Oral Presentation ESA-SRB-APEG-NZSE 2022

Establishing positive relationships with food in toddlers and pre-school aged children (#157)

Lesley S Youde 1
  1. Paediatric Diabetes and Endocrinology, Royal North Shore Hospital, St Leonards, New South Wales, Australia

Optimizing glycaemic control for toddlers and preschool children with type 1 diabetes (T1D) is crucial to minimise acute and long-term diabetes complications and support neuro-cognition, development and health-related quality of life 1. International guidelines promote the establishment of early, positive lifestyle behaviours such as the provision of nutritious family-centred meals as a cornerstone for achieving optimal glycaemic control in pre-school children.

A diagnosis of T1D in early childhood is known to increase the risk of developing poor feeding relationships and suboptimal nutritional intakes 2. The development of a positive feeding relationship between parent and child can be challenged by the additional demands of daily diabetes care. Parents have additional mealtime tasks to attend to such as blood glucose monitoring, carbohydrate counting and pre-prandial insulin administration 3. Parental concern, combined with perceived problematic child eating behaviours, may lead to the adoption and persistence of a variety of non-responsive feeding practices.

The aim of this presentation is examine the research in this area, review guidelines and current clinical practice and to explore options for supportive nutritional interventions.

The conclusion of the presentation will outline early interventions to establish responsive feeding relationships, encourage more healthy core foods, raise parent’s awareness of the effect of ‘treat’ food and snacking and offer advice on alternative approaches for mealtime management.

  1. Sundberg F, Barnard K, Cato A, de Beaufort C, DiMeglio LA, Dooley G, et al. ISPAD Guidelines. Managing diabetes in preschool children. Pediatr Diabetes. 2017; 18(7):499-517.
  2. Streisand R, Monaghan M. Young children with type 1 diabetes: challenges, research, and future directions. Curr Diab Rep. 2014; 14(9):520.
  3. Cunningham NR, Vesco AT, Dolan LM, Hood KK. From caregiver psychological distress to adolescent glycaemic control: the mediating role of perceived burden around diabetes management. J Pediatr Psychol. 2011; 36(2):196-205.