Novembro 2014 vol. 1 num. 4 - 2° Congresso Internacional Sabará de Especialidades Pediátricas

Artigo - Open Access.

Idioma principal

A criança que não come: abordagem pediátrico-comportamental

Fisberg, Mauro ; Tosatti, Abykeyla Melisse ; Abreu, Camila Leonel ;

Artigo:

Uma alimentação adequada durante a infância é essencial para a saúde ao longo da vida e o bem-estar. As boas regras da alimentação já começam na infância, desde o nascimento, pela amamentação exclusiva até os seis meses de vida, para obter um ótimo crescimento, desenvolvimento e saúde. Daí em diante, para satisfazer as suas necessidades em evolução nutricional, as crianças devem receber uma alimentação complementar nutricionalmente adequada e segura, enquanto continua o aleitamento materno até aos dois anos como recomenda a Organização Mundial da Saúde (OMS) e a UNICEF. A industrialização, a urbanização, o desenvolvimento econômico e tecnológico, acarretaram mudanças na alimentação e no estilo de vida, aumentando dramaticamente a prevalência de obesidade no mundo, caracterizando a transição nutricional, em que a desnutrição apresenta acentuado declínio e a obesidade emerge como grave problema de saúde pública. No entanto, aproximadamente 51% das mães de todo o mundo referem que estão preocupadas com o fato de seu filho não comer de forma adequada. O tratamento desta situação deve ser baseado no conhecimento da causa e da individualização do problema, por meio de equipes multidisciplinares especializadas.

Artigo:

In a world where our food is more and more contradictory, a mix between the search for healthier foods and eating less adequate diets, it is quite difficult to understand how we forget our millennial history. Those times when we were hunters and collectors, we ate meat and fish, fruit and vegetables from nature, with an enormous difference in our capacity of storing, preparing and preserving those products for periods of inclement weather. Once we started to settle in, with the beginning of a more sedentary life, planting seeds and other products, we depended less and less on hunting and fishing, on seasonality and started to conserve. At the same time, we started to drink milk from other animal species. Milk is a multifunctional food, as it keeps the protein source available to more people, as people started to raise animals in their farms or villages. Through fermentation, milk became a good-quality protein and it is portable, characterized by the first snack used outside of the household (bread, cookies, dairy products - cheese, yogurt, curd). Since the time of the Cossacks, dairy products have been associated with health and longevity, mainly for the population of the Balkans. The association with health is anecdotal, with priorities that ranged from diarrhea prevention and treatment, physical strength, longevity, and health in general. It was only in 1898 and beginning of the 20th Century that Grigorov and Metchnikoff, associate the yogurt bacillus with longevity and therapeutic properties. The associations between calcium and vitamin D with bone health and rickets were described in the end of the 20th Century. Since then, dairy studies moved from individual studies to large epidemiologic and clinical association studies, relating with weigh and cardiovascular health. Today we define the epidemiologic rule that milk and its byproducts are the major source of calcium in our diet, representing more than 50% of the available sources. Studies from various groups all over the world show that the intake of dairy products is associated with the decrease in body mass and fat amount and bone health, osteopenia and osteoporosis prevention. Nevertheless, different populations have different lactase levels and adjust to more or less intake of dairy products, directly from its byproducts (cheese, creams, butters, curds, yogurts). Today, a new risk situation has risen in the nutrition world, and it is the lactose-free movement. A sudden removal of dairy products from the human diet has led to inadequate prescriptions by health professionals to restrictive diets that do not allow for enough calcium for the human needs. It also led to generalization of situations of lack of capacity of milk digestion to totally dairy-free diets. The health professional needs to have a balance of an adequate diagnosis of partial lactose intolerance and a correct intake of calcium vitamin D, lactose and a crucial food source for human health

Download (PDF)

Palavras-chave: Dificuldade Alimentar, picky eating, estilo parental, anorexia infantil, nutrição normal, feeding difficulties, picky eating, parental style, infantile anorexia, normal nutrition,

Palavras-chave: ,

DOI: 10.5151/medpro-2cisep-019

Referências bibliográficas
  • [1] Alarcon PA. Effect of oral supplementation on catch-up growth in picky eaters. Clin Pediatr. 2003;42:209-217
  • [2] Azevedo TCG, Martins LA, Fisberg M. Distúrbios do apetite na infância. Âmbito Hospitalar. 1993;57-64.
  • [3] Birch LL. Development of food preferences. Annu Rev Nutr. 1999;19:41-62.
  • [4] Birch LL, McPhee L, Shoba BC, Pirok E, Steinberg L. What kind of exposures reduces children''s food neophobia. Appetite. 1987;8:171-8.
  • [5] Bleichfeld B, Montgomery ME. Feeding and sleeping problems of infancy and early childhood. In: Kaye DL, Montgomery ME, Munson SW, editores. Child and adolescent mental health. Philadelphia: Lippincott Williams and Wilkins; 2002. p. 226-251.
  • [6] Bouça D, Sampaio D. Avaliação clínica nas doenças do comportamento alimentar. Revista Portuguesa de Psicossomática. 2002;4:(2),121-133
  • [7] Bresolin AM. Recusa alimentar: abordagem ambulatorial. J Pediatr. 1987;(9):99-102.
  • [8] Burklow KA, Phelps AN, Schultz JR, McConnell K, Rudolph C. Classifying complex pediatric feeding disorders. J Pediatr Gastroenterol Nutr. 1998;27:143-47.
  • [9] Carruth BR. The phenomenon of "picky eater": a behavioral marker in eating patterns of toddlers. J Am Coll Nutr. 1998;19(6):771-80.
  • [10] Cerro N, Zeunert S, Simmer KN, Daniels LA. Eating behaviour of children 1.5-3.5 years born preterm: parents'' perceptions. J Pediatr Child Health. 2002;38:72-8.
  • [11] Chatoor I, Ganiban J, Colin V, Plummer N, Harmon RJ. Attachment and feeding problems: a reexamination of nonorganic failure to thrive and attachment insecurity. J Am Acad Child Adolesc Psychiatry. 1998;37:1217-24.Douglas J. Why won''t my toddler eat? The Practitioner. 1998;242:516-22.
  • [12] Douglas JE, Bryon M. Interview data on severe behavioural eating difficulties in young children. Arch Dis Child. 1996;75:304-08.
  • [13] Fernandez Nunez JM, Sendin Gonzalez C, Paulino Herrera A, Perez Gomez P, Lozano Izquiera C. "Doctor, the child does not eat": a motive for consultation. Aten Primaria. 1997;20:554-6.
  • [14] Fisberg, M e Maximino P- Guia Descomplicado da Alimentação Infantil- editora Abril, 20013.
  • [15] Gottesman MM. Helping toddlers eat well. Journal of Pediatric Health Care. 2002;16,92-96.
  • [16] Grillo E, Silva RJM. Manifestações precoces dos transtornos do comportamento na criança e no adolescente. J Pediatr. 2004;80(2 Supl):S21-S27
  • [17] Jong N, Burd DM, Eicher PS. Effect of dietary supplements and physical exercise on sensory perception, appetite, dietary intake and body weight in frail elderly subjects. Br J Nutr. 2000;83:605-13.
  • [18] Kachani AT, Abreu CLMA, Lisboa SBH, Fisberg M. Seletividade alimentar da criança. Pediatria. 2005;27(1):48-60.
  • [19] Kerzner B. Clinical investigation of feeding difficulties in young children: a practical approach. Clin Pediatr (Phila). 2009 Nov;48(9):960-5. doi: 10.1177/0009922809336074. Epub 2009 Jul 15. Review.
  • [20] Lifschitz CH. Feeding problems in Infants and children. Curr Treat Options Gastroenterol. 2001;4:451-7
  • [21] Madeira IR, Aquino LA. Problemas de abordagem difícil: não come e não dorme. J Pediatr. 2003;79(suppl 1):S43-54.
  • [22] Manikan R, Perman JA. Pediatric feeding disorders. J Clin Gastroenterol. 2000;30 (1):34-46.
  • [23] O''Connor ME, Szekely LJ. Frequent breastfeeding and food refusal associated with failure to thrive. A manifestation of the vulnerable child syndrome. Clin Pediatr. 2001;40(1):27-33
  • [24] Nogueira ANA, Mello ED, Maranhão HS, Vieira MC, Barros R, Barreto JR, Fisberg M. Pediatria Moderna 48(9):340-348,set 2012.
  • [25] Perosa GB, Carvalhaes MABL, Benicio MHA, Silveira FCP. Estratégias alimentares de mães de crianças desnutridas e eutróficas: estudo qualitativo mediante observação gravada em vídeo. Ciênc Saúde Coletiva. 2011;16(11):4445-4464
  • [26] Pliner P, Hobden K. Development of a scale to measure the trait of food neophobia in humans. Appetite. 1992;19:105-120.
  • [27] Pockels R. Uso de estimulantes del apetito en la población infantil. Arch Domin Pediatr. 1994;30(2):30-2.
  • [28] Ramalho VLM, Ribeiro AMP. Uma intervenção cognitivo-comportamental com uma criança com dificuldades alimentares: Pedro descobriu que gostava de comer. Estudos de Psicologia. 2008;13(3),195-201.
  • [29] Rotenberg S, Vargas S. Práticas alimentares e o cuidado da saúde: da alimentação da criança à alimentação da família. Rev. Bras. Saúde Mater. Infant. 2004;4(1):85-94.
  • [30] Skinner JD. Children''s food preferences: a longitudinal analysis. J Am Diet Assoc. 2002;102(11):1638-47.
  • [31] Smith AM. Food choices of tactile defensive children. Nutrition. 2005;21:14-19.
  • [32] Wharton B. Taste and appetite in infancy: possible topics for research. Pediatrics. 2000;106:1278A-1278.
Como citar:

Fisberg, Mauro; Tosatti, Abykeyla Melisse; Abreu, Camila Leonel; "A criança que não come: abordagem pediátrico-comportamental", p. 176-189 . In: Anais do 2° Congresso Internacional Sabará de Especialidades Pediátricas [=Blucher Medical Proceedings, v.1, n.4]. São Paulo: Blucher, 2014.
ISSN 2357-7282, DOI 10.5151/medpro-2cisep-019

últimos 30 dias | último ano | desde a publicação


downloads


visualizações


indexações