EATING AND FEEDING DISORDERS IN THE FIRST FIVE YEARS OF LIFE: REVISING THE DC:0-3R DIAGNOSTIC CLASSIFICATION OF MENTAL HEALTH AND DEVELOPMENTAL DISORDERS OF INFANCY AND EARLY CHILDHOOD AND RATIONALE FOR THE NEW DC:0-5 PROPOSED CRITERIA.

Problems of eating and feeding are one of the most common reasons of referral to pediatric and infant mental health clinics. This article is drawn from work done by the ZERO TO THREE Task Force developing the DC:0-5 Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, specifically dealing with eating disorders in the first 5 years of life. The proposed changes come from both reviewing major studies and reviews published in the last 10 years and reports from clinicians collected through surveys commissioned by the Task Force. The main changes that are proposed include changes in terminology, such as Eating Disorders instead of Feeding Behavior Disorders, as well as focusing on the child's observed eating symptoms rather than on classifying the eating problems by inferred etiologies. Another major change relates to the differentiation between eating disorders that are observed beyond any specific caregiver-child relationship context and those that are confined to one specific relationship. A new category, Overeating Disorder, has been added, as it has been increasingly recognized as a significant and not rare clinical condition. Two illustrative cases are described. The proposed changes in the classification of eating disorders in the first 5 years of life are intended to encourage both clinicians and researchers to study these important disorders in young children.