Background:
Picky eating is a common phenomenal in young children. They might significantly reduce in certain nutrients intake and leading to growth consequence. This can be a challenge to manage due to prolong habit forming.
Client History:
A 8 years old Malay child was referred to the dietitian for weight gain. Patient was the eldest son in a family of 2 siblings, present with social deficits with underlying Asthma.
Assessment:
Anthropometry indicates growth failure and displayed picking eating behavior. Limited food choices and attempts to encourage new food failed leading to poor nutrient intake.
Nutrition Diagnosis:
Inadequate protein energy intake related to limited food acceptance (picky eating) as evidenced by 50% of energy and 70% of protein intake compare to catch up requirement.
Objective of Management & Nutrient Prescription:
To provide adequate energy and protein intake for catch-up growth. Catch up growth requirement were 2100 kcal and 105g protein per day. Interventions focused on build parents’ self-efficacy, education on providing variety and age appropriate servings with frequent meal timing and energy densed food.
Outcome and Follow Up:
No improvement in anthropometry after one month. Intake increased 14% and 19% of total energy and protein intake respectively. Inconsistent food provision on dairy products. Further enhancement on food acceptant and nutrient intake through involvement in meal preparation and nourishing beverages.
Discussion
Meal time routine, frequent meal time, encouraging new foods and providing nutritional supplementation are essentials in nutritional counselling. Encouragement on child’s achievement and parents’ effort are greatly determining the outcome despite small steps forward.
Leaning Points/take home messages
- Emphasis on age appropriate portion from major food groups helps parents to plan nutritious meals for supporting growth.
- Consistent provision on nutritious food to ensure optimum nutrients intake
- Value the child and family’s efforts in making the improvement despite only small steps
