Anorexia in Babies and Children
Loss of appetite means a decrease in the desire to eat, and it is one of the frequent complaints of parents to their pediatricians. The important thing to distinguish here is whether the child who is said to have anorexia is really anorexia.
The frequency of anorexia is between 25-40% in normal children, and this frequency increases up to 90% in those with growth retardation. It has been determined that the education level of the mothers has a positive effect on the implementation of what is said to the mother about infant feeding. Again, it was seen that mothers who were educated about breast milk were more successful in feeding their babies with breast milk in the first 6 months, and they did not have any problems while accustoming their babies to complementary foods. The most important consequence of anorexia for children is that growth is negatively affected.
Appetite is regulated by many systems in the body. The digestive system, brain, adrenal glands and pancreas play a role in the regulation of hunger and satiety. The tension in the stomach after eating creates a feeling of satiety by affecting the brain through some hormones, and the Ghrelin hormone released from the stomach stimulates some centers in the brain and provides a feeling of hunger. The child’s developmental characteristics, mother-infant interaction, and social factors affect appetite.
Anorexia in Babies
In the first 6 months, only breast milk should be given to babies, and complementary foods should be started after the 6th month. Generally, loss of appetite is not seen in infants in the first 6 months (during the period when they receive only breast milk). If there is a lack of breast milk, the baby’s nutrition should be supported with formula foods.
The growth rate of the baby is followed at monthly check-ups. While growth is faster in the first 6 months, there is a decrease in the baby’s growth rate and appetite after 6 months. This is completely normal and parents should not worry about it.
Suitable for transition to supplementary food after 6 months
The transition period to additional foods is a difficult process that requires patience. Babies may have difficulty getting used to the taste of complementary foods such as fruits, vegetables and cereals other than breast milk and may show reluctance to eat. During this period, the appetite of babies should be respected.
Additional foods should be tried when the baby is not sick, hungry and cheerful. It has been observed that babies can get used to some foods only after 10-15 tries.
The most appropriate time for the transition to additional food in infants; It is completely related to the neurological and motor functions of the baby, after the 6th month when he can sit and reach for the food on the table with his hands. During this period, babies should be seated at the family table with a highchair and should be allowed to try to eat appropriate nutrients with their hands. The baby is dependent on the mother during this period. In this stage, babies try to indicate that they are hungry and full. When asked to give food that he does not like; he tries to indicate that he does not want that food by turning his head, crying, gagging. This is not anorexia. In this period when the child is dependent on the mother, meeting the emotional needs of the baby positively affects the nutrition of the baby.
Anorexia in Children
Causes and types of anorexia in children with anorexia: They can be classified as food picky children, children with swallowing-chewing problems, those who chew slowly, those who eat quickly, and those with anorexia due to primary disease.
Children who are picky and eat less prefer to drink milk and juice instead of eating. Children who drink these high-calorie beverages reject other nutrients due to the feeling of satiety. It has been determined that the families of children with anorexia do not spare enough time to feed their children.
It should be emphasized again that the most important factor positively affecting appetite is the education level of the mother. It has been observed that the babies of educated mothers are more successful in starting and continuing breastfeeding for a longer period of time, these babies consume more fruit and are less accustomed to harmful foods. Children who are started to kindergarten early, on the other hand, get used to harmful foods earlier. The older the mother, the greater her experience and positively affects the baby’s nutrition and appetite.
While trying to feed babies while watching TV causes deterioration of nutritional control and loss of appetite, activity and exercise have a positive effect on appetite.
If anorexia is accompanied by other symptoms, it should be investigated.
If there is growth and developmental delay in a child who is said to have anorexia, it should be investigated whether there is a serious underlying cause. Infectious diseases in children reduce appetite. Digestive system diseases such as gastritis, ulcer, reflux, constipation, liver diseases, heart, kidney and lung diseases cause a decrease in appetite. In addition, malignant diseases such as tuberculosis, cancer, hypothyroidism also cause a decrease in appetite. If there are symptoms of any of these diseases, the research is deepened and the underlying disease is treated.
Iron deficiency anemia causes loss of appetite, and if iron deficiency is corrected, loss of appetite will improve. Although there is no vitamin deficiency, multivitamins used for anorexia do not show any effect on anorexia.
What can parents do?
Suggestions that will be useful to families in the follow-up of an anorexia child can be summarized as follows:
-Drinks such as fruit juice, milk, tea, cola should be limited to the child and these drinks should not be given before the meal, during the meal.
-Meals should be prepared taking into account the wishes and priorities of the children, and the child should be allowed to eat himself.
-If the food offered to the child is rejected during the meal, it should not be insisted on at that moment, other options should be offered, but the rejected food should be offered to the child repeatedly at regular intervals.
-The meal times of the child should be regular, they should be seated at the table with family members, and they should be allowed to eat by themselves. Foods such as sugar, chocolate, ready-made fruit juice, and beverages such as cola should not be given between meals.
-The child’s plate should be decorated in a way that attracts his attention.
-The television must be turned off during the meal.
-Eating with the crowd positively affects the child’s appetite.
-Children with no appetite should not be given multivitamins unnecessarily.
-The frequency of meals for children with no appetite should be increased and the contents of the meals should be enriched.
-Families and caregivers of children with anorexia should be trained to correct their mistakes.