Download Appetite Problems in Children - Drs. Bedingfield and Rosewell

Drs. Bedingfield, Rosewell, Silver and Nourbash
Meredith Pike, CPNP, Gail Bedingfield, CPNP, Kim Pieczynski, CPNP
2500 W. Higgins Rd, Suite 440
Hoffman Estates, IL 60169
Telephone: 847-839-0400
Fax: 847-839-0800
APPETITE PROBLEMS IN CHILDREN
(OR IS IT EVEN A PROBLEM?)
Few matters are as concerning to parents as how much (or actually how little) their children
sometimes eat. At times of decreased appetite, it is natural to worry that there must be something
wrong. And too often the dinner table turns into a battleground. If your child is not adequately
gaining weight, we may approach the problem more aggressively.
It is very important, though, to realize how closely children’s appetites are affected by their rate
of growth. We, as parents, get spoiled in that the first year when our children show a wonderfully
enthusiastic appetite. But that appetite stems from tremendous growth during that year. A child’s
growth slows down at a year, however, and slows down all the more at eighteen months. Eating
itself no longer needs to fuel much growth, but simply to fill their “tiny tummies.”
Unfortunately, this natural decrease in appetite occurs as children are entering a stage of negative,
defiant and attention seeking behavior. Getting a child to eat too often becomes a battle of wills.
Then the usually pleasant activity of eating becomes quite unpleasant for all concerned.
Perhaps simply knowing that this is a common problem at your child’s age can be reassuring. But
the following suggestions may be of some help.
 Limit your child’s eating to the basic food groups.
When your child has a limited appetite, “invest” that appetite wisely. Ensure that he gets each
of the basic food groups in the course of the day. Those five groups are as follows:
1. Meats
2. Dairy products
3. Bread and cereal
4. Fruits
5. Vegetables  a multi-vitamin may take the place of vegetables if your child is especially
resistant.
Too often parents are inclined to say, “I know I shouldn’t feed her junk food, but I have to get
something into her.” Starches, sweets and “empty calories” are not nutritious and fill her up
when her appetite is down and nutritious foods will be rejected.
 Explore new foods.
Allow your child to explore new foods by looking, smelling, licking, and chewing the food,
and sometimes even spitting it out. One day he (or she) will finally decide the food is OK and
swallow it! These actions are signs the he is interested in new foods. Praise your child for
trying a new food.
 Expect your child to eat small meals.
Your child’s stomach is small, so it often doesn’t take much to fill it up. Don’t expect much
eating at any one meal. Consider six small “meals” per day  breakfast, lunch and dinner,
with stretched, healthy snacks late morning, mid afternoon and bedtime. Then don’t allow
any other snacks or any liquids beyond water.
 Put only small amounts on your child’s plate.
Anyone who is not very hungry can be “turned off” by too much food on his or her plate.
Children are no exception. Better to put a very small amount of varied foods on your child’s
plate, offering more and giving a little praise when it is all eaten.
 Let your child decide his biggest meal.
If your child seems hungriest at noon, capitalize on the opportunity to provide good nutrition
then. Don’t expect his dinner to be bigger just because it is the “main meal” in your home.
 Limit the time set aside for eating.
Too often children “stretch out” a meal, wanting lunch to last most of the afternoon and
dinner to last all evening. Better to let them know that mealtime is for eating (and pleasant
conversation). Limit the time for eating (to perhaps 30 minutes). Remove uneaten food
without comment if your child looses interest. Then let appetites build up again for the next
meal.
 Teach your child that eating is a pleasure.
Mealtime should be a pleasure, not a battle. Avoid regarding food refusal with undue
attention. The natural consequence of not eating is hunger  the only “punishment” that need
occur. Enjoy your own meal, and please don’t be offended that the fruits of your labor aren’t
always appreciated.
 Encourage family meals.
They should be a high point of the day.
 Quench your child’s thirst with water.
Too often children might spoil their appetite with too much milk, juice or “pop”. When you
child has an appetite problem, limit their milk and juice while prohibiting carbonated
beverages. Serve milk at meals and limit juice intake to 4-6oz a day. Sodas, juice drinks, teas,
and other sweetened fluids are best avoided.
 Exercise you parental role of gatekeeper.
At least in the early years, foods won’t enter your house unless you buy them. If there are
“junk foods” you’re afraid might spoil your child’s appetite, don’t buy them. (Mothers and
fathers may have to approach this one together.)
 You choose the foods; let your child choose the amounts.
You, the parent, are responsible for what is offered and when. Your child is responsible for
how much (and whether) he eats. Present that food in a positive fashion and try to include at
least something you know your child will enjoy.
Dr. T. Berry Brazelton in his excellent book, To Listen To a Child, suggests the following
minimum daily diet for children in the second and third years:
1.
2.
3.
4.
A pint (16-oz) of milk or its equivalent in cheese, yogurt, or ice cream.
A total of 4 ounces of meat or an egg.
An ounce of fresh fruit.
A multiple vitamin preparation.
Naturally, any parent would like to see his child eat more than this, but at least it highlights
just how little your child may need.
 Remember that a sick child may have an extraordinarily limited appetite.
All of the above pertains to the normal feeding problems that can occur in perfectly healthy
children. Remember, though, when your child is sick, his appetite may be miniscule. This is
obvious with stomachaches or sore throats, but even colds and flu can cause a great decrease
in appetite. At times like these, simply providing fluids is all that is necessary. As always,
feel free to consult with us regarding the illness itself.