Paediatric feeding disorder: nutritional and gastrointestinal management — structured clinical encounter

Station brief (candidate)

You are the paediatric registrar in a gastroenterology and nutrition clinic. A three-year-old with cerebral palsy has refused most foods for six months, accepting only smooth yoghurt and milk. Her weight has fallen from the tenth to below the third centile. Her reflux has been poorly controlled and she is constipated, and her food refusal has been labelled behavioural. The team asks you to define her condition, to carry out the four-domain assessment, to explain why the behavioural label is incomplete, to outline the stepped multidisciplinary management, and to advise on the role of enteral feeding. You have twelve minutes with the team and five minutes for examiner discussion. ^[4]