appetite

Appetite is generally one of the top entries on my list of things not to worry about. The instinctive desire for food (OK, hunger) is second only to thirst as a motivator for human action. If a child is hungry, he will eat. It is that simple.

Nevertheless, parents are often very concerned when their child seems to refuse to eat or have a generally poor appetite. Before becoming too concerned, it is well to go through this little appetite checklist in your mind:

Is the appetite really abnormal? Is the child actually eating normally for his age? Your doctor will chart your child's height and weight periodically and if the chart looks OK, your child is eating normally, no matter how little it seems to be.
Is your child ill? Nobody has much of an appetite when he is sick. Many times the loss of appetite is the most distressing symptom for the parents, more than fever, diarrhea or whatever.
Is your child going through a slowdown in growth rate which will naturally lead to a drop off in the appetite? At any rate, ask yourself these questions first if you are concerned about your child's appetite. Remember especially that if your child is ill and loses a little weight because she doesn't eat well, nature has already thought the problem through. The body "remembers" what it weighs. If a person undergoes a period of relative starvation and loses weight, the body always compensates afterwards to restore "normal" weight. If you will think about it for a minute, this is precisely why diets don't work! After you voluntarily starve yourself, your body has the overpowering urge to re-establish your "normal" (pre-diet) weight. For just the same reason your child will compensate for any weight loss during illness, and very quickly.
Is your child at risk for iron deficiency, a fairly common condition in toddlers. If this is not your first baby, or if you were anemic during pregnancy, or if you just couldn't take those prenatals... you might ask your doctor to check your child's blood count. One of the symptoms of iron deficiency is poor appetite, and it seems to manifest itself right about the same time behavioral pickiness and the normal dropoff in appetite appears, so sometimes iron deficiency gets missed.

Here are some tips adapteded from Dr. Barton Schmitt's book Your Childs Heath (Bantam Books) for stimulating your childs appetite.

Limit snacks to two a day, and only if the child asks for them. Limit juice to 6 ounces or less a day. Allow the child to skip a meal now and then. It won't hurt anything.
Let your child feed himself. Start finger foods by 8 to 10 months old to allow partial self-feeding. Once your child is 15-18 months old, he can feed himself.
Limit milk to 16 ounces or less a day. Milk has a lot of calories and crowds out the appetite for solid foods.
Give small portions, and allow your child to succeed at "cleaning his plate." Let him ask for more if he wants it - this reinforces his feelings of selfness and control.
For goodness sake, don't try to force him to eat foods he hates. There is no food that is that critical.
Give your child a multivitamin (with iron, please). You will feel better and your mother will be less tense as well 8-)
Make mealtimes happy times, not an occasion for struggle over eating or review of the day's naughty behavior.
Stop talking about the childs eating in front of the child. Don't praise the child for eating. Eating is just something we do to stay alive... it isn't an accomplishment like getting an A in fingerpainting at playschool.
Don't make the child stay at the table until he finishes his stupid broccoli. You will just increase the struggle factor.
Remember that it is you who has the problem with your child's appetite, not your child. Consider what becomes of picky eaters... they all grow up.

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