Parental Health Beliefs as a Cause of Nonorganic Failure to Thrive

Abstract

Parental misconceptions and health beliefs concerning what constitutes a normal diet for infants is reported as a cause for failure to thrive. There were seven patients (four boys, three girls), 7 to 22 months of age, who were evaluated for poor weight gain and linear growth. They were only consuming 60% to 94% of the recommended caloric intake for age and sex. The children's caloric intake had been restricted by their parents. They were concerned that the children would become obese, develop atherosclerosis, become junk food dependent, and/or develop eating habits that the parents believed were unhealthy. The parents instituted diets consistent with health beliefs currently in vogue and recommended by the medical community for adults who are at risk for cardiovascular disease. These diets caused the infants to experience inadequate weight gain and have a decreased linear growth rate. With nutritional counseling, all food restrictions were removed, the caloric intake was increased to 94% to 147% of the recommended intake for age. The weight gain rate increased significantly (P< .05) from 0.1 ± 0.1 kg/mo to 0.4 ± 0.3 kg/mo, and the linear growth rate increased significantly (P) from 0.4 ± 0.4 cm/mo to 1.0 ± 0.6 cm/mo within 3 months of therapy. Exaggerated concerns about excessive food intake in childhood and/or concern about the sequelae of eating an improper diet has resulted in this entity of failure to thrive due to parental health beliefs.

Development of food acceptance patterns.

“…Reports in the pediatric literature reaffirm that parental concerns and misconceptions about diet and health can have deleterious effects on development. Recently, Pugliese, Weyman-Daum, Moses, and Lifshitz (1987) reported cases of nonorganic failure to thrive among children from middle-class families. Parental concerns about their children becoming obese or becoming junk food addicts and their misconceptions about what constitutes a normal diet for young children led these parents to restrict their children's intake, producing growth failure.…”

The control of food intake by young children: The role of learning.

“…An extreme example of the role of parental beliefs about feeding on children's-food intake has recently been reported by Pugliese, Weyman-Daum, Moses, and Lifshitz (1987). They described seven reported cases of nonorganic failure to thrive among middle-class U.S. children 7 to 22 months old.…”

“…The Pugliese et al (1987) paper underscored the point that parents' ideas about what and how much children should eat are often wrong. In some cases, parents think that children are eating too much or too much of the wrong foods.…”

Children with persistent feeding difficulties: An observational analysis of the feeding interactions of problem and non-problem eaters.

“…con, Spencer, Hopwood, & Kelch, 1982); and oral-motor anatomical defects (Mathisen, Skuse, Woike, & Reilly, 1989). Psychological and behavioral factors implicated in feeding disorders include parental characteristics (maternal depression, household disorganization, and social isolation), parents' beliefs about nutrition (Pugliese, Weyman-Daum, Moses, & Lifshitz, 1987), and parent-child interaction during mealtimes (Agras, Berkowitz, Hammer, & Kraemer, 1988).…”