İştahsız Çocuk ve Beslenme Tedavisi Yaklaşımları

Yıl 2019, Cilt: 17 Sayı: 2, 314 - 324, 02.08.2019

Kadriye Toprak Gülhan Samur

Öz

İştahsızlık, yemek seçiciliği ve
besin fobisi gibi beslenme davranışları, özellikle bebeklerde ve küçük
çocuklarda çok yaygın görülen sağlık problemleridir. Her bir beslenme
davranışının altında önemli fizyolojik sebepler olabileceği gibi psikolojik
sebepler de olabilmektedir. Tedavide öncelikli amaç iştahsızlık ve diğer
beslenme sorunlarının altında yatan nedenlerin saptanmasıdır. Altta yatan
organik bir neden varlığında öncelikli tedavi bu nedenin ortadan kaldırılması
olmalıdır. Diğer önemli yaklaşımlardan birisi de çocukta beslenme güçlüğünün
türünün saptanmasıdır. Bu durum tedavi yaklaşımlarının etkinliği açısından önem
taşımaktadır. Saptanan beslenme sorunlarında çocuk veya bebeğin yaşına uygun
beslenme ilkeleri, pratikte beslenme sorununun etkili bir şekilde tedavi
edilmesini destekleyebilir. Beslenme güçlüğünün türünün belirlenerek tedavi
yöntemlerinin buna yönelik olarak planlanması tedavinin etkinliği açısından
önem taşımaktadır.

Anahtar Kelimeler

iştahsız çocuk, sınırlı iştah

Low Appetite Child and Nutrition Therapy Approaches

Öz

Lack of appetite and nutritional
difficulties such as food selection and food phobia are common health problems
in childhood, especially in infants and young children. Under each nutritional
behavior, there can be important physiological causes as well as psychological
reasons.The primary aim of treatment is to determine the underlying causes of
loss of appetite and other nutritional problems. In the presence of an
underlying organic cause, priority treatment should be elimination of this
cause. One of the other important approaches is the identification of
nutritional problems. This situation is important for the effectiveness of
treatment approaches. Nutritional principles appropriate for the age of the
child or baby may support the effective treatment of nutritional problems in
practice. Determination of the nutritional strength of the patient and the
planning of treatment methods for it are important for the effectiveness of the
treatment.

Anahtar Kelimeler

low appetite, limited appetite

Kaynakça

• 1. Wright C, Birks E. Risk factors for failure to thrive: A population‐based survey. Child Care Health Dev 2000;26(1):5-16.
• 2. Yang L, Bian Y, Shao J, Sheng W, Li W, Zeng L. Efficacy and safety of chiropractic therapy in infantile anorexia: A systematic review. EuJIM 2016;8(2):106-12.
• 3. Aldridge VK, Dovey TM, Martin CI, Meyer C. Identifying clinically relevant feeding problems and disorders. Journal of Child Health Care 2010;14(3):261-70.
• 4. Schädler G, Süss-Burghart H, Toschke AM, Von Voss H, Von Kries R. Feeding disorders in ex-prematures: causes-response to therapy-long term outcome. EJPE 2007;166(8):803-8.
• 5. Kerzner B, Milano K, MacLean WC, Berall G, Stuart S, Chatoor I. A practical approach to classifying and managing feeding difficulties. Pediatrics 2015;135(2):344-53.
• 6. Bıcılıoğlu Y, Elİaçık K, Astarcıoğlu G, Sarıtaș S, Bakİler AR. Are parents right? Evaluation of risk factors and growth in a child with poor appetite. İzmir Dr. Behçet Uz Çocuk Hastanesi Dergisi 2015;5(2):95-100.
• 7. Essex C, Southall A, Southall A. Children with feeding difficulties: medical and nursing perspectives. In: Southall A, Martin C (eds). Feeding Problems in Children:a practical guide. Oxford: Radcliffe Publishing; 2010. p.26-50.
• 8. Levy Y, Levy A, Zangen T, Kornfeld L, Dalal I, Samuel E, et al. Diagnostic clues for identification of nonorganic vs organic causes of food refusal and poor feeding. JPGN 2009;48(3):355-62.
• 9. Albarran-Zeckler RG, Sun Y, Smith RG. Physiological roles revealed by ghrelin and ghrelin receptor deficient mice. Peptides 2011;32(11):2229-35.
• 10. El-Eshmawy MM, Aal IAA. Association of ghrelin and leptin with reproductive hormones in constitutional delay of growth and puberty. Reprod Biol Endocrinol 2010;8(1):153.
• 11. Iñiguez Gn, Ong K, Peña V, Avila A, Dunger D, Mericq V. Fasting and post-glucose ghrelin levels in SGA infants: relationships with size and weight gain at one year of age. J Clin Endocrinol Metabo 2002;87(12):5830-3.
• 12. Şen TA, Şimşek DG, Darcan Ş, Çoker M. Ghrelin levels in children with constitutional delay of growth and puberty. JCRPE 2010;2(3):117.
• 13. Stawerska R, Smyczynska J, Czkwianianc E, Hilczer M, Lewinski A. High concentration of ghrelin in children with growth hormone deficiency and neurosecretory dysfunction. Neuro Endocrinol Lett. 2012;33:331-9.
• 14. Razzaghy-Azar M, Latifi M, Ilbeygi D, Larijani B, Nourbakhsh M. Total And Acylated Ghrelın Levels In Chıldren And Adolescents Wıth Idıopathıc Short Stature And Poor Appetıte. Acta Endocrinol 2015;11(3).
• 15. Kaba S, Karaman K, Kömüroğlu U, Bala K, Demir N, Kocaman S, et al. Role of circulating nesfatin-1 in the underweight children with poor appetite. Eur Rev Med Pharmacol Sci 2015;19(24):4703-6.
• 16. Ramanjaneya M, Addison M, S Randeva H. Possible Role of NUCB2/nesfatin-1 in Adipogenesis. Curr Pharm Design 2013;19(39):6976-80.
• 17. Desreumaux P, Ernst O, Geboes K, Gambiez L, Berrebi D, Müller-Alouf H, et al. Inflammatory alterations in mesenteric adipose tissue in Crohn's disease. Gastroenterology 1999;117(1):73-81.
• 18. Anagnostis P, Vakalopoulou S, Charizopoulou M, Kazantzidou E, Chrysopoulou T, Moka E, et al. Is there any association between leptin levels and bone mineral density in haemophiliac men? Archives of medical science: AMS 2013;9(3):459.
• 19. Yahya RS, Awad SI, Kizilbash N, El-Baz HA, Atia G. Enteric parasites can disturb leptin and adiponectin levels in children. Archives of Medical Science. 2018;14(1):101.
• 20. Matarese G, Moschos S, Mantzoros CS. Leptin in immunology. J Immunol 2005;174(6):3137-42.
• 21. Kyriazakis I, Tolkamp B, Hutchings M. Towards a functional explanation for the occurrence of anorexia during parasitic infections. Animal behaviour 1998;56(2):265-74.
• 22. Arvedson JC. Assessment of pediatric dysphagia and feeding disorders: clinical and instrumental approaches. Dev Disabil Res Rev 2008;14(2):118-27.
• 23. Wu YP, Franciosi JP, Rothenberg ME, Hommel KA. Behavioral feeding problems and parenting stress in eosinophilic gastrointestinal disorders in children. Pediatr Allergy Immunol 2012;23(8):730-5.
• 24. Hyman P. Role of development in infant and toddler food refusal. Perspectives on Swallowing and Swallowing Disorders (Dysphagia) 2010;19(3):64-7.
• 25. Cermak SA, Curtin C, Bandini LG. Food selectivity and sensory sensitivity in children with autism spectrum disorders. J Acad Nutr Diet 2010;110(2):238-46.
• 26. Palmer MM, Heyman MB. Assessment and treatment of sensory-versus motor-based feeding problems in very young children. Infants and Young Children. 1993;6(2):67-73.
• 27. Ibrahim A, Atef A, Magdy RI, Farag MA. Iron therapy and anthropometry: A case-control study among iron deficient preschool children. Gaz Egypt Paediatr Assoc 2017;65(3):95-100.
• 28. Küçük Ö, Göçmen AY, Biçer S. İştahsızlığı Olan Çocuklarda Demir Eksikliği Anemisi Sıklığı. Bozok Medical Journal 2013;3(2):37-41.
• 29. Topaloglu AK, Hallioglu O, Canim A, Duzovali O, Yilgor E. Lack of association between plasma leptin levels and appetite in children with iron deficiency. Nutrition 2001;17(7):657-9.
• 30. Altıntaş S. Çocuklarda demir eksikliği anemisinde girelin, obestatin, nesfatin düzeyi (Tıpta Uzmanlık Tezi). Denizli: Pamukkale Üniversitesi; 2017.
• 31. Park S-G, Choi H-N, Yang H-R, Yim J-E. Effects of zinc supplementation on catch-up growth in children with failure to thrive. Nutr Res and Pract 2017;11(6):487-91.
• 32. Yu KH. A study on the nutrient intakes and zinc nutritional status of preschool children in Ulsan. Korean J Nutr 2007;40(4):385-94.
• 33. Briggs S, Priddis L. Feeding difficulties in infancy and childhood: psychoanalytic perspectives. In: Southall A, Martin C (eds). Feeding Problems in Children:a practical guide. Oxford: Radcliffe Publishing; 2010. p.59-76.
• 34. WHO. World health Organization: International classification of diseases (ICD). Available from: https://www.who.int/classifications/icd/en/bluebook.pdf Accessed 4 Dec 2018
• 35. Kaymaz N, Bulur N, Yildirim S, Cevizci S, Topaloglu N, Tekin M, et al. Poor Appetite in School Children: Is It a False Perception of Parents? J Pediatr Res 2015;2(1):11-6.
• 36. Galloway AT, Lee Y, Birch LL. Predictors and consequences of food neophobia and pickiness in young girls. J Am Diet Assoc 2003;103(6):692-8.
• 37. Dovey TM, Staples PA, Gibson EL, Halford JC. Food neophobia and ‘picky/fussy’eating in children: a review. Appetite 2008;50(2-3):181-93.
• 38. Mei Z, Grummer-Strawn LM, Thompson D, Dietz WH. Shifts in percentiles of growth during early childhood: analysis of longitudinal data from the California Child Health and Development Study. Pediatrics 2004;113(6):e617-e27.
• 39. Taylor CM, Wernimont SM, Northstone K, Emmett PM. Picky/fussy eating in children: Review of definitions, assessment, prevalence and dietary intakes. Appetite 2015;95:349-59.
• 40. Brown CL, Vander Schaaf EB, Cohen GM, Irby MB, Skelton JA. Association of picky eating and food neophobia with weight: a systematic review. J Child Obes 2016;12(4):247-62.
• 41. Yang HR. How to approach feeding difficulties in young children. Korean J Pediatr 2017;60(12):379-84.
• 42. Stratton R, Elia M. The effects of enteral tube feeding and parenteral nutrition on appetite sensations and food intake in health and disease. Clin Nutr 1999;18(2):63- 70.
• 43. Linscheid TR. Behavioral treatments for pediatric feeding disorders. Behav Modif 2006;30(1):6-23.
• 44. Zampollo F, Kniffin KM, Wansink B, Shimizu M. Food plating preferences of children: The importance of presentation on desire for diversity. Acta Paediatr 2012;101(1):61-6.
• 45. Leahy KE, Birch LL, Fisher JO, Rolls BJ. Reductions in entree energy density increase children's vegetable intake and reduce energy intake. Obesity 2008;16(7):1559-65.
• 46. Fraker C, Fishbein M, Cox S, Walbert L. Food Chaining: The Proven 6-Step Plan To Stop Picky Eating, Solve Feeding Problems and Expand Your Child's Diet. New York, NY:Marlowe Company; 2007.
• 47. Chatoor I. Diagnosis and Treatment Of Feeding Disorders İn İnfants, Toddlers, and Young Children. Washington, DC: Zero To Three; 2009.
• 48. Banerjee SP, Bhandari RP, Rosenberg DR. Use of low-dose selective serotonin reuptake inhibitors for severe, refractory choking phobia in childhood. J Dev Behav Pediatr 2005;26(2):123-7.
• 49. Okada A, Tsukamoto C, Hosogi M, Yamanaka E, Watanabe K, Ootyou K, et al. A study of psycho-pathology and treatment of children with phagophobia. Acta Med Okayama 2007;61(5):261.
• 50. Ammaniti M, Lucarelli L, Cimino S, D'Olimpio F, Chatoor I. Feeding disorders of infancy: a longitudinal study to middle childhood. Int J Eat Disord 2012;45(2):272-80.