Homoeopathy for eating disorders of Infancy and early childhood

Dr Asha Shankwar

ABSTRACT
The problems regarding’s food habit’s among children’s are increasing day by day and the concern of parents are increasing the same, so this article us explaining about the food habit’s & it’s concern homoeopathic therapeutic management .Which can improve the general health and food habits of the children.

KEYWORDS – Eating disorders, children’s, Early childhood, Food habits, Paediatrics, Pica, Homoeopathic therapeutics .

INTRODUCTION–
That are characterized by persistent disturbance in eating.That can lead to significant impairments in physical health and psychosocial functioning.The American psychiatric associations fifth edition of the diagnostic and statistical manual of mental disorder (DSM-5) category feeding and eating disorders includes 3 disorders that are often but  always associated with  infancy and early childhood that are –

• PICA
• RUMINATION DISORDER
• AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER.

PICA
DEFINITION Pica is a perverted eating disorder characterized by persistent eating of non-nutritive substances for a period of  at least 1 month at an age above 18-24 months.

ETIOLOGY–

• Nutritional deficiencies specially iron.
• Stress ; Maternal deprivation parental separation , parental neglect ,child abuse.
• Low socioeconomic status.
• Cultural and familial factors.

CLINICAL FEATURES–

• Child with habit of eating substance like clay , dirt ,stones,pebbies,hairs,feces,lead,plastic,pencil,erasers,fingemails,paper,paint chips,coal,chalk,wood,plaster, light bulbs, Needles,string,cigratte,wire and Burt matches etc.
• Constipation
• Acute ,chronic, diffuse and focused abdominal pain.
• Nausea /vomiting
• Loss of appetite

NOTE- Pica often occurs with  impaired functioning with other mental health disorders.

RUMINATION DISORDER

•  Rumination is an painless and effortless regurgitation of partially digested food into
• The mouth soon after a meal , which is either swallowed or split out.
• It typically occurs b/w 3 months and 12 months of age .
• The disorder is less common in older children, adolescents and adults

ETIOLOGY-

• Gastroesophageal reflux may accompany rumination.
• Behaviorists attribute
• In a study of 2,163 children in srilanka b/w the ages of 10 years and 16 years ,it was found that
• Rumination behavior were present in 5.1% of boys and 5.0% of girls.

IN INFANTS-
produces a sense of relief or self – soothing.

IN YOUTH-
Autism spectrum disorder or intellectual disability, rumination may serve as a self
Stimulatory behavior.

CLINICAL FEATURES
The DSM-5 notes that the disorder is repeated regurgitation and Rechewing of food for a period of at least 1 month after a period of normal functioning partially digested Food.

• The infant is irritable and hungry b/w episodes of rumination.
• Secondary complication can develop Eg.- progressive malnutrition ,dehydration and lowered resistance

To disease.

• Bad breath and tooth decay.
• Raw and chapped lips.

AVOIDANT /RESTRICTIVE FOOD INTAKE DISORDER

DEFINITION-

It is also known as feeding disorder of infancy or early childhood.

Eg. Apparent lack of interest in eating food ;avoidance based on the sensory

Characteristics of food; concern about aversive consequences of eating.

CLINICAL FEATURES-

• As children do not take proper nutritional and Energy , it is associated with one or more following-
• Weight loss ( or faltering growth in children and failure to achieve expected weight gain)
• Significant nutritional deficiency  .
• Dependence on enteral (tube feeding) or oral nutritional supplements.
• The disturbance is not better explained by lack of available food or by an associated culturally practice.
• The disturbance in eating does not occur exclusive during the course of anorexia nervosa or bulimia
• Nervosa and there is no evidence of disturbance in the way in which one’s body weight or shape is
• Experienced.
• The disturbance in eating is not due to the current medical condition or not better explained by another
• Mental disorder , when it’s occur in the context of another condition or disorder, it needs additional Clinical attention.

SYMPTOMS-

• Physical signs of AFRID are like those of anorexia, they include;
• Severe weight loss
• Lack of appetite
• Abnormal menstrual periods
• Stomach cramps and pain
• Constipation
• Trouble concentrating
• Low iron or thyroid levels.
• Slow heart rate.
• Dizziness or fainting.
• Feeling cold all the time.
• Dry hair, skin and nails .
• Find body hair growth.
• Thinning of hair on the head.
• Weakened immune system.
• Poor wound healing.
• Cold hands and feets

RUBRICS

Kent’s Repertory

• STOMACH ERUCTATIONS food (regurgitation) 3ant-t., 2 arg-n., 2 arum-t., 2 Bell., 2 Bry., 2 calc., 2 calc-s.,2 carb-v., 3 chin., 2 dig., 3 ferr., 3 ferr-p., 2 hep.,2 kali-bi., 3 ph- ac., 3 phos., 3 puls., 2 sulph.,
• STOMACH DESIRES,raw food;rice ,dry : 2 alum., 1 ter.
• STOMACH DESIRES; raw food: sand : 2 sil., 3 tarent.,
• STOMACH NAUSEA eating, after: 2 agar., 2 alum.,3 am-c., 3 cocc., 3 nux-v ., 3puls., 3 sep., 2 sulph., 2 tarent., 2 zinc.
• STOMACH DESIRES; lime,slate, pencils, earth,chalk,clay: 2 alum., 3 nit-ac., 2 tarent.
• STOMACH DESIRES, Raw food: 1 alum., 1calc., 1 ign., 3 sulph

BBCR Repertory

• NAUSEA AND VOMITING Eructations,after: 3 cham., 3 kali-c., 2 nux-v., 3 op., 1 rhus-t., 1 sep.,
• APPETITE Desire for coal: 1,alu., 2 cic.
• APPETITE Desire for Raw food: 1 Ab-c., 1alu., 1calc-c., 1ign., 4sil. 1 tarent.
• APPETITE Desire for salty things : 1arg-n., 2 Calc-c.,2 carb-v .,3 meph., 4 nat- m., 2 nit- ac., 3 ver- a
• APPETITE Desire for indigestible things: 1ab-c., 1 alu., Calc-c., 1calc-p., 1 nux-v.

Pathak Repertory

• FOOD MILK agg: 3 Aeth., 3 calc., 2chin., 2nit-ac., 1nux-v.
• CRAVINGS lime, chalk,clay,earth: 1alum., 2calc., 2 nit-ac., 2 nux-v., 3 sulph., 2tarn.
• CRAVINGS indigestible things: 1alum., 1calc., 1 calc-p;1cyc.
• CRAVINGS charcoal: 1alu.,1calc; 1cic; 1psor.
• CRAVINGS coarse, raw food: 1 Ab-c; 1 alu;1 ant- c; 1 calc., Calc-p; 1ign; 1 sul; 1 Tarn.

HOMOEOPATHIC THERAPEUTICS

PICA

• ANIMONIUM CRUDUM – It is an excellent remedy for pica,there is craving for raw food and vegetables.
• ALUMINA– It is another top remedy for pica , there is craving for starch, charcoal , cloves ,coffee or tea grounds, raw rice and acids.
• CALCAREA CARB– Calcarea carb patients are fat,fair,slowand sluggish ,they have craving for chalk, charcoal, coal and pencils.
• CALCAREA PHOS– Calcarea phos person are chilly, thin, emaciated, unable to stand, rickety, they are easily perspired, they have desires lime,salt,chalk,penciles,earth clay etc.
• CICUTA VIROSA –in cicuta virosa abnormal for chalk, charcoal ,coal, cabbage .
• NATRUM MURIATICUM– Nat mur patients have craving for salt , they have oily greasy face ,poorly nourished and hot patient.
• NITRIC ACID – Patient have craving for lime , slate,pepper,chalk,craves,fats and spicy food.
• NUX VOMICA- Patient have craving for charcoal,pepper,chalk,craves fats and spicy food.
• SLICICEA– Patients are extremely chilly ,all symptoms are worse by cold except stomach complaints which are better by cold

RUMINATION DISORDER

• ASAFAOETIDA- It is the most common prescribed remedy regurgitation after cesarean birth or inversion of the peristaltic movement of the oesophagus while baby is sleeping the mum hears noise from the abdomen of baby (glou – glou)then the child wakes-up with a laryngitis ,an otitis or an asthma crisis.
• CARBONEUM SULFURATUM– It is the remedy for the kids living in a polluted environment exhaust gas ,especially fuel, for example in the city center or near major crossroads.
• PHOSPHORUS – Hemorrhagic regurgitations on a slim and sympathetic baby ,thirst for cold drinks ,with a tendency to diarrhea.
• AETHUSA CYNAPIUM– Specially for infants who suckle non-stop and constantly vomiting ,the mother has difficulties to understand his/her need, intolerance to cow’s milk protein.

AVOIDANT/RESTRICTIIVE FOOD INTAKE DISORDER

• ANTIMONIUMt is very helpful for infants who vomit milk immediately after breast- feed . The child may be obstinate and cross , not easily satisfied .
• ARSENICUM ALBUM– It is for such people can not bear the sight and smell of food. Nausea  ,retching and vomiting after eating and drinking.
• CARSINOSIN – Is suited for people who have fear of becoming fat and have grief or fears related to body weight.
• IGNATIA AMARA– It is suited for people who give up eating form grief , fight or emotional shocks ,disappointments. They are hysterical persons, loss of control of emotions and they faint very easily.
• LYCOPODIUM- Child may be very hungry , but eating very little food satiates him easily.
• NATRUM MURATICUM– It is suited for those who loose appetite and hunger from ear being rejected or hurt emotionally . They have special craving for salt. They feel better in empty stomach . They have terrible headaches.
• NUX VOMICA – It is another appetite stimulant.
• PHOSPHORIC ACID– It is good for eating disorders resulting from chronic diseases. They are indifferent to all emotions and food with loss of hunger
• SEPIA- It is effective for eating disorder due to hormonal imbalance in teens especially in Girls . They have acid dyspepsia with bloated abdomen and sour belching, and a faint sinking feeling at epigastrium.

References –

1. Ghai essential pediatrics , Vinod k Paul ,Arvind bagga, ninth edition ,ISBN 9789387964105.
2. PG textbook of pediatrics, volume 1,general pediatrics and neonatology,piyush gupta, p s n Menon ,siddharthramji,rakesh lodha,2nd edition,ISBN 9789352702312
3. Boericks new manual of homoeopathic materia medica with repertory isbn 9788131901847
4. Allenskey notes Rearranged and classified with leading remedies of Materia Medica and Bowel Nosodes-H.C Allen M.wikipedia Eating disorders
5. Kent’s Repertory of the homoeopathic materia Medica expanded Kent j t ISBN 81-7021-400-9
6. Boenninghausen’s characteristics materia Medica and Repertory C.M. BOGER ISBN 81-7021-207-3
7. A Concise Repertory of homoeopathic medicines Dr s. R. Phatak ISBN 978-81-319-0200-4

Dr Asha Shankwar
MD scholar
Department of paediatrics, Government homoeopathic medical College and hospital Bhopal Madhya Pradesh
Under the guidance of  Dr Ajay Singh Parihar (MD)
Professor & HOD Department of paediatrics
Government homoeopathic medical College and hospital Bhopal Madhya Pradesh