Podcast: WHAT DOES YOUR DOCTOR SAY?

Episode: What to do when a child doesn't want to eat?

Leading: Dariusz Litera

Guest: Dr. Kamil Bar, MD, PhD, pediatrics specialist

Duration: 15 minutes

A child's lack of appetite is one of the most common causes of concern for parents. In an age of easy access to information online, hundreds of tips can be found on how to address a picky eater, but understanding the underlying causes is much less common.

In a conversation with a doctor, we discuss the physiology of child development, the natural stages of food selectivity, and situations that require in-depth diagnostics. We place particular emphasis on distinguishing between normal development and potential health problems.

The material is educational in nature and helps to organize knowledge about appetite in children, from early years to adolescence.

Full podcast transcript

[00:00:00] Introduction

Dariusz Litera:

If we type the phrase "fussy eater" into a popular search engine, the algorithm instantly suggests thousands of ways to help our little one avoid picky eating and eagerly sit down to every meal. Some methods are touted as scientific, grandma-esque, modern, and from a completely different era. However, few attempt to explain why a young person has no appetite or consistently avoids certain foods.

Our guest is Kamil Bar, MD. Hello, doctor.

Dr. Kamil Bar:

Good morning, hello everyone.

[00:00:30] Is it normal for a child to have a lack of appetite?

Dariusz Litera:

And then there's the lack of appetite. I know stories of parents who—be warned—squeeze their child's nose to get them to swallow what they're feeding them. Fortunately, this is a method from the old days. Is my child's lack of appetite normal? A developmental stage, or a symptom of a serious health problem?

Dr. Kamil Bar:

This is one of the most common questions asked during checkups. The issue isn't clear-cut. We must first answer the question: what does it mean when a child has no appetite?

The first thing we discuss with a parent is what the child's diet looks like.

[00:01:18] Parental expectations and the actual development of the child

Dariusz Litera:

So parents' expectations may be too high?

Dr. Kamil Bar:

Yes. We need to ask whether the lack of appetite is due to the child "not eating" or rather to the child not gaining weight as the parent expects.

This is especially noticeable among parents of their first child. Development is very dynamic in the first year of life, but afterward, the rate of weight gain slows.

Standard:

– between the age of 1 and 2, the child gains about 3 kg,

– between 2 and 3 years of age – approx. 2 kg.

These are values that are often not visible to the naked eye.

Fortunately, we have anthropometric measurements – height, weight, circumference – that allow us to assess a child's development over time.

[00:02:45] Food neophobia – a natural stage of development

Dr. Kamil Bar:

Food neophobia often develops in children between the ages of 2 and 6. This is a transitional stage in which a child refuses to try new foods or accepts familiar foods in a different form.

For example: cooked carrots are acceptable, but raw ones are not.

[00:03:46] Food selectivity – when is there no reason to worry?

Dariusz Litera:

So the child starts choosing?

Dr. Kamil Bar:

Yes, but there's usually no cause for concern. This stage passes by preschool or early school age.

However, we need to identify situations in which the diet is very limited – to a few foods. In such cases, a broader diagnostic approach should be considered, including:

– developmental disorders,

– food allergies or intolerances.

[00:04:41] Is the baby getting enough nutrients?

Dariusz Litera:

Parents often ask: does their child get enough nutrients to grow?

Dr. Kamil Bar:

There's no single study that will give us a complete answer. There's no "magic package" of studies.

The most important thing is to analyze your child's diet. Even with a limited number of foods, you may find that your child is getting most of the nutrients they need.

If the diet includes:

– vegetables and fruits,

– source of protein,

– elements that allow you to create a complete meal,

most often we can calmly wait out this stage.

[00:06:00] Poor eater in teenagers – a warning sign

Dr. Kamil Bar:

Let's not forget about teenagers. In their case, a sudden restriction in food intake may indicate an eating disorder.

The social and image pressures are enormous. This applies to both girls and boys.

[00:07:24] Elimination diets – when can they be a problem?

Dr. Kamil Bar:

Various elimination diets are in vogue. Each diet should be balanced.

Rejecting products without knowledge can lead to shortages.

Dariusz Litera:

What if a teenager says he is vegan?

Dr. Kamil Bar:

This can be safe if the diet is well-planned. Otherwise, there is a risk of deficiencies, for example:

– iron,

– B vitamins.

It is worth consulting such decisions with a dietitian.

[00:09:06] Food allergy and intolerance – the differences

Dariusz Litera:

What is the difference between food intolerance and food allergy?

Dr. Kamil Bar:

A food allergy is a reaction of the immune system to a food ingredient.

Food intolerance is not related to the immune system – it results from, for example, a lack of an enzyme.

The most common in Poland is lactose intolerance – related to lactase deficiency. 

Symptoms include:

– abdominal pain,

- diarrhea,

– overflowing in the intestines.

[00:10:57] Body reactions – when should you be careful?

Dr. Kamil Bar:

In intolerance, there is a dose of tolerance – small amounts may not cause symptoms.

In allergies, even a trace amount can cause a severe reaction, including anaphylaxis.

[00:12:16] How to encourage a child to eat?

Dr. Kamil Bar:

The most important rules:

– don't get discouraged,

– offer the same product multiple times,

– serve products in various forms,

– do not punish the child for refusing to eat,

– eat together at the table.

Eating meals together increases the chance that your child will try new foods.

[00:13:59] Ending

Dariusz Litera:

So it's worth encouraging your child to eat together and try new things.

Today's guest on the CO NA TO WYJ DOKARZ podcast was Kamil Bar, MD. Thank you very much.

Dr. Kamil Bar:

Thank you too.

Key takeaways for patients:

• A decrease in a child's appetite is often a natural stage of development.
• The rate of weight gain after the first year of life decreases significantly.
• Food neophobia is a common, temporary phenomenon in children.
• The key is to evaluate the entire diet, not individual meals.
• There is no single test that assesses all nutritional deficiencies.
• An extremely restricted diet requires medical consultation.
• In teenagers, a lack of appetite may be a symptom of an eating disorder.
• Elimination diets require proper planning and often specialist consultation.
• Food allergy and intolerance have different mechanisms and different health consequences.
• The most effective method is to patiently and repeatedly offer different products and eat together.

Information about participants:

Guest: Kamil Bar, MD, PhD, physician, doctor of medical sciences, specialist in pediatrics, currently specializing in allergology, dealing with the diagnosis and treatment of allergic diseases in children and adults.

Presenter: Dariusz Litera, medical editor, health communications specialist, and creator of the podcast CO NA TO TWÓJ ELEKARZ. He has been involved in patient education for years, conducting interviews with specialists in various fields of medicine.

ATTENTION!

This material is for educational purposes only. It does not replace a medical consultation. If you experience any disturbing symptoms, consult a doctor.