What is considered normal and what is a violation?
After a year, the growth rate slows down, and the child objectively eats less than in the first year of life - this is normal. The age from two to five years is often accompanied by wariness towards new foods: in order to accept unfamiliar food, the child needs to see it on the table many times. The narrowing of the diet to a few dishes, the rejection of entire food groups, weight loss, growth retardation, as well as food that has become a source of constant conflict and tears are considered alarming. The guideline for parents is not the amount eaten at one time, but the dynamics of weight and height.
- Slowing appetite after a year is normal
- Refusal of new things at two to five years of age is a common age-related feature.
- Alarming: three to four course diet
- Worrying: weight loss or stunting
- Alarming: Food has become a daily conflict
Possible reasons
The reasons are divided into physical and behavioral. Bodily ones include anemia and iron deficiency, which reduce appetite, constipation, reflux, allergies to cow's milk protein, chronic diseases, dental problems and painful swallowing. Behavioral reasons are related to the experience of eating: force feeding, anxious parents, punishment for not eating, the habit of eating with cartoons, snacks and sugary drinks between meals. Some children have severe sensory sensitivity - they cannot tolerate certain textures and smells, which is also typical for children with developmental disabilities.
- Iron deficiency and anemia
- Constipation, reflux, abdominal pain
- Food allergies and intolerances
- Feeding through force and conflicts at the table
- Snacks and sweet drinks between meals
- Sensory sensitivity to textures
- Previous episode of choking or vomiting
What to look for in teenagers
In adolescents, selectivity may be accompanied by conscious dietary restriction. The sharp exclusion of carbohydrates and fats, counting calories, exhausting workouts, eating alone, going to the toilet immediately after eating, using laxatives, as well as talking about the body being “fat” at normal or reduced weight should be of concern. These are signs of possible eating disorders that require professional help because they affect the heart, bones, hormonal system and mood.
- Severe food restriction and calorie counting
- Fear of gaining weight at normal weight
- Eating alone, hiding
- Toilet immediately after eating
- Laxatives, diuretics, fat burners
- Stopping menstruation in girls
What examinations are needed
They start with a visit to the pediatrician: the doctor measures weight and height, estimates them using age tables and looks at the dynamics in the medical record. Basic tests help identify anemia and deficiencies, which themselves reduce appetite. According to complaints, an examination of the gastrointestinal tract, a dental examination, and, in case of choking and coughing while eating, an assessment of swallowing are added. The psychological part is no less important: the specialist examines how feeding is organized at home, what rules and reactions reinforce refusal.
- Examination by a pediatrician, measurement of weight and height over time
- Complete blood count and ferritin
- Vitamin D according to indications
- Examination of the gastrointestinal tract for pain and vomiting
- Dentist examination
- Swallowing assessment for choking
- Conversation with a child psychologist
What should parents do?
The division of responsibility works: the adult decides what, when and where the child eats, and the child decides how much to eat and whether to eat at all. Offer a new dish next to the familiar one, without pressure or reward, and repeat the attempts many times. Eliminate snacks and sugary drinks between meals, turn off screens at the table, and limit meals to twenty to thirty minutes. Eat together: Children copy adults' behavior. If the weight decreases, the diet remains extremely narrow, or there is a suspicion of a disorder in a teenager, the help of a pediatrician and psychologist is needed.
- Sharing responsibility for food
- A new dish next to a familiar one, multiple offers
- Without persuasion, rewards or punishments
- Avoiding snacks and sugary drinks between meals
- No screens at the table, meals 20–30 minutes
- Shared family meals
- Correction of iron and vitamin D deficiency as prescribed by a doctor