Dear Doctor,

My child has no appetite, some times I fear for the worst to be an underlying illness. He looks normal but I am restless about this low appetite?

How old is your child? How many times has your child presented this resentment towards food? It is important to find out whether it is frequent or just an on and off scenario. The child could be experiencing other problems like abdominal pain, cough, running or blocked nose. Such answers aid in finding out why there is loss of appetite.

Commonly a child can have loss of appetite due to some acute sickness. In fact, not feeding can be the first symptom of any illness like flu, cough, fever, and abdominal pain. Any bacterial, protozoa, parasitic worms or viral infection can manifest as cessation of feeding. Among serious medical conditions, chronic infections like tuberculosis, liver or kidney disorders, congenital heart conditions or tumors, can cause anorexia in children. But in all these conditions, there would be clear overwhelming symptoms of underlying condition because the child will lose weight and look weak.

However, a child may lose interest in food due to simple indigestion. Sometimes small children are unable to describe problems like bloating or sense of fullness after food, nausea, burning pain and dyspeptic symptoms.

Discomfort from constipation may make the child lose appetite.

Monotony of food is another factor which parents have to look out for. Children need favourite snacks in between meals, even when they are satisfied they can crave for such foods. Loss of appetite is a tool used by small children to seek attention. A child can lose appetite due to psychological stress. Death of a pet, a favourite toy being damaged or lost, quarrelling among adults are such stressful situations. He may simply not understand hunger sensation and cry or throw tantrums instead of saying I am hungry and need food.

If the child is healthy, not cranky, not losing weight, there is nothing to worry. Try to give him variety of food, which should be of his choice. Make meal times interesting and do not be rigid. If he prefers snacks over proper meals, try giving him freshly made nutritious snacks.

By-Dr. Rachna Pande Specialist-internal medicine Ruhengeri Hospital

E-mail- rachna212002@yahoo.co.uk