Appetite Drop & Feeding Challenges: When to Seek Professional Help Day 2: Appetite Drop & Feeding Challenges: When to Seek Professional Help

Appetite Drop & Feeding Challenges: When to Seek Professional Help

Feeding your toddler can be an adventure filled with phases of picky eating, mealtime resistance, and changing appetites. For parents, it can be concerning, but it's important to understand that some of these behaviors are part of normal development. In this article, we'll explore when to seek professional help for atypical feeding behaviors.

Picky Eating: A Normal Phase in Children

At around 1 year, toddlers often go through phases of picky eating. They might refuse certain foods during these periods, which is completely normal. These behaviors are part of their development and can be influenced by various factors, as we discussed in detail yesterday.

Typically, these mealtime challenges last for a short duration, usually around 4 weeks. Consistency with routines and creating a positive mealtime atmosphere can help these behaviors fade away.


However, if these behaviors persist or intensify, it may be time to seek professional guidance. Feeding challenges in children are common, but it's essential for parents to recognize when they should reach out for help.

Atypical Behaviors Around Food: When to Seek Help

Every child is unique, and sometimes they exhibit food-related behaviors that can surprise or even frustrate parents and caregivers. It's an experience shared by parents all around the world, so know that you’re not alone. Our goal should be to make their mealtimes more positive and less stressful, thus helping them foster a healthy relationship with food.

The concerns we discuss below are absolutely solvable and can be effectively addressed with the right professional guidance. Remember, seeking help is a proactive and positive step in your journey as a parent. By doing so, you're also teaching your child the valuable lesson that it's okay to seek assistance when needed – a sign of strength, not weakness.

Let's now look at some atypical feeding behaviors that require professional intervention:

1) Limited variety of food: If a toddler’s diet is extremely limited in terms of variety of foods, it may be a cause for concern. For instance:

  • They avoid entire food groups, such as pulses or veggies, which can compromise their nutrition and affect their growth.
  • They prefer to eat only 1-2 food groups (e.g., they like only cereals and fruits).
  • They may eat 1-2 foods from each food group but only in specific forms or preparations. This means, they avoid foods with certain textures or consistencies (e.g., they prefer soft foods like bananas or prefer dry dishes and reject wet dishes like dals or curries).
  • They may cry, push food away, or refuse to open their mouth. They may display fussiness or discomfort during meals. [Note: Occasional reluctance to eat can happen when a child is unwell, tired, or simply not hungry. But, if this behavior occurs too frequently or at every meal, professional help is required.]

Everyone has food preferences, and we can't expect children to accept every food presented to them. But, it’s vital they have a balanced variety of foods in their diet. E.g., a child shouldn't be limited to eating the same khichdi every day for dinner, especially if it's prepared in a specific way they prefer. This could be a sign of feeding difficulties, indicating an underlying cause that warrants investigation with professional help.

2) Explosive emotional reactions to food: If a child has explosive meltdowns or displays extreme emotions during mealtimes, especially when asked to eat a particular food they dislike, it's flagged as uncommon behavior. Signs of this may include coming to meals upset, crying, or displaying big emotional outbursts when served new foods. 

While it's normal for children to feel disappointed when their favorite foods aren't on the plate, consistent or frequent extreme emotional meltdowns during mealtimes are not healthy. [Note: Occasional meltdowns when a child is tired, sleepy, or unwell are understandable and normal.]

3) Extreme physical reactions to food: Some toddlers may have strong physical reactions to new or specific foods, even when those foods are present on the table during mealtimes. These physical reactions can include excessive gagging, vomiting, crying, screaming, or running away at the mere sight of that food.

In some cases, they may refuse to sit at the same table as others during meals or be uncomfortable with the food's presence on their plate. Some children may even ask to have their hands wiped if they come in contact with the food. This requires professional intervention.

4) Rigid food preferences: Some toddlers insist that their food be prepared in very specific ways. They simply cannot handle any variations in its preparations. Here are some examples:

They may enjoy chicken nuggets (chicken in the form of finger food) but refuse to eat chicken when added to curries or pulao.

  • They may enjoy thick dal. If you serve them thinner dal, they will reject it.
  • They might have a preference for a specific preparation of dal khichdi at home and reject similar dishes served at a restaurant or someone's home.
  • They may also be partial toward specific brands of food, refusing other brands (e.g., curd from a certain brand they’re used to).

If you consistently observe these behaviors every time a particular food is presented, it's advisable to seek professional guidance.

5) Growth and nutritional concerns: If a child's growth is slowing down, they are not gaining weight, their weight remains stagnant for 6 months, or they are falling off the expected growth curve, it's a significant sign that their eating challenges go beyond mere behavioral concerns. In such cases, their food selectiveness is not just picky eating.

In India, undernutrition is a major concern that is observed as early as conception. Our data indicates that around 20% of infants are born with low birth weight. By the time these children turn 2, nearly 45% of them continue to grapple with undernutrition. This is why it’s important for parents to address feeding difficulties in children by seeking professional support.

6) Dependency on screens or distractions: If a child just cannot eat a meal without a screen, TV, or tablet, it's not a good sign. Screens and other distractions can take away a child’s attention from their meal. If parents try to take away the screen, it will likely result in tantrums or meal rejection.

7) Requiring separate meals: If parents find themselves preparing a separate meal for the child every time, different from what the rest of the family is eating, it can be a sign of concern. This behavior indicates that the child is not willing to eat the same foods as the rest of the family.

8) Anxiety in social settings: Some children may have anxiety in social situations like parties, where they come across unfamiliar or new foods. E.g., if the child refuses to eat at a birthday party because the food is not what they are used to at home or if they are always averse to trying new foods.

9) Other behaviors

  • Chewing and swallowing difficulty: When the child struggles to chew or swallow their food or just gulp it down without chewing.
  • Pocketing or prolonged mealtime: When the child takes an unusually long time to eat or tends to store food in their mouth without chewing or swallowing.
  • Texture preferences: When the child only accepts one specific food texture, such as smooth or mashed; they may gag excessively when textures are altered even slightly.
  • Extended periods of little or no eating: When the child goes for several days without eating or consumes very little food over a week’s time.
  • Constipation: When the child has constipation frequently, which can in turn affect their appetite.

These behaviors are not typical and should be evaluated by a healthcare provider. 

10) Stressful mealtimes: If mealtimes between parent and child consistently feel stressful and strain their relationship, it can lead to future eating difficulties for the child. If this scenario occurs frequently, it is advisable to ask for professional help.

In cases of feeding challenges, traditional approaches may not always work for these children. Unlike most kids who eat when they're hungry, these children might choose to go hungry rather than eat due to various reasons mentioned earlier. This can seriously impact their growth and development. Limited food choices can also lead to nutritional deficiencies.

In such cases, seeking professional guidance is essential. Professionals like pediatricians, feeding therapists, or child nutritionists can provide valuable support. They can address the underlying issues, helping children develop healthy eating habits while reducing mealtime stress.

Early intervention is key. It lays the foundation for a child's lifelong relationship with food and influences their physical and mental health. So, don't hesitate to seek help when needed. Your proactive approach can help your child overcome these challenges and ensure their overall well-being!


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