By: Teresa Chueca García Pye
Throughout my years of experience as a nutritionist in an office, seeing children and adolescents, there is a concern that is repeated in many parents: "my child does not eat". Faced with this alarming statement, we must analyze the situation objectively in order to find the most appropriate solution.
If it were the case that our child has a total loss of appetite and does not want to eat any food, we should worry about the possible existence of anemia, parasites or another disease that could interfere with the survival instinct that all human beings have. feed us, like animals that we are. If, on the other hand, our child has decreased the amount of food they used to eat or has become more selective with the foods they used to eat, things change.
The first thing we should observe, more than weight, is the size of our children. There are some indicators called percentiles that show, out of an amount of 100 children of the same sex and age range, the position in which our child is. Note that there is no better or worse position. Depending on the genetics (height of the father and/or the mother), our children may be within the average range (50th percentile), high range (90th percentile) or low range (25th percentile), without meaning that they have any growth deficiency. . We might be concerned, for example, if our child has been in the 90th percentile for the past 5 years and then drops to the 25th percentile; in that case, it would be necessary to go to our pediatrician to carry out the analysis of the case.
As for the weight, in the growth stage it is not very decisive. There are children of the same age who have different builds and therefore different weights; As long as our son maintains his height growth range, we don't have to worry. It is natural that as the years go by, due to the increase in size, our children do not gain weight as before or even lose a little weight and/or visually appear to be thinner.
Let us remember that, from birth, the total food that our children receive is milk (whether breast or infant formula) and then, from 6 months, we begin to introduce complementary foods to start the transition from a purely liquid diet to a solid food, which in the future will provide, by itself, all the nutrients you need. This complementary feeding, as its name says, complements breast milk or infant formula (it does not supplant it); free will milk intake should not be suspended in its entirety until our hijx turns 2 years old. Why? Because from 6 months to 2 years old, milk changes in terms of density and the nutrients that our children need due to growth, and foods must be introduced little by little as our children recognize different flavors, colors and textures.
It is very important, at first, to use crushed porridge and not liquefied, to later increase the size of the pieces each month and that it strengthens the jaw for normal chewing. A trick that can help us accept new foods in our children is, for example, by giving them a broccoli porridge, putting a broccoli stalk next to them so that they can recognize it, even play with it, and associate it with the color and texture of what they are eating. This way, the transition will be easier.
Another important aspect during the introduction of food is to make our children aware of what they are eating in a pleasant and familiar environment. How do we do it? First, we must avoid any distraction that generates important stimuli that distract him from the central activity: eating. For example, screens or toys. Why? If our children ingest the food that we give to their mouths with another stimulus present, the taste, smell, texture and vision of the food will go completely unnoticed. This can lead, in the future, to our children being reluctant to eat, starting at approximately 3 years of age, since they have more developed decision-making faculties that will make them reject the unknown.
As for the environment, we must ensure that it is the most pleasant at mealtime. Our children learn by imitation and are very emotionally sensitive. Feeding time should be a time of happiness and discovery, with a stress level of zero. If at mealtime, we force them to eat something they didn't like or we find ourselves in a bad mood, we pass it on to them and it is very likely that they feel blocked. Also, let's be careful what we say in front of them regarding food; mothers and fathers, for our children, we are the owners of the absolute truth and the models to follow. If our son hears us saying that he does not eat or that it is difficult to eat, he will assume it as a reality and that will probably be the result. In the same way, if he hears us say that we do not like a food or does not see us eating it, he will not understand why we give him something that is unpleasant for us and he will receive it with the same attitude.
The schedules and gastric capacity are also important. Has it ever happened to you that at one point you may be hungry, but if the hour goes by because you have had things to do, you are automatically no longer hungry? Or when you are on a diet and eat less food the first few days you are hungry, but then you get used to it because your stomach shrinks? The same thing happens to our children. Let's keep in mind that our children's schedules will not always be in sync with ours, but we can coincide in the main meals. To maintain a weight and, above all, proper growth in our children, it is important that they receive a continuous supply of nutrients. This means that we must provide them with a balanced breakfast and then they must have a food intake at least every 2 hours and at most every 3 hours. The gastric capacity of our child is also important to be able to calculate the volume that we should give him. Our children's stomach is the size of their fist (not ours, the fist of the person who is going to ingest the food), and it can expand a maximum of 2 ½ to 3 times its size. Give a smaller or larger amount to your stomach capacity, I could alter the appetite by reducing it by getting used to a smaller volume or by feelingbeing stuffed with food and having excess bulk that remains until the next meal.
Last but not least, there is the psychological aspect. Food intake is one of the few variables that children can control in their lives, from 2 to 3 years old. What does this mean? That, if our child is under some kind of stress, they can make the decision not to eat as a sign of protest. Why? When children are unable to express their emotions, whether due to fear or emotional immaturity, they manipulate the environment around them (consciously or unconsciously). That way, they get us to pay attention to them and let us know that there is something they don't agree with.
What can those reasons be? The unexpected change. It may well be due to a move, change of school, separation of family figures (mom-dad, mom-mom, dad-dad, etc), greater absence of fathers or mothers, etc. Any unexpected change in children's lives that alters their emotional stability can affect their eating behavior, either overeating or not eating. How can we prevent it? Talking with our children to anticipate the change and tell them that we understand that it is an overwhelming situation but that we will be accompanying them throughout the process.
Let us always remember that when we identify a problem in our child's feeding that apparently has no reason and we cannot reach a solution, we must go to health specialists: doctor, pediatrician, nutritionist, psychologist, art therapist. They are the ones who, with their knowledge and experience, can better guide us to find a harmonious solution.
Teresa Chueca Garcia Pye
Degree in Nutrition and Dietetics.
Master in Mindfulness-Based Therapies
Collaborator of the NGOs Aprendo Contigo and Unos con Bobby.