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Does your child have PFD? Does you GP recognise PFD?, Judith Yeabsley|Fussy Eating NZ, questionnaire, #questionnaireformedicalprofessionals, #vegetablesforfussyeaters, #vegetablesforpickyeaters, #dinnerideasforveryfussyeaters, #dinnersforfussyeaters, #dinnersforforpickyeaters, #theconfidenteater, #fussyeatingNZ, #pickyeatingNZ #helpforpickyeaters, #helpforpickyeating, #recipespickyeaterswilleat, #recipesfussyeaterswilleat #winnerwinnerIeatdinner, #Recipesforpickyeaters, #Foodforpickyeaters, #wellington, #NZ, #judithyeabsley, #helpforfussyeating, #helpforfussyeaters, #fussyeater, #fussyeating, #pickyeater, #pickyeating, #supportforpickyeaters, #creatingconfidenteaters, #newfoods, #bookforpickyeaters, #thepickypack, #funfoodsforpickyeaters, #funfoodsdforfussyeaters

Does your child have PFD? Does your GP recognise PFD?

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Does your child have PFD? Does you GP recognise PFD?, Judith Yeabsley|Fussy Eating NZ, questionnaire, #questionnaireformedicalprofessionals, #vegetablesforfussyeaters, #vegetablesforpickyeaters, #dinnerideasforveryfussyeaters, #dinnersforfussyeaters, #dinnersforforpickyeaters, #theconfidenteater, #fussyeatingNZ, #pickyeatingNZ #helpforpickyeaters, #helpforpickyeating, #recipespickyeaterswilleat, #recipesfussyeaterswilleat #winnerwinnerIeatdinner, #Recipesforpickyeaters, #Foodforpickyeaters, #wellington, #NZ, #judithyeabsley, #helpforfussyeating, #helpforfussyeaters, #fussyeater, #fussyeating, #pickyeater, #pickyeating, #supportforpickyeaters, #creatingconfidenteaters, #newfoods, #bookforpickyeaters, #thepickypack, #funfoodsforpickyeaters, #funfoodsdforfussyeaters

Does your child have PFD? Does your GP recognise PFD?

Pedatric Feeding Disorder was added to the ICD-10 on 1st October 2021. If you would like a simple explanation of what it is, why it is important that you know and whether it’s applicable to your child, you can link here: https://theconfidenteater.com/pediatric-feeding-disorder-pfd-a-new-picky-eating-diagnosis/

Last week on the blog I explained how for a Uni assignment I was asked to produce a policy brief about fussy eating for children. As I was writing it, I realised I had stumbled across a solution to many of the major challenges parents of picky eaters’ face in NZ.

Even better the solution is virtually cost free. Imagine, a solution to a major health/social problem that does not cost millions? Plus, the solution is just as easy to implement in Australia, the UK, or any other Western country with a centralised health system.

As I have yet to submit my policy brief it is probably better not to post publicly, however, I will do so once submissions close for this particular assignment.

However, what I can do is list the specifics of PFD in a format that would make it easy for either you or a medical professional to assess your child and establish whether there is cause for concern.

This is the dream, a simple check list on the database of every GP and every paediatrician so they can see at a glance whether a child is a problem feeder.

The next hurdle is of course then providing support and services to work with the family of a problem feeder. In a centralised public health system, ideally this is for free. At the moment there is a huge service gap. However, step one, which is recognition and validation is critical.

Does your child have PFD? Does you GP recognise PFD?, Judith Yeabsley|Fussy Eating NZ, questionnaire, #questionnaireformedicalprofessionals, #vegetablesforfussyeaters, #vegetablesforpickyeaters, #dinnerideasforveryfussyeaters, #dinnersforfussyeaters, #dinnersforforpickyeaters, #theconfidenteater, #fussyeatingNZ, #pickyeatingNZ #helpforpickyeaters, #helpforpickyeating, #recipespickyeaterswilleat, #recipesfussyeaterswilleat #winnerwinnerIeatdinner, #Recipesforpickyeaters, #Foodforpickyeaters, #wellington, #NZ, #judithyeabsley, #helpforfussyeating, #helpforfussyeaters, #fussyeater, #fussyeating, #pickyeater, #pickyeating, #supportforpickyeaters, #creatingconfidenteaters, #newfoods, #bookforpickyeaters, #thepickypack, #funfoodsforpickyeaters, #funfoodsdforfussyeaters

Imagine how much more likely a support system will be if medical professionals from around the country complain that they have problem feeders who need treatment, but there is nowhere to send them? A medical professional’s duty after all is to figure out what the problem is and then either fix it or find someone who can!

I hope that it also resolves two other major negatives for parents who have a child who struggles to eat variety:

1. That their concerns are validated, given a name and that medical professionals recognise the challenges that both children and families face.

2. That as a society we begin to recognise that eating challenges, just like reading or talking struggles need our empathy and support, not our censure.

Should my dream become a reality and a questionnaire be distributed to all medical professionals, it would naturally be done in consultation with local experts in all of the four domains that may impact eating.

I can give a great basic overview, but for some of the more medically oriented areas, a specialist in those areas would be better placed to finalise questions.

Does your child have PFD? Does you GP recognise PFD?, Judith Yeabsley|Fussy Eating NZ, questionnaire, #questionnaireformedicalprofessionals, #vegetablesforfussyeaters, #vegetablesforpickyeaters, #dinnerideasforveryfussyeaters, #dinnersforfussyeaters, #dinnersforforpickyeaters, #theconfidenteater, #fussyeatingNZ, #pickyeatingNZ #helpforpickyeaters, #helpforpickyeating, #recipespickyeaterswilleat, #recipesfussyeaterswilleat #winnerwinnerIeatdinner, #Recipesforpickyeaters, #Foodforpickyeaters, #wellington, #NZ, #judithyeabsley, #helpforfussyeating, #helpforfussyeaters, #fussyeater, #fussyeating, #pickyeater, #pickyeating, #supportforpickyeaters, #creatingconfidenteaters, #newfoods, #bookforpickyeaters, #thepickypack, #funfoodsforpickyeaters, #funfoodsdforfussyeaters

However, what I can do, is take the areas that were studied to create the diagnosis of PFD by a panel of experts in many areas from paediatric feeding to gastroenterology and Autism Spectrum Disorder, and summarise what they mean to provide a basis for understanding.

PFD diagnosis

Please understand this is only an example of the list of feeding challenges that would go into a questionnaire to make it easy for medical professionals to recognise problem feeding.

The PFD diagnosis covers four separate ‘domains’ that can impact on feeding. Although these are separate, challenges in one could cause issues in another. For example, if your child has sensory sensitivities it could mean they consciously avoid certain foods, which has knock on effects in other areas.

PFD is defined as “impaired oral intake that is not age-appropriate, and is associated with medical, nutritional, feeding skill, and/or psychosocial dysfunction”.

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The four ‘domains’ that affect feeding/eating are therefore:

1. Medical
2. Nutritional
3. Feeding skill
4. Psychosocial dysfunction

A. Disruption to intake of foods by mouth, not appropriate for age that continues for at least 2 weeks and correlates with 1 or more of the following criteria:

1. Medical dysfunction – shown by any of the following:
a) Cardiorespiratory challenge during feeding (for example, children who find it difficult to breathe when they are eating).
b) Aspiration or ongoing aspiration pneumonitis

2. Nutritional dysfunction – shown by any of the following:
a) Malnutrition
b) Individual nutrient deficiency or significantly low intake of one or more nutrients due to limited dietary variety
c) Necessity for tube feeding or supplementation to maintain nutrition or hydration

3. Feeding skill dysfunction – shown by any of the following:
a) Necessity to change the texture of liquid or food
b) Necessity to change the feeding position or equipment
c) Necessity to modify feeding strategies
This includes limitations to activities/participation in relation to eating.
4. Psychosocial dysfunction – shown by any of the following:
a) Avoidance behaviour by child when eating or being fed
b) Inappropriate management of feeding or nutritional needs by the caregiver
c) Disruption of social functioning in the feeding context
d) Disruption of the relationship between child and caregiver associated with eating/feeding
This includes limitations in activities/participation in relation to eating.

B. The cognitive processes associated with eating disorders are not present, food intake is not due to lack of food availability or due to cultural norms.

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When I think of the families I speak with on a weekly basis and those I have worked with over the years, the questions are spot on. In combining expertise from all fields from medical, to sensory to psychology PFD explains the areas where challenges occur.

A duration of under 3 months is ‘Acute’ and over 3 months ‘Chronic’. Just the words ‘Chronic Condition’ conveys something very different to ‘Fussy or Picky Eating’ and I am sure most parents who have been managing eating challenges for a while have had moments when it truly has felt chronic.

When I recall the children who can’t go to camp, refuse to do sleepovers or even the older teens who turn down placements at Uni or work due to the food, chronic seems far more appropriate than ‘fussy/picky’ which implies choice.

The diagnosis for PFD also focuses on function. The whole idea is how eating challenges affect the ability of a child to function well. It is also why it sits under the ICF (International Classification of Functioning, Disability and Health). To not be able to participate, for example, in a school camp, falls under a disability.

I’d love to know whether this would tick boxes for your child. Would you be excited if your doctor were able to access something similar to this to evaluate whether your child’s eating falls into the area of problem feeding?

Judith Yeabsley, The Confident Eater. Judith Yeabsley|Fussy Eating NZ, #helpaddingfoodsfussyeating, #helpfortoddlerfussyeaters, #helpfortoddlerpickyeaters, #helpaddingfoodforpickyeaters, #theconfidenteater, #fussyeatingNZ, #pickyeatingNZ #helpforpickyeaters, #helpforpickyeating, #recipespickyeaterswilleat, #recipesfussyeaterswilleat #winnerwinnerIeatdinner, #Recipesforpickyeaters, #Foodforpickyeaters, #wellington, #NZ, #judithyeabsley, #helpforfussyeating, #helpforfussyeaters, #fussyeater, #fussyeating, #pickyeater, #pickyeating, #supportforpickyeaters, #creatingconfidenteaters, #newfoods, #bookforpickyeaters, #thepickypack, #funfoodsforpickyeaters, #funfoodsdforfussyeaters

 

Judith, MA Cantab, is an AOTA accredited picky eating advisor and internationally certified nutritional therapist. She works with 100+ families every year resolving fussy eating and returning pleasure and joy to the meal table.
She is also mum to two boys and the author of Creating Confident Eaters and Winner Winner I Eat Dinner. Her dream is that every child is able to approach food from a place of safety and joy, not fear.
Learn more about Judith here: https://theconfidenteater.com/about/

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