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Part 4: Keeping Your Child Healthy  >  The A-Z of Childhood Illnesses  >  Anorexia (Poor Appetite)


Mothers in rural India will rarely consult a doctor because their children are not eating enough, but almost 50% of urban mothers will bring their children to a paediatrician because they worry they are not eating enough.

If your preschooler is not eating enough, but is otherwise active and full of life, there is probably nothing wrong with him. I would certainly be worried if a newborn baby suddenly stops suckling. If he has thrush (curd-like white patches which do not come off easily) inside his mouth, a simple treatment will set matters right. Otherwise, a severe infection may be cooking which needs urgent attention.

CAUSES: In case you are worried that your child weighs less than those around him, keep in mind that the child who was small at birth (though he was born at the expected time) is likely to remain small. Also, his size will mimic yours or your husband’s. If you are concerned that your child’s weight gain and appetite seems to be less in the second 6 months than in the first 6 months, remember that an average breastfed infant may gain about 20 to 30 gms of weight per day in the first 3 months, about 15 gms between 3 and 6 months and even less in the next 6 months.

The bulk of the cases of anorexia belong to the age group of 1 to 3 years, and usually parents of first children will bring them in to be examined. In these cases, the mother has usually tried all possible methods to make the child eat, and he has rebelled. Your anxiety probably transfers itself to your child. 

An older child or an adolescent who is losing weight (weighed on the same scale at intervals) or one who gets tired easily and appears unwell and listless may also need a thorough check-up and investigations. He may, for instance, be anaemic or may have diseases like jaundice (due to infection of his liver), tuberculosis or a urinary infection. 

TREATMENT: Work with a baby’s natural appetite. Just as a baby suckles as much milk as he needs at the breast, a child will usually eat when he is hungry. No intervention is required as long as he is otherwise healthy.

Remember that a toddler likes to play with his food. Nearer his first birthday, he will show interest in feeding himself. If permitted, he will enjoy doing so though he makes a mess and manages to put hardly anything in his mouth. A clever mother allows him to learn to manage by himself. In between, she assists him but makes him feel that he is doing it himself. She does not mind the mess. She knows that the child could be persuaded to eat more without his messing around, but she avoids the temptation to take over and allows him to manage with his own fingers or with the help of a spoon. The moment he shows reluctance to eat any more, she avoids any attempt to make him finish the remaining food. Such a child is likely to create fewer problems while eating compared to the child of a mother who forces him to eat. Clever handling is the key.

Offering a child too much of milk or milk products is not desirable. At times, the milk may have to be stopped for a couple of months until the child develops healthy food habits. 

Children who don’t eat much at mealtimes should be offered food or feeds more often, say every 2 to 3 hours. If a child does not eat enough of one item, but you feel he is still hungry, offer him something else — say a fruit or your feed. Try to get the child involved in the preparation of the meal. 

Although some doctors prescribe drugs like cyproheptadine to stimulate the appetite, I do not recommend these.

Anorexia Nervosa
In adolescence, girls often fall prey to an eating disorder called anorexia nervosa. The patient gets a compulsive desire to lose weight and becomes emaciated due to vigorous dieting. Dr. Vibha Krishnamoorthy, an expert on developmental disorders, reveals, “Anorexia nervosa, though extensively described in the Western world, is now seen in Indian society, especially in the urban middle and upper classes. The disorder is usually seen in adolescent girls, though it can be seen in boys as well. The child begins to diet, or restrict her overall intake excessively, particularly of fats, resulting in excessive weight loss. It is accompanied by a distortion in the perception of body image — they always see themselves as fat or overweight even if they have lost a lot of weight or are emaciated. The dieting may also be associated with excessive exercise, or the use of laxatives and forced vomiting to lose weight. Although the exact cause of anorexia nervosa is unclear, it appears to occur around the time of adolescence when a girl’s self esteem may be low. Added to this is the role of the media and societal pressure and the portrayal of very thin women as acceptable or beautiful.” Such a condition is related to a severe emotional disturbance and must be taken care of with the help of a psychiatrist or a family counsellor. Adds Dr. Krishnamoorthy, “Our goal for our children should include encouraging a healthy diet, and at the same time, de-emphasising the importance of looks, and building the child’s overall self esteem.”

Indeed, if your child or adolescent looks unwell in addition to going off food, your doctor might like to have a close look at her to find and treat the other possible causes of anorexia.

7 March, 2016

Part 4
The A-Z of Childhood Illnesses

Abdominal Pain
Abrasions or Scratches
Acute Glomerulonephritis
Acute Nephritis
Acute Watery Diarrhoea
Anorexia (Poor Appetite)
Bed-Wetting (Enuresis)
Birth Deformities
Bites and Stings
Bone, Joint and Muscle Injuries
Bowlegs and Knock-Knees
Calcium Deficiency
Cardiac Pulmonary Resuscitation
Cerebral Palsy (CP)
Cleft Lip and Palate
Common Cold
Congenital Heart Disease
Convulsions or Fits or Seizures
Dengue Fever
Diabetes Mellitus
Diarrhoea, Dysentery ...
Down's Syndrome
Earache, Ear Infections ...
Electric Shock
Eye Problems
Foot Problems
German Measles (Rubella)
Glands in the Neck ...
Head Injury
Influenza (Flu)
Joint Disorders
Limp and Pain in the Legs
Malnutrition (Undernutrition)
Menstrual Problems
Mental Retardation (MR)
Mouth To Mouth Breathing
Nephrotic Syndrome
Nose-Related Problems
Premature Baby
Prolapse of the Rectum
Rheumatic Fever
Rheumatoid Arthritis
Short Child
Skin Conditions
Sleep and Sleep Problems
Sore Throat (Pharyngitis)
Stridor (Noisy Breathing)
Teething and Care of Teeth
Tetanus (Lock Jaw)
Tracheoesophageal Fistula
Tropical Eosinophilia
Tuberculosis (TB)
Umbilical Problems
Undescended Testis
Urinary Infection
Vaginal Discharge
Whooping Cough (Pertusis)

Part 4
Keeping Your Child Healthy
Choosing A Paediatrician
Proper Use of Medicines
Home Remedies
A First Aid Kit
The A-Z of Childhood Illnesses
Psychological Concerns
Managing A Hospital Stay
Prayer And Your Child's Health
The Role of Nature Cure
Ayurveda and Child Care
Congenital Heart Disease FAQ
Guide to Child Care
1 Pregnancy, Childbirth ...
2 The Growing Years
3 Feeding Infants, ...
4 Keeping Your Child Healthy
5 Keeping Your Child Happy
About Dr. R. K. Anand

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