Feeding schedule and food preferences can also be reviewed. Children with special growth concerns should be referred to a dietitian to evaluate whether or not the child's specific nutritional needs are being met. Obtaining information about the gastrointestinal tract functioning is invaluable. Constipation can cause reduced appetite, which becomes a vicious cycle when trying to improve nutritional intake and weight gain. Medical follow-up is essential to evaluate these complex problems.
Medications can also affect appetite and the absorption of nutrients.
Timing of medications, nutrient supplementation, and other side effects need to be addressed. It is very helpful to observe a feeding at home to assess the foods offered, serving sizes, texture, and amount of food consumed. Observation of the environment including feeding equipment and the amount of distractions is also helpful. Feeding interactions between the child and the caregiver also provide valuable information including communication, behavior, and other developmental skills. Observing the duration of feeding is also helpful as prolonged feedings require additional energy and can negatively impact weight gain.