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Voedingsproblemen zoals spugen, diarree, moeizame of harde ontlasting en eetproblemen, zoals kieskeurigheid, niet willen eten van een lepel weinig of traag eten, uitspugen, liever drinken dan eten, knoeien en gevoerd willen worden komen bij veel peuters voor, ook als zij gezond zijn en zich voorspoedig ontwikkelen. Vaak zijn deze problemen van tijdelijke aard en kan de JGZ de ouder met enkele praktische adviezen geruststellen. Maar als de problemen aanhouden, dan is het goed om deze verder te onderzoeken en het kind zo nodig te verwijzen.
De JGZ brengt op basis van de spontaan genoemde symptomen, de afname van een voedings- en eetanamnese en lichamelijk onderzoek het voedingspatroon, eetgedrag en de lichamelijke toestand van het kind in kaart. Aan de hand van de bevindingen bij anamnese en lichamelijk onderzoek (incl. biometrie) beoordeelt de JGZ in samenspraak met de ouders of verwijzing op grond van de aard en de ernst van de klachten geïndiceerd is.
Biometrie Lengte en gewicht worden op de reguliere wijze bepaald en vastgelegd. Bij kinderen van 2 jaar en ouder wordt de BMI-waarde (gewicht in kg gedeeld door de lengte in meters in het kwadraat, kg/m²) geïnterpreteerd.
Anamnese Er wordt op de reguliere manier een anamnese afgenomen. Indien ouders aangeven dat er problemen zijn rondom eten inventariseert de JGZ de zorgen (aard en duur van de zorgen, leeftijd waarop problemen zijn ontstaan) en neemt een voedingsanamnese (wat, hoeveel en wanneer) af. Bij twijfel over de hoeveelheid en de samenstelling van de voeding kan een voedingsdagboekje worden gebruikt. Daarnaast wordt bij signalen van problemen rondom eten door de JGZ navraag gedaan naar:
Welbevinden van het kind (malaise, moeheid, lusteloosheid).
Lichaamsbeweging (wat, hoeveel).
Eetgedrag (kokhalzen, manier waarop ouders het eetgedrag van hun kind ervaren en hanteren).
Eetlust (verandering van eetlust na ziekte, recidiverende koortsperioden).
Lichamelijk en ontwikkelingsonderzoek Lichamelijk onderzoek en ontwikkelingsonderzoek (Van Wiechenonderzoek) worden zoals gebruikelijk uitgevoerd. Bij het lichamelijke onderzoek wordt gelet op:
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