Dear Doctor,

For weeks now, my toddler’s appetite has been strange. I’ve tried to make her all sorts of things but she refuses to eat and just wants milk. I’ve been advised to give her toractin syrup but I do not know much about it. Is it safe for babies? Are there natural remedies for her condition?

Kate

Dear Kate,

As the growth rate slows down slightly and toddlers start developing taste for foods, many of them start eating poorly. A toddler may not recognise tell tale signs of "feeling hungry”. She may simply become cranky and irritable on feeling hungry, but may not eat readily as she may not understand the need for it.  Food may be avoided due to having strong dislike for some foods. At times a toddler may be so busy playing or watching cartoons that they may not like to be interrupted to go and eat. Refusing to eat may be part of a temper tantrum to demand something or protest against something. A small child may take enough quantity of chocolates or some favourite snacks, due to which, they may not have an appetite at meal times. If the plate is piled with food, the sight may be stressful for a toddler and she may refuse food or eat properly. Children tend to copy their elders. Therefore, if parents are finicky and poor eaters, small children may follow the same. Anything stressful in the home environment, like disputes among parents, loss of a pet, and etcetera, can kill the appetite of a child.

Acute tonsillitis, blocked nose, gastro intestinal reflux, dental problems, any heart or lung problems, any birth defect like cleft palate, cleft lip, among others, can cause feeding problems in toddlers.

If the child is not sick, not irritable or crying, is playing and sleeping well, there is no need to worry. But she does need food for better nutrition which is important for growth and good health. Make feeding times playful and interesting for her. To ensure that the child takes nutritious things, try making different and new dishes, which should keep her interested in” trying out” things. Give her small servings to make her comply better. Meal times should be happy and comfortable for the child with no disputes or arguments in that time. Also, ensure that there is no distraction like TV while the child is eating.

If needed, investigations can be done to exclude any physical problem. Treatment of the medical problem will cure the anorexia as well.  Medicines like toractin syrup are better avoided. They act on the appetite centre of the brain. They cause drowsiness, dizziness, blurred vision, dry mouth, and etcetera as side effects which a child cannot explain but will suffer from.

Herbs like ginger, cinnamon and asafoetida can improve the appetite naturally and augment digestion as well. They can be used while cooking.                       

Dr.Rachna  Pande is a specialist in internal medicine.