Close-mouth movement (GTM) in children is often a scourge for parents. This condition is characterized by a child's rejection of food, which can trigger concerns about a lack of nutritional intake. GTM is not just a problem of picky eating, but can be triggered by various factors, ranging from health problems, boredom, to psychological factors. Understanding the causes of GTM is very important so that parents can take the right steps to overcome it.
The problem of children not wanting to eat or Mouth Shut Movement (GTM) is almost experienced by every parent. Seeing this concern felt by many parents, MAKUKU together with Babyologist held an Instagram Live with the theme “Stay Calm in Facing GTM During MPASI” on Thursday, September 2, 2021 on three channels simultaneously. Inviting Pediatrician from Carolus Hospital, Dr. med. Peggy Yulia, Sp. A, to thoroughly discuss the problem of GTM in children.
Causes of GTM and How to Overcome It
Eating for adults is a fun activity. But maybe it's different for your little one, some like to devour whatever is given but some have to be persuaded in various ways to want to eat to children who are difficult to eat or GTM.
Many say GTM is a phase of eating children that is considered normal and allowed. Because later the child will ask to eat by itself. Then is it true like that and when does GTM occur in children?
Dr. Peggy explained that this Mouth Shut Movement usually occurs when the child is sick so that their appetite decreases. Teething also affects GTM in children, boredom with the same food, the mood or mood of the child during the pandemic. As well as the condition of the child's trauma to food or the eating process itself. We recommend that the process of eating children is carried out in a pleasant atmosphere.
Parents should also be suspicious if GTM that occurs in children occurs continuously and must immediately find out the root cause so that it can be resolved. This is because GTM can be a sign that the child is experiencing serious health problems. Here are some medical problems that cause children to not want to eat as follows:
- Structural abnormalities of the gastrointestinal or respiratory tract, for example in children with cleft lip or open palate.
- Narrowing of the esophagus so that the child cannot swallow large pieces of food.
- Obstructed nasal passages or koana atresia and difficulty breathing and eating, which requires coordination between eating and breathing.
- Mental neodesha or neurological or developmental abnormalities. For example, children with cerebral palsy, muscular dystrophy and autism. Where the prevalence of feeding problems is greater compared to other normal children.
- Frequent vomiting, repudiation, crying in pain, the child may have GERD. A condition where food goes down the stomach and back up the esophagus and stomach acid causes stinging in the esophagus area.
- TB characterized by lumps in the child's neck and armpits that can reduce appetite.
- Heart defects that make it difficult for the child to eat.
Feeding Rules
Dr. Peggy reminds parents not to give up, get discouraged and continue to find out how to overcome GTM. If the cause is not from the clinical problems mentioned above, most of the causes are wrong eating behavior. A study said that around 30% of GTM children are caused by the wrong eating behavior of the child. Faulty eating behavior can arise from not following good and correct feeding rules. Feeding rules should be applied to children since the first complementary food.
“Because eating problems may not just suddenly occur, but through a process from the provision of complementary foods, so what must be considered is following the rules of eating and feeding rules, especially for new mothers,” explained Dr. Peggy.
These feeding rules must be adhered to so that your child can eat. The three feeding rules are as follows:
Schedule
Parents must create a regular and structured schedule for their children to eat. With the aim of creating the right sense of hunger and satiety in children and getting used to it. dr. Peggy suggests giving the main meal to children three times a day. Also pay attention to the child's meal time, try not to force and feed for a long time, which is only about 30 minutes.
“The rule is that the main meal for children is three times a day, then between these two main meals can be given a snack or snack. When eating, only water is given and do not give milk outside of meal times,” said Dr. Peggy.
Environment
Create a pleasant environment and avoid forcing your child to eat. Forcing children to eat can traumatize them and make them avoid mealtimes. A comfortable environment and no distractions can help children focus on their eating activities.
“Parents or caregivers when feeding should not have distractions such as being given gadgets, watching TV, given toys and eating by carrying the child around. That is the least that can be done,” explained Dr. Peggy.
Dr. Peggy said that children should only be allowed to sit during meals and there should not be any activities other than eating. Mealtime is the time when parents and children can interact the most and devote their attention to each other.
Procedure
Parents should get the child used to sitting at the table. If the child is able to eat by himself, let him eat by himself or help him if he cannot. If the child refuses to eat, you can stop for a while and then offer it again.
“If it has been 10-15 minutes and the child still refuses, we should stop,” she added.
Parents must pay attention to the quality and quantity aspects of the food. Give food that is appropriate for their age and development as well as the texture of the food. Giving food that does not match the texture can inhibit oral motor development in children.
“We have to increase the texture of the food according to age, starting from fine porridge, coarse porridge, mushy food until finally one year old should be able to eat family food,” she explained.
Dr. Peggy added that the ratio between solid and liquid food in children should not be ignored. The diet for children aged 1-3 years is 70% solid food and 30% liquid food such as milk. As for children who are picky eaters, where children eat little or eat with a certain texture, parents can try food training. Food training is the systematic introduction of new foods to children.
“If children don't want to, don't give up, because children need 10-15 times exposure to new foods until the child is willing to accept,” added Dr. Peggy. (Aq/MKK)
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