Paeds Cases · gastroenterology-hepatology-and-nutrition
Paediatric feeding disorder: nutritional and gastrointestinal management — structured clinical encounter
Structured encounter testing the nutritional and gastrointestinal management of a three-year-old with cerebral palsy whose food refusal, faltering growth and poorly controlled reflux have been labelled behavioural: recognising the four domains of paediatric feeding disorder, treating the medical driver first, applying structured behavioural intervention, and deciding on enteral feeding with a tube-weaning plan.
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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]
You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.
References6Show ledgerHide ledger
- [1]Goday PS; Huh SY; Silverman A Pediatric Feeding Disorder: Consensus Definition and Conceptual Framework. J Pediatr Gastroenterol Nutr, 2019.PMID 30358739
- [4]Silverman A; Wall MA; Begotka A Feeding Disorders: Current State and Future Directions. Gastroenterol Clin North Am, 2025.PMID 41238275
- [5]Sharp WG; Volkert VM; Scahill L A Systematic Review and Meta-Analysis of Intensive Multidisciplinary Intervention for Pediatric Feeding Disorders: How Standard Is the Standard of Care? J Pediatr, 2017.PMID 27843007
- [9]Katzman DK; Norris ML; Zucker N Avoidant Restrictive Food Intake Disorder. Psychiatr Clin North Am, 2019.PMID 30704639
- [11]Taylor C; Badawi N; Novak I Caregivers' experiences of feeding children with cerebral palsy: a systematic review of qualitative evidence. JBI Evid Synth, 2025.PMID 40012369
- [12]Homan M; Hauser B; Romano C Percutaneous Endoscopic Gastrostomy in Children: An Update to the ESPGHAN Position Paper. J Pediatr Gastroenterol Nutr, 2021.PMID 34155150