Нарушения пищевого поведения у детей раннего возраста: современные подходы к диагностике и коррекции

Нарушения пищевого поведения у детей раннего и дошкольного возрастов являются весьма актуальной проблемой в современной педиатрии в связи с высокой распространенностью и негативными последствиям для здоровья и развития детей из-за хронического дефицита нутриентов при отсутствии своевременного выявления и адекватной коррекции. Наиболее частые нарушения, затрудняющие процесс кормления, - избирательность в пище, снижение аппетита и страх перед приемом пищи. Коррекция нарушений пищевого поведения у детей раннего возраста - длительный процесс, в ходе которого целесообразна постановка краткосрочных целей для достижения благоприятного исхода в перспективе. В начальной фазе первоочередной задачей является выявление тревожных признаков (красных флагов), представляющих опасность для детей. Лечение должно быть комплексным и направленным в первую очередь на психологическую сторону проблемы с одновременной коррекцией питания при необходимости. В статье представлен современный подход к ведению пациентов с наиболее распространенными трудностями при кормлении в амбулаторной педиатрической практике. Данный подход предусматривает исключение тревожных признаков соматической и психоневрологической патологии, оценку развития оральной моторики, нутритивного статуса детей и выявление патологических типов кормления. В настоящее время выделяют четыре основных стиля кормления: внимательный (авторитетный), контролирующий (авторитарный), потакающий и невнимательный. Терапевтическая тактика зависит от ведущего нарушения пищевого поведения. Рекомендации по коррекции аппетита зависят от ведущей причины его нарушения. Обеспечение ребенка необходимыми нутриентами путем назначения пищевого страхования при помощи включения в рацион изокалорийных продуктов, содержащих полноценный белок и микронутриенты, позволяет снизить тревожность родителей и избежать использования принудительных тактик кормления.

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