Therapeutic play within infant-parent psychotherapy and the treatment of infant feeding disorders

This clinical article presents an infant mental health approach to the treatment of feeding disorders in infants and toddlers that involves the infantparent psychotherapist directly working with the infant's representations within infantparent psychotherapy sessions. The treatment is informed by an assessment of the infant's emotional development, subjective experience, and the dynamics of the infantparent relationship. This model involves therapeutically using play and words with infants and draws upon concepts from D.W. Winnicott and attachment theory as well as principles from the psychodynamic treatment of posttraumatic stress disorder in infants. The model was developed from clinical work over 2 decades in a tertiary pediatric hospital with infants who presented with feeding disorders ranging from breast or bottle refusal, refusal to wean onto solids, feeding aversion, tube dependency, and failure to thrive.