Some eating problems are behavioral in nature. Parents of young children often are concerned that their children are not eating enough or eating too much, eating the wrong foods, refusing to eat certain foods, or engaging in inappropriate mealtime behavior (such as sneaking food to a pet or throwing or intentionally dropping food). Most eating problems do not last long enough to interfere with a child's growth and development. Growth charts (see Physical Growth of Infants and Children) can help parents determine whether their children's growth rate is of concern. Parents should consult a doctor if their children
Eating disorders (see Eating Disorders), such as anorexia nervosa and bulimia nervosa, typically do not occur until adolescence.
A decrease in appetite, caused by a slowing growth rate, is common among children around 1 year of age. However, an eating problem may develop if a parent or caregiver tries to coerce the child to eat or shows too much concern about the child's appetite or eating habits. The extra attention children with an eating problem receive when parents coax and threaten may inadvertently reward and thus reinforce the child's tendency to refuse eating. Some children may even respond to parental attempts at force-feeding by vomiting.
Decreasing the tension and negative emotions surrounding mealtimes may be helpful. Emotional scenes can be avoided by putting food in front of the child and removing it 20 to 30 minutes later without comment. The child should be allowed to choose from whatever food is offered at mealtimes and scheduled snacks in the morning and afternoon. Food and fluids other than water should be restricted at all other times. Young children should be offered 3 meals and 2 to 3 snacks each day. Mealtimes should be scheduled at a time when other family members are eating. Distractions, such as television or pets, should be avoided. Sitting at a table is encouraged. Children should participate in cleaning up any food that is thrown or intentionally dropped on the floor. Using these techniques balances the child's appetite, amount of food eaten, and nutritional needs.
Overeating is another problem caused by many factors. Overeating can lead to childhood obesity (see Obesity in Adolescents). Once fat cells form, they do not go away. Thus, obese children are more likely than children of normal weight to be obese as adults. Because childhood obesity can lead to adult obesity (see Obesity), it should be prevented or treated.
Last full review/revision February 2014 by Stephen Brian Sulkes, MD