DEAR DOCTOR,

My son is almost two years old but he doesn’t want to eat.  His appetite is very low, I have to force him eat. What can I do to boost his appetite?

SONIA

DEAR SONIA, 

It is indeed a very difficult situation and many mothers globally face this problem. A 2-year-old human baby is still very young. With a growing, slow awareness of his own self and environment, he is unable to understand the sense of hunger. 

A small child, on feeling hungry may get cranky, cry for no reason, may become very quiet and cry silently, but is unable to understand or communicate that he is hungry. Therefore it is important for the mother or care taker to ensure that the child is fed well, such that he gets necessary calories and nutrients for his body.

A child at this age can eat whatever the elders are eating. Offer freshly cooked and warm food to the toddler. Set an example by serving and eating the same food that you offer to your baby.  Let meal times be fun time. For him, meals can be a game, in which he is participating along with his mother. 

Alternatively, you can have meal time as a good story-telling session. Feed him while he is being attentive to a good story being told to him. If he takes less than what is necessary, or you feel that his hunger is not satiated, give him healthy fruits, desserts after main meal.  

Instead of three main meals as for an adult, a child can be given small frequent meals. Do not force-feed him. Also, never criticise or scold him for not eating properly. That will put him "off” from food further. Create a pleasurable situation where he starts looking forward to food and starts enjoying eating in company.  Let food be interesting for him where he looks forward to what is available for meals that day. 

This can be done by introducing variety on the menu. Also ensure that the child plays regularly. Regular physical activity helps keep him cheerful and also builds appetite.

Avoid giving him fast and ready-to-eat foods, processed foods and very sugary foods. Nuts, fruits, snacks made out of grains, egg, etc. form good choices for snacks.

A small child loses appetite in case of some acute or chronic sickness. But in such a case, there would be other features of the sickness present like, throat pain, fever, cough, cold, etc. Any such sickness, if present or suspected, can be easily diagnosed by suitable relevant investigations and is treatable. 

Appetite builds up spontaneously after the child is cured. Do not give the child any medicine for promoting appetite, unless advised and prescribed by a medical doctor for some medical condition. Because these "appetisers” cause much drowsiness, also avoid giving artificial health supplements and drinks, as these given before meals, can suppress appetite.

Dr Rachna Pande is a specialist in internal medicine 

E-mail rachna212002@yahoo.co.uk