Eating disorders in children

The amount of food that should be given to children is one of the most frequent concerns of parents and caregivers. This concern, very positive, can sometimes be exaggerated and cause the appearance of inadequate habits in children, such as the excessive ingestion of food, not in accordance with the real requirements.Although parents' alarms about a child who does not eat enough are almost always based on not very objective assessments -such as comparisons with what he/she ate in other stages, or with what other children of his/her age eat, etc.-; it is very important that when in doubt, the pediatrician is consulted as soon as possible, so that he/she can assess whether there is a health disorder behind the lack of appetite.While deficiencies of some micronutrients -iron, for example- cause developmental delays -especially neurological and cognitive-; malnutrition affects the immune system of children in particular, making them very vulnerable to infectious diseases, which, when they occur too frequently, weaken children more and more, putting their lives at risk.

Factors that can cause weight deficits in children

Underweight in children can be caused by environmental or organic factors or by the incorrect relationship of parents, guardians or teachers with the child.

Environmental factors

Establishing rigid feeding schedules during the first four months of life. During this stage, infants manifest hunger in a pattern between two and a half and four hours; this may vary among different infants, and even in the same child throughout his development. Setting schedules without taking into account the child's demand -for example, nighttime demands- could subject infants to a feeding regimen that does not meet their needs, causing malnutrition.Late introduction -after 7 months- of complementary feeding.Feeding in inappropriate environments. For example:

• Lack of ventilation, lighting and hygiene.
• Presence of televisions or other audiovisual media that disturb the tranquility and proper relaxation of the child.

Uncaring parents or caregivers, who leave the children alone during meals, without adequate attention. Frequent changes of teachers, caregivers or tutors in charge of the feeding of the children.

Organic factors

• Motor alteration of swallowing. This difficulty, known as dysphagia, usually occurs secondary to another condition, such as nervous system disorders.
• Neurological disease.
• Gastrointestinal disease.
• Delay in the introduction of some foods due to some pathology.
• Intrinsic poor appetite.

Incorrect relationship of parents or caregivers with children.

• Parents or guardians who aggressively force children to eat all the food.
• Intolerant parents or caregivers who frequently scold when the child messes, touches food, has poor manners, or dawdles.

Recommendations for helping children gain weight

Once the pediatrician diagnoses that the child is underweight, he/she will guide the family on the feeding plan to follow in order to solve the specific situation of each patient. Among the general indications that the family should take into account are the following:

To distribute the food in 6 daily meals: breakfast, mid-morning, lunch, snack, dinner and afternoon snack.

Include in all meals a wide variety of foods: healthy carbohydrates -bread, pasta, cereals, potatoes, sweet potatoes-; fruits and vegetables; proteins -fish, lean meats, eggs, grains-; dairy products with their fat -whole milk, cheese, yogurt-; healthy fats -olive oil, seed oils (soybean, sunflower, corn, rapeseed), nuts, avocado.

To improve the caloric and nutrient content of some dishes, healthy fats or milk can be added. For example: salads and purees can have a tablespoon of olive oil or other seed oil added; fruits can be beaten with milk and no sugar added; and toast can be offered with oil, avocado, cheese or peanut butter.

Adapt the fiber content of the diet to the requirements of the age, since when this is ingested in quantities higher than recommended it can hinder the assimilation of nutrients. To put this recommendation into practice, consider the following:

• Provide only three times a week legumes.
• Remove the peel from apples and other fruits.
• Do not allow the child to eat the peels of citrus fruits -oranges, tangerines and grapefruit-.

Do not offer foods that contain many calories and few nutrients -sweetened drinks, chips, candy, sweets, sweets, etc.-, since these products, although they favor weight gain, do not provide sufficient amounts of vitamins, minerals and bioactive substances required by the child for it