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[Anorexia in the first year of life. Case contribution]
A Paci1, V Zappia, L Ricciardi
1Cattedra di Clinica Pediatrica II, Università di Pisa, Italia.
Insights
Pediatric anorexia, often linked to disturbed mother-child dynamics, can be resolved by addressing maternal anxiety and avoiding forced feeding. Treatment focuses on supportive care and medication when necessary.
Area of Science:
- Pediatric Gastroenterology
- Child Psychology
- Maternal-Child Health
Context:
- Anorexia is a common reason for pediatric consultations, particularly in infants under one year.
- Prolonged infant anorexia often stems from disturbed mother-child-environment interactions rather than organic causes.
- Maternal anxiety and forceful feeding tactics can exacerbate infant appetite loss.
Purpose:
- To investigate the etiopathogenesis and treatment of protracted infant anorexia.
- To explore the role of mother-child dynamics in the development of oppositional anorexia.
- To evaluate the effectiveness of interventions in resolving infant anorexia.
Summary:
- This study examined 16 cases of infant anorexia (40 days to 12 months), often triggered by minor illnesses, dietary changes, or weaning.
- Forceful feeding by mothers worsened anorexia, establishing a pattern of oppositional behavior.
- Hospitalization with maternal presence, supportive care, and cyproheptadine in 14 infants, along with anxiolytics for mothers in some cases, led to positive resolutions.
Impact:
- Highlights the critical role of maternal psychological state and feeding practices in infant anorexia.
- Demonstrates successful treatment outcomes through a combination of supportive care, behavioral adjustments, and pharmacotherapy.
- Provides insights for pediatricians and healthcare providers on managing infant feeding disorders.
Abstract:
The anorexia is a frequent cause for paediatric consultation, especially during the first year of life, during which often it is not due to illness or to some organic cause. Particularly interesting from the etiopathogenetic and most of all from the curative point of view are the protracted anorexias in which the relationships mother-child-surroundings appear disturbed. Generally, the loss or the simple reduction of the appetite could heal, all the same and also in a short while if the mother would accept willingly the new situation, trusting in a spontaneous resolution. On the contrary she usually forces the infant to take the meal even if incompletely, meeting at each new attempt, the infant's resistance initially passive and then more and more active and efficacious. Thus an "anorexia for opposition" is established by the conflict between mother and child that the mother stirfs up to then end looser if not even victim. An exemplar in this connection is given by the anorexias of the 16 personal cases extracted from a larger casuistry: infant of age between 40 days and 12 months in the most part of which the anorexia was arisen from different causes (illness from slight infections, the replacement of the human milk with the adapted milk, the weaning, copious rations); in some infants the loss of appetite was without an apparent cause. The anorexia became worse after the mother's reiterated attempts to force the infant to have a meal. During the hospitalization the mother was detained with the son; the giving of the meals was in a first time done by the paramedical personnel with the mother present an then by the mother only. In 14 infants the cyproheptadine was given. Only in a few cases the mothers were treated with anxiolytic. All the cases have been resolve positively.