food diversification

How to overcome a child's refusal to eat    ?   



As strange as it may sound, a psychological factor can often be invoked when a baby refuses a more varied diet, after the age of 5-6 months and especially after the age of one year. It may be necessary to ration formula, and in older children this may lead to the transient advice not to exceed 250 ml a day in order to elicit interest, through hunger,  for other foods. It is however essential to maintain a good fluid intake, as water or by diluting the formula or milk.

One common psychological mistake  is to propose too much at a time. It is wise to start with a small amount of various  foods. Another serving should  be offered only if the child has finished his/her plate. If  a baby chooses some foods and rejects others, everything should then be mixed to defeat this behaviour. 

Never insist if the child refuses to eat, don't  keep him/her alone at the table after others have left it.  Don't explain, or as little as possible. It is seldom necessary, and commonly inappropriate or counterproductive, since too often explaining is apologizing.  

On the other hands verbal  commands to the child may  put him/her in front of a dilemma : refusing is an opportunity to  assert oneself while yielding may be perceived as a sort of face loss. 

These efforts sometimes meet a  resistance so unusual and strong that the parents are unable to overcome it.  Then an organic cause must be suspected. Iron and zinc deficiencies decrease the sense of taste, to the point of abolishing it sometimes and low iron  may contribute to  behaviour problems, including stubborness.  

Iron and zinc supplements can then gradually  restore the sense of taste, improve the child  abitity to adapt and allow him/her to accept new foods.

This may also result from milk allergy causing chronic and otherwise unsuspected blood loss from the gut mucosa. In addition, one puzzling feature of milk allergy observed in some children is a  dependency to milk,  presenting as craving. When milk is removed from the diet,  the child may develop transient withdrawal symptoms, i.e. a marked malaise,  a situation mimicking addiction.

Eventually and very seldom, towards the end of a respiratory infection and even when it seems over, a baby may refuse  to be fed, without any obvious reason. This may result from an unsuspected esophagitis, secondary to the disease, and  require  a specific (anti-reflux) treatment.







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