Merck Manual

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Eating Problems in Young Children

By

Stephen Brian Sulkes

, MD, Golisano Children’s Hospital at Strong, University of Rochester School of Medicine and Dentistry

Reviewed/Revised May 2023
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Some eating problems are behavioral in nature. Parents of young children often are concerned that their children are picky eaters, not eating enough or eating too much, eating the wrong foods, refusing to eat certain foods (see also Avoidant/Restrictive Food Intake Disorder Avoidant/Restrictive Food Intake Disorder Avoidant/restrictive food intake disorder is an eating disorder characterized by eating very little food and/or avoiding eating certain foods. It does not include having a distorted body image... read more ), 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 Weight Physical growth refers to an increase in body size (length or height and weight) and in the size of organs. From birth to about age 1 or 2 years, children grow rapidly. After this rapid infant... read more can help parents determine whether their children’s growth rate is of concern.

Parents should consult a doctor if their children

  • Repeatedly voice concerns about their appearance or weight

  • Lose weight or stop gaining weight at an age when growth and weight gain are expected

  • Begin to gain weight at a faster rate than usual

Undereating

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.

Did You Know...

  • Excessive concern by parents about their child's eating habits may contribute to the development of an eating problem.

Overeating

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