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Is your child a fussy eater? Learn how to differentiate it from a disorder

20 August 2025

Is your child a fussy eater? Learn how to differentiate it from a disorder

New Delhi: For parents, there are few worries more consuming than watching your child refuse food. Experts say that they often meet anxious mothers and fathers who sit across my desk and ask, “Doctor, is my child just being fussy, or should I be concerned?” The truth is—sometimes it is just a passing phase. But at other times, a poor appetite is the body’s way of telling us something more is going on. Knowing how to tell the difference makes all the difference. Dr. Vittal Kumar Kesireddy, Consultant & In-Charge, Department of Paediatrics, CARE Hospitals, Banjara Hills, Hyderabad, explained the difference between fussy eating and medical problems.

Phases of Fussy Eating

Children don’t eat the same way adults do. Their appetites naturally ebb and flow depending on growth spurts, activity levels, and even mood. Between the ages of two and five, it’s very common to see selective eating. Some children want the same food every day, others pick at tiny portions and leave the rest untouched. Growth is slower in these years, so their calorie needs aren’t as high as when they were infants.

If a child is otherwise active, playful, and gaining weight along their expected growth curve, these quirks are usually nothing to lose sleep over. It is advised not to turn mealtimes into battlefields. Gentle exposure to different foods, eating together as a family, and trusting the child’s hunger cues usually help things settle with time.

When Loss of Appetite Means More

Where doctors ask parents to pause is when the lack of appetite is persistent, distressing, or accompanied by other symptoms. Here are some of the medical issues that can hide behind a child’s refusal to eat:

Digestive Discomfort

A child who constantly complains of stomach pain, bloating, or nausea may be avoiding food because it hurts. Reflux, chronic constipation, or even conditions like lactose intolerance and celiac disease can make eating uncomfortable. Over time, the child may simply learn to associate food with pain.

Hormonal and Metabolic Concerns

Though less common, appetite can also be affected by imbalances in the thyroid gland or by rare metabolic conditions. These issues often show up not just as poor eating but also as poor growth, fatigue, and sometimes unusual irritability.

Deficiencies That Create a Cycle

Iron deficiency is something we pick up often in clinic. Children who are iron deficient may have reduced appetite and low energy, which in turn worsens their food intake. Vitamin D deficiency and other nutrient gaps can also play a role in slowing growth and dulling appetite.

Sensory and Developmental Issues

Some children are not “picky” in the usual sense but are genuinely overwhelmed by textures, smells, or even the look of food. This is something often seen in children with sensory processing difficulties or those on the autism spectrum. Others may have subtle motor difficulties with chewing or swallowing that make eating a stressful task rather than a pleasant one.

Emotional and Psychological Triggers

Stress, anxiety, or major family changes can quietly affect how much a child eats. In adolescents, poor appetite can sometimes be an early marker of disordered eating, which needs timely and sensitive intervention.

Red Flags That Should Prompt Medical Review

Parents don’t need to panic at every skipped meal, but some signs should not be ignored:

  • Consistent weight loss or no weight gain over weeks to months
  • Ongoing abdominal pain, vomiting, or diarrhea
  • Severe restriction to only a few “safe” foods
  • Extreme lethargy, irritability, or loss of playfulness
  • Feeding difficulties that persist beyond the toddler stage

When these symptoms are present, it is best to seek professional advice rather than waiting it out.

The first step is always to take a careful history—when did the eating difficulties start, what patterns parents notice, and whether there are associated symptoms. Growth charts are reviewed to see if weight or height have fallen off their expected tracks.

A simple check-up can reveal a lot—pale skin may suggest anaemia, an enlarged thyroid a hormone issue, or abdominal tenderness a digestive concern. Based on this, doctors may order blood work, stool tests, scans, or sometimes an endoscopy.

Not every child needs extensive investigations, but where warning signs exist, these tools help us identify whether the issue is medical, nutritional, or developmental.

Supporting Children at Home

Medical evaluation is important, but I also remind parents that the way food is approached at home plays a big role. A calm, pressure-free table often helps children respond better to meals.

  • Offer smaller, more frequent meals instead of overwhelming portions.
  • Eat together as a family so the child sees healthy eating modelled.
  • Avoid turning food into a reward or punishment.
  • Introduce new foods slowly, without forcing.

Most importantly, respect the child’s own hunger and fullness cues.

Every child has days when they eat less—that in itself is not alarming. But when a poor appetite becomes a pattern, it’s worth listening carefully to what the body may be trying to say. Often timely diagnosis uncovers a medical or developmental issue that, once addressed, allows the child to thrive again. In both scenarios, what matters most is that you don’t dismiss your concern or your child’s struggle. Food is not just fuel—it is growth, play, and joy. Every child deserves the chance to experience that fully.

Reference Link

https://www.tv9english.com/lifestyle/is-your-child-a-fussy-eater-learn-how-to-differentiate-it-from-a-disorder-article-10872537.html