The goal then is to identify and find ways to reduce stress, especially around mealtimes. The primary care provider should offer a phone number and return the caregiver's calls promptly, and return visits should be scheduled as often as necessary to keep the parental apprehension minimal. Pulmonary Aspiration occurs with GER in preterm infants without an effective cough, and in children with neuromuscular disorders involving the pharynx. Parents demanding that the doctor solve the pitting problem are a sign of impaired parent-child interaction. Obviously, those calories are needed as the child triples its birth weight by the end of the first year.
Growth rate decelerates in the second year of life, as do caloric requirements.
Toddler's diarrhea is characterized by loose stools, described as running over the diaper and down the leg four to eight times daily, in an otherwise asymptomatic toddler. The morbidity of this condition is proportional to the caregiver's trepidation. If the parent is not given effective reassurance that there is not a problem, there will be a series of elimination diets and medical tests, all of which will be unrevealing. Unfortunately, the testing and diet changes interfere with normal nutrition, and affected children with concerned parents may fail to grow at the expected rate because of artificially reduced caloric intake. Erickson assisted patients in change by using modeling clay as a metaphor for feces to treat a small sample of children who had failed to respond to other therapies.