Feeding Problems in Children: A Practical Guide. Second edition

Feeding Problems in Children: A Practical Guide. Second edition Southall A and Martin C (eds). Radcliffe Publishing Ltd, Oxford New York, 2011, 358 pages, US$49.95, ISBN-13: 978-1-84619-386-6 This book aims to be a comprehensive guide, describing the development and management of feeding problems in chil- dren. Food refusal and fussiness may be considered a normal and transient behaviour during the early years of life. This book focuses on the 3–10% of children in which feeding difficulties become so severe that the quality of life of child and family is affected or in some cases are life-threatening. The editors, recognising the ‘inherently multidiscipli- nary nature of feeding problems’, hope to reach a wide audience—general practitioners, psychologists, psychia- trists, nurses and allied health professionals ‘in paediatrics in primary or secondary care’. Southall and Martin are both clinical psychologists working in the UK and this book is one of a series published under the header Paediatric Psychology Series. There are 22 additional contributors with an impressive depth of clinical and research experience. Contributors come from the UK, Europe, USA and Australia. Disciplines include psycho- logy, speech pathology, occupational therapy, nursing and medicine. The book is divided into three parts. ‘Part I: Approaches’ is divided into seven chapters outlining the normal develop- ment of feeding skills in babies and children, how this might be disrupted and where multidisciplinary intervention might be useful. Oral motor deficits, sensory disorders and behav- ioural issues are discussed, as are cultural aspects of feeding. Each chapter finishes with a reference list and some include suggestions for further reading. ‘Part II: Applications’ consists of eight chapters, each out- lining the management of specific problems or situations. These include establishing breastfeeding, selective eating, children with chronic illness or neurological problems, in particular cerebral palsy and enteral feeding. One chapter describes telehealth interventions. ‘Part III: The Clinical Practice Toolkit’ contains examples of assessment forms, clinical reports and patient handouts, all of which can be downloaded from a companion website. It is here, in the last three pages of this section (and the book) that a dietitian from Denmark describes a ‘dietitian’s perspective on assessment and intervention’. The information is simplis- tic and does not provide the reader with much insight into the work of a dietitian. The author is not noted in the ‘list of contributors’. This brings me to my main criticism. Despite the emphasis on multidisciplinary care, it seemed at times that the input from a dietitian was an optional extra. In chapter 2, recommended nursing assess- ment includes asking ‘What is the child total calorie intake per day and in what form is it taken?’, recording the ‘diet of the breastfeeding mother’ and ‘a detailed diet history must be taken with the help of a dietitian, if possible’. My sug- gestion for future editions would be a dietitian writing a detailed chapter within part II, so that other practitioners may have a better understanding of the dietitian’s role in supporting families and children with feeding problems. This may also result in inaccurate nutrition information within the book being corrected. I wonder if the authors have been treating feeding problems for so long that they have forgotten what typically developing children eat. With the exception of Suzanne Coulson, contributors present breastfeeding and formula feeding as equal choices and it is assumed that breastfeeding stops around the time that solids are introduced. On page 11, introduction of solids is described to babies aged three to six months as ‘at some time during this stage, the mother will wean the baby on to runny pureed food from a spoon’. This is contrary to current guidelines that recommend introduction of solids at around six months of age.1 On page 97 a ‘normal’ diet at age 18–24 months is described as ‘Toddlers drink 100% juice and eat chopped food.’ In summary, this book would be useful for a dietitian wanting to understand more about the overall management of paediatric feeding difficulties. While some interventions suggested are outside the scope of dietetic practice, these sections are still highly informative. Dietitians working in multidisciplinary feeding clinics will already have a good understanding of this topic, but may be interested in reading about the approaches used by other clinicians. Dietitians wanting to improve their own knowledge in the nutrition management of children with feeding problems will need to look elsewhere. Rebecca Byrne, APD PhD Candidate, Institute of Health and Biomedical Innovation, School of Public Health, Queensland University of Technology, Brisbane, Queensland, Australia Reference 1 World Health Organization, UNICEF. Global Strategy for Infant and Young Child Feeding. Geneva: WHO, 2003. Book Reviews © 2012 The Authors Nutrition & Dietetics © 2012 Dietitians Association of Australia 168