6 medical reasons your child might be a 'fussy eater'

 
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As a parent, there’s nothing more frustrating than a child who refuses to eat dinner after you’ve slaved away in the kitchen. But did you know there are a number of underlying medical conditions that may be causing or contributing to your child’s apparent fussy eating?

  1. Teething

Like most things, the distress caused by teething varies between babies. A study of Australian parents revealed that teething was just as distressing for parents as it was for their children. Signs of teething include: red or swollen gums where the tooth is erupting, red cheeks, drooling, biting/ sucking, ear pulling, increased irritability (crying and crankiness), and loss of appetite. Of course some children may experience almost all of these symptoms, while others experience very little, if any, at all.

Try giving your child frozen teething rings/ wash cloths to chew on, as this may sooth their swollen gums. If your child has no other teeth, try offering them a ‘hard munchable’ such as a whole, raw carrot. Once your child’s teeth have emerged (or they can take a bite our of the carrot) this is no longer appropriate and may become a choking hazard. Other foods that your child may enjoy gnawing on include cobs of corn or home made ice-blocks made from breast milk, yoghurt or pureed fruit/ veg (pictured below).

If your child’s symptoms are severe or persistent, please seek medical advise to rule out any other medical conditions, particularly if your child has a high temperature (above 38C).

2. Constipation

Constipation refers to reduced bowel movements or difficulty passing a stool., and there are a number of factors that can cause a young child to become constipated. A study of 2426 children found that once constipation was treated, their was a significant increase in the child’s appetite and growth!

Constipation can be bought on by the introduction of solid foods, as your babies digestive system adapts to breaking down food other than breast milk or formula. Try offering them foods that naturally soften the stool, such as pureed/ mashed pear, apple, kiwifruit, grapes or berries.

In preschoolers and older children, constipation can be bought on by dehydration or not eating enough fiber. The Australian and New Zealand guidelines recommend 14g of fibre p/day for children aged 1-3 years, 18g p/day for 4-8 year olds, 20-24g p/day for 9-13 year olds and 22-28g p/day for adolescents aged 14-18 years. This can be achieved by eating a variety of fresh fruit/ vegetables, lentils and wholegrain bread or crackers throughout the day:. The following list outlines the typical amount of fibre in some everyday foods:

  • 1 whole apple with skin = 3g

  • 1 whole pear with skin = 4g

  • 1 slice wholegrain bread = 2g

  • 4 small wholegrain crackers = 4g

  • 1/2 cup vegetables = 3g

  • 1/2 cup salad = 2g

  • 1/2 cup cooked black beans, black-eyed peas, kidney beans, navy beans = 7g

  • 1/2 cup cooked chickpeas, lentils, split peas = 5g

If your child appears to be straining or in pain when going to the toilet, or their bowel movements are small and pebbly, please take them to see your GP or child health nurse as they may be constipated.

3. Reflux

Reflux occurs when stomach acids combines with the food (or drink) we swallow and comes back up the throat. This is very common in infants as the valves in their oesophagus (throat) are immature and still developing. Around 6 months, when babies start to sit up on their own, gravity helps to keep the food down, and reflux often resolves in its own around this time. For some children, however, reflux is a persistent and painful condition. Children with severe reflux may begin to recognize feeding as a painful experience. As a result, delayed treatment may lead to feeding problems as the child gets older. If you think your child may have reflux, please see your GP or pediatrician, as there are a variety of treatments available.

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4. Food allergies or intolerances

Food allergies and food intolerances are different. Food allergies are caused by an abnormal immune response to proteins that naturally occur in food. Allergic reactions to food can vary from mild gastrointestinal discomfort and rashes to life threatening anaphylaxis and asthma. Symptoms of anaphylaxis include swelling of the mouth, tongue or throat, difficulty breathing, dizziness and unconsciousness. In young children in Australia the most common foods allergens are: cow’s milk, eggs, peanuts, tree nuts, sesame seeds, soy and wheat. Food allergies are believed to affect 8-10% of infants and children, however, many children appear to grow out of them with time. Food intolerances occur when our body is unable to process certain foods properly. They more common than food allergies, with milder symptoms such as bloating, cramping, and diarrhoea.

These uncomfortable systems experienced as a result of a food allergy or intolerance can often lead children to avoid for reject food that cave caused distress in the past. Sometimes these symptoms, such as stomach pains, are not always apparent to us as parents straight away. If you suspect your child has a food allergy or intolerance, please seek medical advice to ensure a proper diagnosis and treatment plan is made available.

Current research on the cause of food allergies is still inconclusive, however, there are some things that may help reduce you’re child’s likelihood of developing allergies:

  • Introduce solids to your baby around 6 months of age (not before 4 months and no later than 6 months)

  • expose your child to high risk foods (eg well cooked egg, peanut butter) in the first 12 months of life

  • introduce your baby to one new food at a time- this will allow you to know what has caused the reaction if one occurs

If you have a family history of food allergies, it’s always a good idea to seek medical advice from your GP, child health nurse or pediatrician before starting solids.

5. Oral-motor difficulties

As adults we rarely think about what’s actually involved in eating, however, it’s quite a complex process. Our tongue must be strong enough to move food from the front of our mouth and place it on our back molars to be chewed. Chewing is not just an up/down motion, but an up/down/ round/ rotary motion, that requires bilateral coordination (I told you it’s complex). Indicators that your child may be having oral-motor difficulties include chewing using the front teeth, spitting food back out, pocketing food in their cheeks.

6. Nutritional deficiencies

Nutritional deficiencies refers to not having enough of certain nutrients, such as vitamins and minerals, and can occur for a number of reasons including poor diet and poor digestion and absorption. Most people don’t realise that deficiencies can affect all aspects of our functioning. For example, low zinc and B3 can lead to low appetite, and low B12, potassium, magnesium, folate or fibre can cause constipation (which we know can lead to low appetite). If you suspect you’re child’s poor appetite is due to a nutritional deficiency, take them to see your GP or a dietician. You may find that once their vitamin and mineral levels are back to normal, so is their eating!

 

Hi, I’m Aspen, a university qualified teacher and nutritionist. As one of seven kids, a mum and ten years teaching experience, I understand just how challenging mealtimes can be. That’s why I’m so passionate about giving families a range of strategies to reduce fussy eating and make mealtimes an enjoyable family experience. I also work with schools doing incursions, parent information sessions and canteen menu assessment.