in very young children, but increases the risk of lead poisoning.
Rumination disorder of infancy is a rare, but potentially fatal eating disorder in the first year of life.
Feeding disorder of infancy or early childhood is what had historically been called psychosocial dwarfism or failure to thrive.
All feeding and eating disorders require a full medical workup for etiology.

Clinical Description

Feeding and eating disorders of infancy or early childhood are typically diagnosed and treated by primary care physicians. There are few maladies that are more upsetting than an infant who is not thriving. Collaboration between the primary care physician, the child’s caretakers, and mental health professionals
is essential to optimize prognosis. In severe cases, infants die from malnutrition or the secondary consequences of rumination.

Infants who have had multiple caregivers, neglect or abuse, and suboptimal care and bonding are at higher risk of eating disorders. However, in some cases, the cause is never elucidated.

Pica

Pica is the eating of non-nutritive substances on a persistent basis for at least 1 month. This behavior must not be developmentally appropriate and not part of a culturally sanctioned practice.

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