Eating disorders in children: a guide to parents. Types and forms of psychogenic overeating

In modern culture, phenomena such as healthy eating and lack of physical activity. Children are also subject to this. Experts say that today's children are the first generation to have poorer health than their parents.

Moreover, when unhealthy eating is combined with a sedentary lifestyle and the characteristics of our culture, in which the standard is a thin body, all this leads to disorders. eating behavior. According to statistics, 23% of modern girls and 6% of boys suffer from them. Therefore, eating disorders pose a danger to the younger generation. Fortunately, parents are able to prevent them, but for this it is necessary to intervene as early as possible. Intervention in adolescence, when children assert their right to autonomy, is less effective.

What can be done to prevent an eating disorder in a child? First of all, help him develop healthy body and a healthy relationship.

1. Help your child form the right relationship with his body

You should love your body, no matter what you see in the mirror. But under the influence of modern culture, many of us have obsession be thin. We strongly condemn ourselves for not conforming to this ideal image. Therefore, when we see how a child begins to gain weight, all our self-condemnation turns on, and we project it onto the child, worrying that he will struggle with being overweight all his life. Unfortunately, children pick up our fears and conclude that there is something wrong with them. Parents should develop a healthier relationship with their own bodies so as not to pass on feelings of shame and inferiority to their children.

2. Explain to your child how the media promotes an ideal body image that has nothing to do with reality.

Explain that the images of models on the covers of glossy magazines are always processed in Photoshop and are simply unrealistic. Describe how the modern beauty industry sets unrealistic beauty standards that people subsequently begin to orient themselves to. Talk to your child about how beautiful appearance alone does not make a person happy.

3. Show your child an example of good nutrition

Recognize that the child takes an example from you in everything. If you drink carbonated drinks, your kids will too. If you'd rather nibble on carrots than chips for a snack, your kids will, too. All your good and bad habits are adopted by your children. Do you want to change your child and protect him from bad habits? Change your habits. Health, good vitality and appearance will be an additional reward to you in addition to the good habits of your children.

4. Don't talk about diets

Don't follow any diets, just eat healthy food. Do physical exercise permanent part Everyday life in your family. Studies show that diets do not give the desired result, but only lead to overeating later. In addition, diets can change chemical composition body, which can cause a person to gain weight again, and it will be much more difficult to lose it the next time. Only a healthy diet and physical activity helps maintain optimal body weight.

If you want to teach your child self-control, start by teaching him to listen to his own body. Is he hungry or does he eat a lot just out of habit? If a child asks you for sweets, instead of saying no, tell your child that you will buy them next time: “The candy store will always be here. We will come here on special occasions, not every day.” Studies show that this approach teaches a child to make more informed decisions, while a simple refusal leads to the fact that the child has a strong desire for sweets and, as a result, overeats when you buy them them.

5. Don't taunt your child if they have scored excess weight- by this you hurt his self-esteem

Instead, get him into regular physical activity and reduce the amount of sugar in his diet. If you decide that the child should lose weight, all family members should follow a special diet. Changing eating habits is difficult for everyone, so you should not expect your child to refuse treats that everyone else in the family will eat.

6. Learn more about nutrition

Over the past century, the number of people suffering from overweight has increased, and this percentage continues to grow. At the same time, the percentage various diseases. Causes - sedentary image life, constant stress, overeating, and the evolutionary tendency to eat more during times of affluence.

However, nutritionists say that main reason overweight - processed foods. AT recent times people consume less saturated fat and more processed foods. Modern products have a long shelf life. They are tasty, but less useful. They are made with hydrogenated fats, preservatives, corn syrup, and carbohydrates stripped of their nutritional properties. All this is very harmful to the body and leads to chronic diseases when we get older. But even from childhood, they cause addiction and inflammatory processes in the body.

And, of course, most processed foods contain sugar. Research shows that more than 10% of our daily calories come from added sugar, which negatively affects the entire body. As a result, more fat is deposited in the body than under the influence of other carbohydrates.

7. Cut out junk food and don't stockpile food.

Do not eat unhealthy food and do not stockpile food, except special occasions. The whole family can suffer from this. If children see adults eating unhealthy food, they will follow suit. They will eat everything, sometimes secretly. Many teenage girls develop bulimia when they first surreptitiously eat ice cream and then vomit.

8. Encourage your child to eat vegetables.

Kids usually don't like new foods the first time they try them. But sooner or later they get used to it. Research shows that children are more likely to eat foods they are already familiar with.

9. Involve your child in sports

Every child needs regular physical activity. When girls play sports, they begin to have a positive attitude towards their body, and this attitude remains with them throughout their lives. When children find a sport they like, there is a high probability that this hobby will remain with them for a long time. long years. Instead of telling your child that exercise is essential for weight loss, tell them that exercise changes the body's biochemistry and makes us healthier and happier. Encourage your family to play sports together as a family every weekend.

10. Never comment on other people's looks.

If you focus on how thin or fat people, then the child concludes that appearance is important, and begins to think that people always pay attention to his appearance.

11. If you leave a child with a nanny, tell her what the child can eat and what not.

Too much strict attitude to the child causes him

a strong desire to secretly eat unhealthy food. On the other hand, if the nanny allows him to eat chips and drink carbonated drinks every day, this will nullify all your attempts to teach him to eat healthy.

12. Raise a child

Raising your child will help you reduce the chance of your child becoming overweight as an adult.

13. Reduce stress levels

Children who have high level stress hormones are less healthy physically. They are also prone to overweight.

14. Watch less TV

Children who watch TV for 2 hours or more every day are prone to overweight and high cholesterol. Probably, the reason is not only a sedentary lifestyle associated with watching TV, but also advertising of harmful products. Researchers say that children are highly influenced by advertising, which is why advertising aimed at children (including television) is banned in many countries.

I realized that it is impossible to remain silent any longer! And it is necessary, of course, to write on topics that many do not like and cause protest. We often tend to do what is convenient without thinking about the consequences. I want to tell you how modern parents, more and more often, ruin the eating behavior of their children, causing enormous harm to their health. And at the same time, maybe you will see something useful for yourself and draw conclusions!

What do I want to talk about? About the eating behavior of children and how not to break it! The other day I spoke with my supervisor, and he is such a source of fresh psychological news for me! So, according to the latest data, the age of childhood anorexia and bulimia has decreased to 8 years (this is the moment when they make a diagnosis, by the way, 10 years ago it was 14 years and was associated with adolescence) ! And of course it's terrible! There are a lot of factors here. I will not tell you now about the degrees and stages of diseases. But I will be surprised that the symptoms are not necessarily vomiting, and I will also tell you what to do so that the children are healthy! Of course, below is information about other forms of eating disorders) that are milder!

Let's start in order. Every child experiences hunger and appetite several times a day. Psychologists define this state as an emotional urge to eat. Moreover, feeling the appetite, the baby mentally imagines what pleasure this or that food will bring him. But there are certain appetite disorders, for example, when a child constantly wants to eat and chews something non-stop, or he refuses all types of food except one, and it also happens that the child has no appetite at all and there is a complete refusal of food. It is because of this disorder of appetite that the baby begins to develop anorexia.

Moreover, anorexia in a child can manifest itself in different ways. Some children start crying and simply refuse to sit down at the table, other children throw tantrums and spit out food, others eat only one particular dish all day long, and the fourth after each meal starts severe nausea and vomiting. But anyway it causes serious concern parents who are trying with all their might to feed the child, which only exacerbates the situation.

The pleasure of eating is one of the basic and lies at the bottom (first level) of Maslow's pyramid. And what do parents do, how do they kill this pleasure in the first place. Did many guess?

YES, include cartoons, games, arrange a theater! What is happening at this moment? The brain ceases to fix the pleasure of food, it is easier and faster for it to get joy from the cartoon. The child eats automatically, the importance of what is happening is not laid in the subconscious!
What other factors? Monotonous food! At a certain point, children begin to eat one or another type of food, and parents are comfortable. It's really not very scary (according to doctors) if this period lasts 2-3 months. Next, you need to carefully observe what is happening.
Frequent meals and endless snacks. Sometimes, no matter what the child pulls and distracts, something is constantly shoved into his mouth. Not the best moment. The amount of food consumed per day should be clearly regulated and correspond to age and weight.
The other extreme is to cram food! The child does not want, but “you can’t leave it”
Improper upbringing of parents, constantly satisfying any whims and whims of the baby, which leads to excessive spoilage of the child and refusal of food
The attitude of parents to the process of feeding the child, constant persuasion or, conversely, threats
Negative events that constantly accompany the process of eating food. If parents constantly swear in the kitchen, or rudely force the child to eat obviously tasteless food, then the baby risks losing positive perception food, and in the future he simply will not have an appetite, since there will be no desire to repeat his negative experience experienced in early childhood
Severe stress can also involve a child in primary anorexia nervosa, which, depending on the reaction of adults, may pass in a few days, or may remain for a long time. Such stress can be both a strong fright directly during a meal, and a severe life situation associated with the loss of loved ones, separation from mother, etc.

What to do? In order!

Entertainment clean up, completely, and immediately. iPad or TV can easily "break"
Eat with your child at the table! Creating a culture of food consumption.
Over food, we only have calm conversations, without quarrels! The positive is very important.
Establish a healthy diet for the family. You don’t need to force your child to eat exactly on time, but you shouldn’t go too far off the schedule either.
If the child does not want to eat, feel free to skip meals so that the next time the baby is well hungry.
The food should be beautiful, and the meal should be interesting, accompanied by pleasant conversations at the family table.
Food should be healthy, but you can’t force a child to eat frankly tasteless unleavened foods either. Look for the golden mean.
Do not show your baby delicious desserts until he has eaten the soup.
Don't put too much food on your child's plate so that he leaves the table a little hungry, or asks for more - that's fine too.
In no case do not force him to finish eating, it is better to leave part of the portion on the plate - this is a healthy approach to nutrition, and you do not need to wean the child from it.
Check out the ingredients! I always read labels! And I ask the composition of everything in the store, this information should always be with the seller! Part food additives and taste stabilizers are addictive, and in children this happens very quickly! I carry a list of them with me in notes on my phone) and I advise you! You can find them with any search engine!

INTRODUCTION

In young children, mainly in the 1st year of life, due to physiological features organism, a variety of reasons - errors in nutrition, infection, defects in care, etc., in addition to impaired digestive function, can lead to significant metabolic disorders. In this case, absorption is impaired nutrients tissues and cells of the body, the exhaustion of the child, malnutrition occurs. Such a tendency to deep eating disorders is inherent only in a young child; this is not observed in older children.

State healthy baby

The state of normal nutrition - “normotrophy”, is characterized by physiological growth and weight indicators, clean velvety skin, a properly developed skeleton, moderate appetite, normal in frequency and quality of physiological functions, pink mucous membranes, the absence of pathological disorders from the internal organs, good resistance to infections, proper neuropsychic development, positive emotional mood.

Dystrophy - is a chronic disorder of both nutrition and tissue trophism, as a result of which the full and harmonious development of the child is disturbed. This disease can develop at absolutely any age, but children under 3 years of age are especially susceptible. Dystrophy is accompanied by the following factors: material breach all metabolic processes, a significant decrease in immunity, a delay in both physical and psychomotor, as well as intellectual development. Chronic eating disorders in children may present as various forms depending on the nature of trophic disorders and age.

According to the classification of G.N. Speransky is distinguished:

Children in the first 2 years of life:

Hypotrophy (lagging body weight compared to height)

Hypostature (uniform lag of body weight and height)

Paratrophy (excess body weight in relation to height)

Most common cause chronic eating disorders is protein-energy malnutrition combined with a lack of vitamins and trace elements.

Relevance of the topic

The prevalence of digestive and nutritional disorders in children in different countries according to economic development is 7 - 30% (in developing countries 20 - 30%).

Purpose of the study:

To study the types of digestive and nutritional disorders in young children and the risk factors leading to them.

Object of study:

Parents and children with eating disorders

Subject of study:

Digestive and nutritional disorders in young children leading to malnutrition, causes and risk factors.

Research objectives:

1. To study the structure of digestive and nutritional disorders in young children.

2. Make a conclusion on the theoretical part of the work.

3. Spend practical research to identify risk factors for eating disorders and digestion in young children.

4. To study the problematic points based on the results of the study.

5. Draw general conclusions about the work as a whole.

CHAPTER 1

Theoretical part

1.1 Chronic digestive and nutritional disorders - malnutrition

Hypotrophy is a chronic malnutrition and digestion in young children, characterized by the development of malnutrition with a lack of body weight in relation to length. Occurs with a significant decrease in immunity, changes in body weight, skin growth and subcutaneous tissue, as well as a violation of many vital important functions child's body.

Hypotrophy is distinguished according to the degree of body weight deficiency: 1 degree body weight deficiency is 10 - 20% compared to the norm, 2 degree body weight deficiency is 20 -30% in relation to body length, 3 degree body weight deficiency is more than 30%.

The occurrence of malnutrition is promoted by a number of factors related to the state of the mother's health: nephropathy, diabetes mellitus, pyelonephritis, toxicosis of the first and second half of pregnancy, inadequate diet and nutrition of the pregnant woman, physical and mental overstrain, alcohol consumption, smoking, use of drugs, fetoplacental insufficiency, diseases uterus leading to malnutrition and blood circulation of the fetus.

Dairy malnutrition is observed in children who, up to 10-12 months, eat only milk or milk formulas without carbohydrate complementary foods. This leads to an excess of proteins, partly fats and a lack of carbohydrates and further inhibition of cell reproduction, constipation.

Causes of acquired malnutrition can be: enough milk in the mother (hypogalactia), difficulty sucking with a tight mammary gland or an irregular shape of the nipples in the mother (flat, inverted).

Endocrine diseases: adrenogenital syndrome. Violation of the diet: erratic feeding. Insufficient amount of milk mixture with mixed and artificial feeding. Too frequent feeding leads to a violation of the absorption of food. Prescribing milk formulas that are not appropriate for the age of the child. An important role is played by unfavorable sanitary and hygienic conditions: insufficient stay on fresh air, rare bathing, improper swaddling.

Infectious diseases: chronic inflammatory diseases, AIDS. Body weight decreases with severe psychosocial deprivation, metabolic disorders, immunodeficiency states.

Endogenous factors are hereditary metabolic abnormalities (galactosemia, fructosemia), immunodeficiency states, prematurity, birth trauma, birth defects development (cleft lip, hard palate, pyloric stenosis, congenital heart defects), perinatal CNS damage, endocrine disorders. Metabolic defects (disorders of amino acid metabolism, storage diseases).

The process of digestion consists of - food intake - splitting - absorption - assimilation and deposition - excretion.

Violation of any of these stages leads to starvation of the child with the development of malnutrition.

Importance has a violation of enzymatic activity digestive glands, suppression of secretion gastrointestinal tract, which entails a violation of the breakdown and absorption of nutrients in the intestine, the development of dysbacteriosis.

The excitability of the cerebral cortex and subcortical centers is disturbed, which leads to inhibition of the function of internal organs.

To maintain life, the body uses reserves of fat and glycogen from the depot (subcutaneous tissue, muscles, internal organs), then cell breakdown begins parenchymal organs. The immunological reactivity of the body is sharply reduced, as a result of which infectious diseases easily join.

1.2. Classification and clinical manifestations of chronic eating disorders

By the time of occurrence: prenatal, postnatal, mixed.

By etiology: alimentary, infectious, regimen and diet defects, prenatal factors, hereditary pathology and congenital anomalies development.

By severity: 1st. - easy, 2st. - medium, 3st. - heavy.

Period: initial, progression, stabilization, convalescence.

Clinical manifestations are grouped into a number of syndromes:

Syndrome of trophic disorders - thinning of subcutaneous fat, decreased tissue turgor, lack of body weight relative to height, signs of polyhypovitaminosis and hypomicroelementosis.

Syndrome digestive disorders- anorexia, dyspeptic disorders, decreased food tolerance.

Syndrome of dysfunction of the central nervous system - a decrease in emotional tone, the predominance of negative emotions, periodic anxiety (in severe forms of malnutrition - apathy), a lag in psychomotor development.

Causes of malnutrition in newborns

The reasons as a result of which malnutrition may develop in newborns can be divided into internal factors and external.

The first includes encephalopathy, due to which the work of all organs is disrupted; underdevelopment lung tissue leading to an insufficient supply of oxygen to the body and, as a result, to a slowdown in the development of organs; congenital pathology digestive tract and other pathological conditions.

The latter include underfeeding and misfeeding, late introduction of complementary foods, exposure to toxic substances, including medicinal ones, and the incidence of various infections. All these negative external factors leading to hypotrophy of newborns. However, they should not be underestimated.

Malnutrition in children can be of two types: congenital and acquired. The first develops while the baby is in the womb. The second occurs after the birth of the child.

Hypotrophy 1 degree:

The body weight deficit is 10 - 20% compared to the norm (normally more than 60%). (Appendix 1) There is no growth retardation. It is rarely diagnosed, it is detected only upon careful examination of the child. It is characterized by a slight weight loss, a decrease in the subcutaneous fat layer on the abdomen, and its preservation on the limbs and face. The skin is smooth, elastic, pale. Tissue turgor is reduced. There is a slight weakness, sleep disturbance, loss of appetite. Glycogen depot is not disturbed.

With 1 degree of malnutrition, there is no functional disorders from organs and systems, no clinical manifestations vitamin deficiency. protective immunity reduced, a child with grade 1 malnutrition becomes less resistant to infection. Psychomotor development corresponds to age. The chair is normal. Urination is not disturbed.

Hypotrophy 2 degrees:

The body weight deficit is 20 - 30%. The child lags behind in growth by 2 - 4 cm. . The large and small fontanelles are wide open, the sagittal and frontal sutures often remain open, fractures of the clavicles are often detected at birth. There is a decrease in activity, lethargy, weakness, irritability, sleep disturbance. In such children, appetite is significantly reduced, vomiting occurs periodically.

Gradually decreases glycogen stores in skeletal muscles, heart muscle, liver. Muscle weakness appears, a decrease in the mass of the muscles of the limbs, motility is disturbed.

Marked functional disorders from various organs: CNS (development of conditioned reflexes slows down);

Gastrointestinal tract (decrease in enzymes, dyspeptic disorders);

Cardiovascular system (tachycardia, muffled heart sounds);

Respiratory organs (increased breathing, decreased ventilation of the lungs);

Enlargement of the liver. The stool is unstable, constipation is replaced by loose stools. Urine has an ammonia odor. Thermoregulation is disturbed (children are easily supercooled and overheated). The skin is pale with a grayish tint, easily folded. Skin elasticity decreases, tissue turgor is reduced. Dry skin and flaking are noted.

Most children have somatic pathology (pneumonia, otitis media, pyelonephritis). Food tolerance is reduced.

Decreased reserves of vitamins and appear clinical symptoms polyhypovitaminosis, children often get sick, the disease is severe, there is a tendency to a protracted course.

With the predominance of carbohydrates in food, stools can be liquid with an admixture of mucus, yellow-green in color, with an acidic reaction; in a laboratory study, they find a lot of starch, fiber, fat, as well as the presence of leukocytes.

When abused whole cow's milk, cottage cheese, protein stool (“sheep”) is noted: feces acquire a soapy-lime appearance and brown color, become dry in the form of balls, finely crumble and crumble, and have a putrefactive odor.

With quantitative malnutrition, a “hungry” stool appears: dry, scanty, discolored, with a putrid, fetid odor.

Hypotrophy of the 3rd degree (atrophy):

reflects the full clinical picture diseases. The body weight deficit is more than 30%. The length of the child's body is less than the age norm by 7-10 cm. (Appendix 3) anorexia.

It is observed mainly in children of the first 6 months of life;

Clinically characterized by a sharp exhaustion of the child. The subcutaneous fat layer is absent on the abdomen, chest, limbs and face, the skin sags in folds. In appearance, the child resembles a skeleton, covered with dry, pale gray skin. The child's face becomes "senile", wrinkled.

Signs of dehydration are expressed: eyeballs and a large fontanelle sink, the nasolabial fold is deep, the jaws and cheekbones protrude, the chin is pointed, the cheeks are sunken, aphonia, dryness of the conjunctiva and cornea, bright staining of the mucous membrane of the lips, cracks in the corners of the mouth. Tissues completely lose turgor, muscles are atrophic. The body temperature is reduced to 34 - 32 ° C, the child is prone to hypothermia, the extremities are always cold. Glycogen disappears in the child's body, and a decrease in protein reserves is gradually observed, atrophic processes develop in organs and tissues. Muscles become thinner, become flabby, there is a delay in the central nervous system. Delayed psychomotor development. Heart sounds are significantly muffled. Pulse rare, weak filling. Blood pressure low. Breathing is superficial, arrhythmic, apnea periodically appears. The abdomen is enlarged due to flatulence, anterior abdominal wall thinned, visible loops of intestines. The liver and spleen are reduced in size. Dyskinetic disorders are almost always noted: regurgitation, vomiting, frequent loose stools. Urination rare, small portions. As a result of thickening of the blood, hemoglobin and red blood cells are within the normal range or increased. ESR is slow. in the urine a large number of chlorides, phosphates, urea, sometimes acetone and ketone bodies are found.

The terminal period is characterized by a triad of symptoms: Hypothermia (34 - 32); Bradycardia (42 - 60 bpm); Hypoglycemia; The patient fades away gradually and dies imperceptibly.

1.3. Diagnosis of chronic eating disorders

Diagnosis is based on characteristic symptoms hypotrophy, laboratory methods are auxiliary.

Anamnesis of complaints and anamnesis of the disease: impaired appetite, sleep, change in the nature of the stool (scanty, dry, discolored, with a sharp bad smell), the child is lethargic, irritable.

General examination: the skin is pale, dry, malelastic, the subcutaneous layer is depleted, the fontanel sinks, signs of rickets, muscle tone is reduced.

Anthropometry:

Lagging body weight and length from the norm.

Control weighing of the child before and after feeding (helps to identify the fact of malnutrition)

Laboratory data:

Blood test: anemia, signs inflammatory processes(leukocytosis, accelerated ESR), low blood sugar (hypoglycemia).

Biochemistry of blood:

hypoproteinemia (decrease total protein), dysproteinemia (violation of the ratio of different types of proteins), dyslipidemia (violation of the ratio of different types of fats), hypocholesterolemia (decrease in the amount of cholesterol), acidosis ("acidification of the blood"), hypocalcemia (decrease in calcium), hypophosphatemia (decrease in the amount of phosphates).

Analysis of feces: signs of impaired digestion of food, dysbacteriosis.

Urinalysis: elevated creatinine, low total urine nitrogen.

1.4. Principles of treatment of chronic digestive and nutritional disorders

Complex therapy includes: Determination of the cause that caused malnutrition, simultaneously with an attempt to regulate and eliminate it. Treatment of malnutrition in children involves changing the regimen, diet and caloric intake of the child and the nursing mother; if necessary, parenteral correction of metabolic disorders.

basis proper treatment malnutrition is diet therapy. It should be noted that both an insufficient amount of food ingredients and their excess adversely affect the condition of a child with malnutrition. Based on many years of experience in treating children with this disease, representatives of different schools have developed the following tactics for diet therapy.

The implementation of diet therapy for malnutrition in children is based on fractional frequent feeding of the child, weekly calculation of the food load, regular monitoring and correction of treatment.

Symptomatic treatment, which includes the use of multivitamin and enzyme preparations. Appropriate regimen with proper care and educational activities. Periodic courses of massage and therapeutic exercises.

Principles of treatment of malnutrition:

Elimination of factors causing starvation, organization of the regimen, care, massage, exercise therapy, optimal diet therapy, replacement therapy(enzymes, vitamins, trace elements), stimulation of reduced body defenses, treatment concomitant diseases and complications.

The main directions of drug therapy:

Replacement enzyme therapy is carried out mainly with pancreatic preparations, with preference given to preparations of the combined composition panzinorm, festal. Used to stimulate the digestive process gastric juice, acidin pepsin, hydrochloric acid with pepsin. With intestinal dysbacteriosis, biological preparations - bifidumbacterin, bifikol, baktisubtil in long courses.

Parenteral nutrition is carried out in severe forms of malnutrition accompanied by malabsorption phenomena. Prescribed proteins for parenteral nutrition- Alvezin, levamine, protein hydrolysates.

Correction of water and electrolyte disorders and acidosis. Infusions of glucose-salt solutions, a polarizing mixture are prescribed. Drug therapy includes the appointment of enzymes for better absorption of food. Use pepsin with 1-2% hydrochloric acid solution 1 teaspoon 3 times a day before meals, natural gastric juice 1 teaspoon in 1/4 cup of water 2-3 times before meals, abomin 1/4 tablet or 1/4 2 tablets 2-3 times during meals, pancreatin 0.1-0.15 g with calcium carbonate, panzinorm forte (1/2-1 dragee during meals 3 times a day), festal. Behind last years to enhance intracellular metabolism, improve appetite, protein-synthetic function of the liver and as a lipotropic agent for malnutrition in children, carnitine chloride 20%, 4-5 drops in 5% glucose solution, is used orally.

1.5. Prevention of chronic eating and digestive disorders

Should be used during pregnancy preventive actions according to the correct mode of a pregnant woman. proper care, good nutrition and prevention of the influence of harmful environmental factors will minimize the risk of malnutrition at birth. From birth, very important point in the prevention of malnutrition is breastfeeding mother of her baby. Mother's milk contains a huge amount of nutrients and vitamins necessary for a young body, and most importantly - in an easily digestible form.

Under conditions of shortage women's milk produce supplementary feeding of the child with nutritious milk mixtures. One of the main rules of supplementary feeding is that it should be done before breastfeeding.

Starting from the age of six months, the child must begin to feed. There are several main rules for complementary foods:

The child must be completely healthy. Eat food according to the age of the child. Complementary foods are introduced gradually, and before breastfeeding. The child eats with a small spoon. The change of one type of feeding is replaced by one type of complementary foods. The food you eat should be rich in vitamins and essential minerals.

Timely diagnosis infectious diseases, rickets and other disorders of the gastrointestinal tract, will allow you to start appropriate treatment, and prevent the development of malnutrition. Summing up the above material, it should be noted that the prognosis for the development of malnutrition depends, first of all, on the reasons that participated in the occurrence of this pathological condition. The conditions of the external and internal environment, the nature of feeding, as well as the age of the patient - all this plays a big role in the development of malnutrition. With alimentary insufficiency, the outcome of the disease is usually favorable.

1.6. Nursing Process with chronic digestive disorders

Treatment of patients with malnutrition should be staged, complex, taking into account etiological factors and the degree of eating disorders.

It must be individual, functional state organs and systems, the presence or absence infectious process and its complications. Treatment of young children with hypotrophy of the I degree in most cases is carried out at home. By a detailed survey of the mother should find out the cause of the disease. Most often it is of alimentary origin. The introduction of an appropriate supplement in the form of acidic mixtures, the correction of nutrition by the appointment of cottage cheese with a lack of protein, or an increase in the amount of carbohydrates in the diet based on the proper body weight, help to eliminate the onset of an eating disorder. It is necessary to give recommendations to the mother on improving child care (walking, regular hygienic baths, etc.). Children with malnutrition II and III degree must be hospitalized. At the same time, it is necessary to provide for the placement of patients with malnutrition in small wards or semi-boxes in order to protect them from unnecessary contact with children, and especially with ARVI patients. The room is ventilated, carried out twice a day wet cleaning. The temperature should be maintained in the range of 25-26 C.

Careful care of the skin and visible mucous membranes is organized, washed, the skin is treated with boiled sunflower oil.

Table 1. Problems of a child with malnutrition and digestion

Real Problems

Potential problems

Lack or decreased appetite

Movement disorder

Weakness, lethargy

Weight loss, weight loss

Poor weight gain

Emaciation

Backlog in physical development

exhaustion

Unstable chair

Stomach ache

Maceration of the skin around anus

Anxiety, flatulence

regurgitation, vomiting

Violation of comfort

Dehydration

Weight loss

The priority problem is "regurgitation, vomiting". The expected result is that the frequency of vomiting will decrease and stop.

Nursing Intervention Plan:

0.25% in age dosage:

up to 3 years - 1 hour. the spoon

from 3 to 7 years old - 1 day spoon

over 7 years old - 1 tablespoon

Conclusion to chapter 1:

When studying the theoretical part, which deals with the issue of malnutrition as a chronic eating disorder and digestion, we considered such issues as: factors for the development of malnutrition, degrees of malnutrition, diagnosis of chronic eating disorders, prevention of chronic eating disorders and treatment. Chronic eating disorders in children can manifest themselves in various forms, depending on the nature of trophic disorders and age. The most common cause of chronic eating disorders is protein-energy malnutrition combined with a lack of vitamins and trace elements.

nursing care with chronic disorders of digestion and nutrition one of the essential conditions get well soon child. Treatment of patients with malnutrition should be staged, complex, taking into account etiological factors and the degree of eating disorders. It should be individual, taking into account the functional state of organs and systems, the presence or absence of an infectious process and its complications.

CHAPTER 2

Research part

We carried out our practical research in the polyclinic network of the Children's City Polyclinic, Balakovo, during the internship. We have developed an author's online questionnaire and posted it athttps://www.survio.com/en/

The survey involved 73 mothers whose children had digestive and nutritional disorders.

1. When asked about their age, the respondents answered as follows (Fig. 1):

Fig. 1 Statistics of the age of the interviewed mothers

Conclusion : The highest percentage of surveyed mothers aged 20-25 years. On average, all respondents are over the age of 22.

2. When asked about the age of the child, mothers answered (Fig. 2):

Fig. 2 Children's age statistics

Conclusion: The main part of the children of the respondents under the age of 3 years.

3. Respondents answered the question about toxicosis during pregnancy (Fig. 3):

Fig. 3 Toxicosis during pregnancy

Conclusion: Approximately 76.7% (56) of the women surveyed suffered from nausea and vomiting in the first trimester, and 11% (8) suffered throughout pregnancy. There was no toxicosis at all in 12.3% (9) of women. Toxicosis during pregnancy is a risk factor for malnutrition in both the fetus and the newborn.

4. To the question about the genetic predisposition to diabetes mellitus (Fig. 4):

Fig. 4 Genetic predisposition to diabetes

Conclusion: Maternal diabetes has a negative impacton fetal development and delivery. Its occurrence in the early stages has the most unfavorable outcome. During the period when the development of organs and systems of the fetus occurs,various pathologies. Gestational diabetes leads to the formation of various pathologies in the fetusThe onset of diabetes later in pregnancy leads toto an increase in the size of the fetusthat do not meet the deadline. As we can see, a small percentage of surveyed women have a predisposition to diabetes. 16.4% (12 people) have genetic predisposition to diabetes. 83.6% (61 people) do not have a predisposition to diabetes.

5. When asked about following dietary recommendations during pregnancy, the respondents answered as follows (Fig. 5):

Conclusion : A high proportion of many partially followed the prescribed pregnancy diet. 37.0% (27 people) - complied with the nutritional recommendation, 50.7% (37 people) - partially complied, 12.3% (9 people) - did not follow the recommendations for nutrition during pregnancy at all.

6. When asked about the use of alcohol during pregnancy (Fig. 6), mothers answered:

Fig.6. Drinking alcohol during pregnancy

Conclusion: 89% (65 people) did not drink alcohol during pregnancy. 11.0% (8 people) - drank alcohol during pregnancy, which is a risk factor for the development of pathology of the child's gastrointestinal tract and various disorders in organs and systems in the future.

7. Respondents answered the question about smoking during pregnancy (Fig. 7):

Fig.7 Smoking during pregnancy

Conclusion: 79.5% (58 people) did not smoke during pregnancy. 20.5 (15 people) - smoked, which is also a risk factor for the development of malnutrition both in the fetus and in the postnatal period in a newborn child.

8. When asked about the duration breastfeeding mothers answered (Fig. 8):

Fig.8. duration of breastfeeding.

Conclusion: Long-term breastfeeding (up to 1.5 years) contributes to the full maturation of the child's gastrointestinal tract. This is important not only in the first months, during the introduction of complementary foods, but also after a year. Since the child's gastrointestinal tract needs help, and breast milk facilitates this process.

9. To the question of the time of introduction of complementary foods, the respondents answered (Fig. 9):

Fig. 9 Introduction of complementary foods

Conclusion : Up to six months, all the needs for food and drink of the child, in minerals, vitamins and biologically active substances are replenished through breast milk, and no additional products need to be introduced. Large quantity women introduced complementary foods from 6 months, which is correct. Nevertheless, a certain percentage of women grossly violate the rules for the introduction of complementary foods, unreasonably starting complementary foods from 1 month, as well as not introducing complementary foods after 6 months.

10. When asked about the shape of the nipples, the respondents answered (Fig. 10):

Fig. 10 Mother's nipple shape

Conclusion : With flat and inverted breasts, the baby may have difficulty latching onto the breast during feeding. 13.7% (10 people) have flat nipples. 17.8% (13 people) have inverted nipples. 68.5% (50) have prominent nipples.

11. Answers were received to the question about the presence of endocrine diseases in the mother (Fig. 11):

Fig.11 Endocrine pathology at mother.

Conclusion: In the course of the study, we see that endocrine diseases are not so common, in our group only 10 women out of 73 respondents, which is 13.7%. 86.3% (63 people) do not have endocrine diseases. Endocrine pathology in the mother is a risk factor for the development of malnutrition and digestion in the child.

12. To the question about the full-term child, mothers answered (Fig. 12):

Fig.12. gestational age

Conclusion : Among the women surveyed, there is a low percentage of premature births.All the reasons leading to the birth of premature babies can be grouped into several groups. The first group includes socio-biological factors, including too young or old age of parents (under 18 and over 40), bad habits pregnant, malnourished and unsatisfactory living conditions, occupational hazards, unfavorable psycho-emotional background, etc.91.8% (76 people) - the child was born full-term, 8.2% (6 people) - gave birth to a premature baby. Prematurity is one of the main causes of malnutrition and digestion in newborns.

13. When asked about the condition of the child's skin, mothers answered (Fig. 13):

Fig.13. The condition of the skin and PZhS of the child

Conclusion : Most women 76.7% (56 people) have pink and smooth skin with good pzhs, it speaks of sufficient nutrition and proper care. 4.1% (3 people) - children have pale skin, with reduced elasticity. 15.1% (11 people) - children have pale dry skin. 4.1% (3 people) - children have gray, dry skin that folds.

14. To the question about the state of the subcutaneous fat of the mother, they answered (Fig. 14):

Fig.14 The state of the subcutaneous fat of the child.

Conclusion : By birth, subcutaneous adipose tissue more developed on the face (fatty bodies of the cheeks - Bish's lumps), limbs, chest, back; weaker on the stomach. In the case of a disease, the disappearance of subcutaneous fatty tissue occurs in the reverse order, i.e., first on the abdomen, then on the limbs and trunk, in, which is associated with the composition of fatty acids. A good condition of subcutaneous fat is one of the signs of a child's health. In 5.5% (4 people) - in children, the skin is thinned subcutaneously - fatty tissue on the abdomen, 11.0% (8 people) - in children, fatty tissue is absent / thinned on the abdomen and limbs, 11.0% (8 people) - have well-defined Bish's lumps, 72.6% (53 people) - children have good subcutaneous - fatty tissue, according to a prediatrician.

Fig. 15 Elasticity of the skin.

Conclusion : The elasticity of the skin depends on the condition of the subcutaneous fat of the child. With a good condition of the subcutaneous fat, the fold on the skin is well assembled and easily straightened. 83.6% (61 people) - a fold on the skin of children gathers well and is easily straightened, 12.3% (9 people) - a fold on the skin of children gathers and is difficult to straighten, 4.1% (3 people) - a fold on the skin in children does not straighten out for a long time, i.e. elasticity is reduced.

16. To the question about the weight gain of the child, the mothers answered as follows (Fig. 16):

Fig.16. Weight gain.

Conclusion : Compliance with the weight of the age norm indicates the normal development of the child, since the lag in weight or its excess indicates any violations. 15.1% (11 people) - the body weight of children does not lag behind the norm, 6.8% (5 people ) - the body weight of children exceeds the norm, 8.2% (6 people) - children are underweight, 69.9% (51 people) - body weight is normal.

17. When asked about the growth of the child, the respondents answered (Fig. 17):

Fig.17. Child's height.

Conclusion : Compliance of growth with the age norm indicates the normal development of the child, since growth retardation or its excess indicates any possible changes or violations. 74.0% (54 people) - the growth of children corresponds to age, 13.7% (10 people) - the growth of children is 1-3 cm behind the norm, in 4.1% (3 people) - the growth of children is significantly behind the norm , in 8.2% (6 people) - the growth of children exceeds the age norm.

18. To the question about the appetite of the child, mothers answered (Fig. 18):

Fig.18. Child's appetite.

Conclusion: Of the 73 women surveyed, 61.1% of children have a good appetite, which indicates that the diet is observed, a sufficient number of feedings and / or food quality, and the absence of disorders in the gastrointestinal tract. In 19.2% (14 people) children have a reduced appetite, 2.7% (2 people) have a significantly reduced appetite in children, 1.4% (1 person) have a sharply reduced appetite in a child, 61.6% (45 people) - children have a good appetite, 15.1% (11 people) - children have a very good appetite.

19. To the question about the nature of the child's stool, mothers answered (Fig. 19):

Fig.19. The nature of the child's stool.

Conclusion : in 41 mothers the child's stool is not changed, in 16.4% (12 people) - children have unstable stools, in 8.2% (8 people) - liquefied stools, in 15.1% - sometimes they have constipation, and in 1 mothers, the child constantly suffers from constipation, in one mother, the child's stool depends on his nutrition.

20. To the question about the state of the nervous system of the child, mothers answered (Fig. 20):

Rice. 20. The state of the child's nervous system.

Conclusion : 54.8% of mothers deny pathologies in the state of the nervous system. MIn addition, the development, behavior and character of the child, the state of his health largely depend on the creation of correct, normal conditions for her activities. It is especially important to ensure the normal activity of the nervous system in the first years of a baby's life, at a time when its rapid development takes place. 5.5% (4 people) - children sleep restlessly, in 2.7% (2 people) children often have negative emotions, in 1.4% (1 person) lethargy, in 2.7% (2 people) children are depressed, in 28.8% (21 people) children are active and hyperactive.

21. To the question about congenital (sucking, swallowing) and acquired reflexes of the child, mothers answered (Fig. 21):

Fig. 21 Percentage of answers to the question "Does the child have reflexes?"

Conclusion : A set of unconditioned reflexes that facilitate adaptation to new living conditions: reflexes ensure the functioning of the main body systems. From birth, the child develops adaptive reflexes. With age, the child acquires new reflexes, then some disappear. But if by a certain age the child does not develop a reflex inherent in him (in accordance with age), then one can judge about some kind of pathology of the central nervous system. 98.6% (72 people) - children do not have reflex disorders, 1.4% (1 person) - the child has not previously performed half of the innate reflexes, in this moment the situation returned to normal on the background of treatment.

22. When asked about the muscle tone of the child, the respondents answered (Fig. 22):

Fig. 22 Share of answers to the question " Muscle tone The child has?"

Conclusion : Omuscle weakness (hypotonicity) is considered a deviation from the norm, overvoltage- hypertonicity - preserved even in sleep, and muscle dystonia - uneven tone. Each of these conditions is expressed in its own way, but they all bring discomfort to the baby and require timely treatment. In the respondents, 72.6% (53 people) have no disorders, 11.0% (8 people) have reduced muscle tone in children , 5.5% (4 people) - children have a sharply reduced muscle tone, 11.0% (8 people) - increased muscle tone.

23. When asked about the sleep of a child, mothers gave the following answers (Fig. 23):

Fig.23. The dream of a child.

Conclusion: In 71.2% (52 people) of the respondents, children do not have problems with sleep, which indicates a good condition of the child, in 24.7% (18 people) the depth and duration of children's sleep is reduced, in 4.1% (3 people) - Significantly disturbed sleep.

24. To the question about the immunity of the child, mothers answered (Fig. 24):

Fig.24. Child immunity

Conclusion: The child's immune system plays an important role, as poor resistance to infections can lead to the risk of developing serious diseases. In 60.3% (44 people) of the interviewed women, the immunity of children is good. In 23.3% (17 people) of children, immunity is moderately reduced, in 12.3% (9 people) immunity is significantly reduced, and in 4.1% (3 people) immunity is sharply reduced (observed by an immunologist).

25. To the question about the psychomotor development of the child (according to the doctor’s conclusion), the mothers answered (Fig. 25):

Fig.25. Psychomotor development of the child.

Conclusion : According to the doctor's conclusion, in 80.8% (59 people) children correspond to their age in terms of their psychomotor development, in11.0% (8 people) - children lag behind in psychomotor development, which may also indicate a violation of nutrition and digestion in a child with a lack of nutrients or pathology of the gastrointestinal tract, in 8.2% (6 people) it exceeds psychomotor development.

26. When asked about the presence of anemia in children, the respondents answered as follows (Fig. 26):

Fig.26. Anemia in a child.

Conclusion: Most often, anemia in children occurs when their diet contains an insufficient amount of iron, as well as prematurity, Negative influence environment, the presence of helminths. 65.8% (48 people) - children do not suffer from anemia, 17.8% (13 people) of children are diagnosed with anemia, 16.4% (12 people) find it difficult to answer the question.

CONCLUSION

normal development the child is in close connection with the activity of his digestive organs. Indigestion leads to malnutrition, metabolic disorders, which is often accompanied by dysfunction of many organs and systems.

The primary health care worker is in a unique position to diagnose eating and digestive disorders early and prevent their progression to early stages illness. Primary and secondary prevention includes the need for screening for eating disorders and measurement of height and weight as part of routine annual follow-up activities.

Careful attention needs to be paid to identifying early symptoms eating disorders. Early recognition and treatment of eating and digestive disorders can prevent the physical and mental consequences of digestive disorders that lead to advanced disease progression. Weight and height should be determined regularly. The data obtained regarding height and weight should be entered into pediatric records in order to timely determine their delay associated with reduced intake of nutrients, or weight loss due to the disease.

Great importance has an organization for the care of a child with eating and digestion disorders. Such children are not so much treated as nursed. It is very important to create a positive emotional tone in a child - it is necessary to take him in your arms more often (prevention of hypostatic pneumonia), talk to him, walk, create a positive emotional background around the child.

During term paper we reviewed modern literary scientific data on the problems of indigestion and nutrition in young children. Conclusions are drawn on theoretical section, an author's questionnaire was created, on the basis of which a study was conducted and conclusions were drawn that confirmed the data of literary sources discussed in Chapter 1. Based on the results research work we identified problematic points in the knowledge and statements of mothers-respondents, therefore we developed material for sanitary and educational work (the booklet "Eating and Digestive Disorders in Children").

We consider the goals and objectives of the course work achieved.

LIST OF USED LITERATURE

Algorithms professional activity nurses (textbook for students of medical schools. Madan A.I.; Borodaeva N.V.; Krasnoyarsk, 2015);

Childhood diseases. Textbook. 20016 (

Medical Encyclopedia, publishing house " Soviet Encyclopedia", second edition, 1989. Moscow;

Pediatrics - a textbook for medical schools (P. Shabalov, 20010)

Nursing in pediatrics. Textbook (Sokolova N.G., Tulchinskaya V.D.; Rostov-on-Don, Phoenix, 20015)

Nursing in pediatrics. Textbook (Edition 16th, edited by Honored Doctor of the Russian Federation, Professor R.F. Morozova. Rostov-on-Don. "Phoenix", 2016);

Handbook of Pediatrics (Edited by Candidate medical sciences A.K. Ustinovich);

Internet sources:

Appendix 3

3 degree of malnutrition and dehydration

Appendix 4

Conducting research in the form of an online survey.

Appendix 5

Questionnaire

Hello Dear Moms! A student is conducting a study on digestive disorders in children. I ask you to sincerely answer the questions of the questionnaire. The survey is anonymous. All results will be summarized.

1.Your age

2.Age of the child

3. Did you have toxicosis during pregnancy?

a) Only in the first trimester of pregnancy

b) Throughout pregnancy

c) your choice

4. Do you have a genetic predisposition to diabetes

a) Yes

b) No

a) Yes

b) Partly

c) No

6. Did you drink alcohol during pregnancy

a) Yes

b) No

7. Smoked during pregnancy

a) Yes

b) No

8. Until what age did the child breastfeed

9. Since how many months have complementary foods been introduced

10. The shape of your nipples

a) Flat

b) Retracted

c) Convex

11. Do you have endocrine diseases

a) Yes

b) No

12. Was your baby born full term?

a) Yes

b) No

13. The condition of your baby's skin

a) pale, elasticity is reduced

b) pale, dry,

c) gray, dry, gathers in folds

d) pink, smooth

14. State of subcutaneous fat

a) exhausted on the stomach

b) fatty tissue is absent / depleted on the limbs and abdomen

d) Bish's lumps (on the cheeks) are well expressed

15. Elasticity of the skin

a) the fold on the skin gathers well and straightens easily

b) a fold on the skin gathers and is difficult to straighten out

c) the fold on the skin does not straighten out for a long time

16. Weight gain

a) behind the curve

b) missing

c) underweight

d) corresponds to the age norm

17.Child growth

a) age appropriate

b) 1-3 cm behind the norm

c) far behind the norm

d) exceeds the age norm

18. Child's appetite

a) lowered

b) significantly reduced

c) sharply reduced

d) good

19. The nature of the child's stool

a) not changed

b) unstable

c) liquefied

d) sometimes constipation

d) your option

20. State of the nervous system

a) anxiety

b) negative emotions

c) lethargy

d) oppression

e) activity and hyperactivity

21. Reflexes in a child

a) not violated

b) lowered

c) sharply reduced

22. Muscle tone of the child

a) not violated

b) lowered

c) sharply reduced

d) elevated

23. Child's sleep

a) not violated

b) depth and duration reduced

c) significantly impaired

24. Immunity of the child

a) reduced moderately

b) significantly reduced

c) sharply reduced

d) good resistance to infections

25. Psychomotor development of the child according to the conclusion of your doctor

a) age appropriate

b) lagging behind

26. Presence of anemia

A) the child is anemic

B) no anemia

B) find it difficult to answer

There is a small percentage of patients in whom the disease is due to heredity or is associated with organic causes. Such a possibility cannot be completely ruled out. But in the vast majority of cases, eating behavior changes under the influence of psychological reasons. The origins of the problems should be sought in the relationship of the patient with his parents.

The Psychology of Eating Disorders

The child has not yet mastered adult games and understands everything literally. Every word he heard from the closest people, from his parents, influences his worldview extremely strongly. And sometimes this influence becomes deforming, injuring and painful.

Anorexia can be caused by the desire to conform to the stereotypes accepted in society today: a successful and beautiful person is certainly thin. The degree of success begins to be determined by the degree of weight loss, and the adolescent leaves tangible harm to health and deterioration of well-being outside the zone of his attention, ignores. This course of development of the disease is most often found in adolescent girls seeking to acquire a socially approved type of appearance.

Another path to anorexia is the desire of a teenager to take control of at least some part of his life. This happens in families where parents exercise total control over children, suppress any manifestations of independence. Refusal of food in this case is a form of hidden protest. This unannounced hunger strike by the child himself is perceived as a victory in the battle for personal space.

According to the accumulated statistical data, eating disorders are most often found in families dominated by an overbearing mother prone to perfectionism. At the same time, the mother does not attach importance to “calf tenderness” and does not care about building close, trusting relationships with the child. The father in such families almost does not participate in upbringing: he is aloof, non-contact and does not show emotional interest in the child. His role as an educator is limited to financial investment.

Treatment for eating disorders

Success can only be achieved through complex therapy. Without a psychotherapist, as well as without dietitians, treatment will be ineffective.

The fact is that most patients with eating disorders do not consider themselves sick and resist treatment in every possible way. The first and mandatory step should be the consultation of a psychotherapist. Moreover, in most cases, you will have to work with the patient himself and with his environment. If the psychotraumatic situation is not changed, the other components of the treatment will have no effect.

The problem must be recognized and recognized by both the patient and his parents.

But even with successful treatment, the consequences of eating disorders may not disappear without a trace. Often, doctors are faced with relapses of the disease. In many cases, as a result of bulimia or anorexia, irreversible changes have time to occur in the body, which will remind of themselves for a lifetime.

The main task of parents and doctors is to convince the child that he is valuable and dear, regardless of his external or internal qualities. A person of any age must learn to accept himself as he is, to love himself. And learn to forgive - and yourself for your mistakes, and others.

Elena Savelova

What do I want to talk about? About the eating behavior of children and how not to break it! The other day I spoke with my supervisor, and he is such a source of fresh psychological news for me! So, according to the latest data, the age of childhood anorexia and bulimia has decreased to 8 years (this is the moment when they make a diagnosis, by the way, 10 years ago it was 14 years old and was associated with adolescence! And this, of course, is terrible! There are a lot of factors here. I I won’t tell you about the degrees and stages of diseases now, but I will surprise you that the symptoms are not necessarily vomiting, and I will also tell you what to do so that the children are healthy!Of course, below is information about other forms of eating disorders that are easier!

Moreover, anorexia in a child can manifest itself in different ways. Some children start crying and simply refuse to sit down at the table, other children throw tantrums and spit out food, still others eat only one particular dish all day long, and fourth after each meal, severe nausea and vomiting begin. But in any case, this causes serious concern for parents who are trying with all their might to feed the child, which only aggravates the situation more.

The pleasure of eating is one of the basic and lies at the bottom (first level) of Maslow's pyramid. And what do parents do, how do they kill this pleasure in the first place. Did many guess?
Yes, they include cartoons, games, arrange a theater! What is happening at this moment? The brain ceases to fix the pleasure of food, it is easier and faster for it to get joy from the cartoon. The child eats automatically, the importance of what is happening is not laid in the subconscious!

What other factors? Monotonous food! At a certain point, children begin to eat one or another type of food, and parents are comfortable. It's really not very scary (according to doctors) if this period lasts 2-3 months. Next, you need to carefully observe what is happening.

Frequent meals and endless snacks. Sometimes, so that the child does not pull or distract, something is constantly shoved into his mouth. Not the best moment. The amount of food consumed per day should be clearly regulated and correspond to age and weight.
The other extreme is to cram food! The child does not want to, but "You can't leave it."

Improper upbringing of parents, constantly satisfying any whims and whims of the baby, which leads to excessive spoilage of the child and refusal of food.
The attitude of parents to the process of feeding the child, constant persuasion or, conversely, threats.

Negative events that constantly accompany the process of eating food. Attention! Only if parents constantly swear in the kitchen, or rudely force the child to eat obviously tasteless food, then the baby risks losing a positive perception of food, and in the future he simply will not have an appetite, since there will be no desire to repeat his negative experience experienced in early childhood.

Severe stress can also involve a child in primary anorexia nervosa, which, depending on the reaction of adults, may pass in a few days, or may remain for a long time. Such stress can be both a strong fright directly during a meal, and a difficult life situation associated with the loss of loved ones, separation from mother, etc.

What to do? In order!

Entertainment clean up, completely, and immediately. An iPad or TV can easily "Break".

Eat with your child at the table! Creating a culture of food consumption.

We only have calm conversations over food, no quarrels! The positive is very important.

Establish a healthy diet for the family. You don’t need to force your child to eat exactly on time, but you shouldn’t go too far off the schedule either.

If the child does not want to eat, feel free to skip meals so that the next time the baby is well hungry.

The food should be beautiful, and the meal should be interesting, accompanied by pleasant conversations at the family table.

Food should be healthy, but you can’t force a child to eat frankly tasteless unleavened foods either. Look for the golden mean.

Do not show your baby delicious desserts until he has eaten the soup.

Don't put too much food on your child's plate so that he leaves the table a little hungry, or asks for more - that's fine too.

In no case do not force him to finish eating, it is better to leave part of the portion on the plate - this is a healthy approach to nutrition, and you do not need to wean the child from it.

Check out the ingredients! I always read labels! And I ask the composition of everything in the store, this information should always be with the seller! Some food additives and flavor stabilizers are addictive, and in children this happens very quickly! I carry a list of them with me in notes on my phone and I advise you! You can find them in any search engine! Larisa Surkova.