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Feeding Problems in Children: a practical guide. Edited by Southall A, Schwartz A. (Pp 280, paperback; £19.95.) Abingdon: Radcliffe Medical Press, 1999. ISBN 1 85775 208 2
Given the wide prevalence of feeding problems in children and their potential impact on health, it is important for all health professionals working with children to gain an understanding of feeding difficulties. In several chapters of this book there is a refreshing focus on the role of organic factors in feeding problems, which may highlight the wide range of subtle organic features that can contribute to and exacerbate feeding difficulties in children. The impact of other factors on feeding is also covered—for example, the effect of temperament, appetite, growth, developmental stage, prior experience with foods, and cognitive development, all of which are critical in understanding each child's feeding difficulty and creating appropriate intervention strategies.
The various theories of feeding difficulties from physiological (oral motor, regulatory, neurological), psychological (behavioural, cognitive behavioural, and psychoanalytical) and cultural perspectives are covered. These are discussed with reference to multidisciplinary teamwork and the development of both hospital and community feeding services. The chapter covering the psychoanalytical perspective sits somewhat oddly within the context of the book. Less helpful advice and practical intervention techniques stem from this chapter than the others, but perhaps those with an interest in psychoanalysis will find it an appealing diversion.
It is vital that health professionals in this field develop an understanding of the impact of cultural factors, from the effect of cultural feeding practices on feeding difficulties, to the perception and importance of food and feeding within cultures. This is critical in understanding the factors that contribute to the development and maintenance of feeding problems in children, and is also essential to facilitate culturally sensitive intervention strategies. The perspectives of Indian culture are discussed and whilst one text alone cannot cover the breadth of multicultural issues that are relevant to the UK population, there is useful commentary on issues which are specifically related to cultural practices and those which are related to social disadvantage and poverty in general.
Whilst some chapters focus on clinical practice and opinion that may not appeal to an academic audience, practical advice, such as special issues in tube feeding, neurological impairment, and chronic illness, combined with generally sound theoretical discussion, makes this text a useful resource for health professionals involved in the assessment or treatment of feeding difficulties.
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