what causes loss of appetite in children?

If I list the most common complaints of parents visiting my clinic, “My child does not eat adequately” will be in the top five.

The bulk of children who are supposed to have poor appetite does not have true appetite loss. Most of them are fussy eaters. I will discuss the problem of fussy eaters in another post.

Some parents misinterpret their child’s eating habits. These kids eat milk or liquid food properly but dislike solid food. The problem is very common in children aged 1-3 years. I will discuss its management of it in a separate post.

Many parents just shove the food in the mouth of the baby, without caring about his/her appetite or mood. This tactic of feeding can work in infants(<1 year). But, as the baby grows, he will not stay still when someone tries to feed him forcefully. This causes further use of strength by parents/caregivers which develops a sense of fear of food in these children.  I have given some tips on feeding techniques in a separate post.

APPETITE LOSS DUE TO ILLNESS

ACUTE/ SUDDEN ONSET

Any child with acute onset illness will have some degree of appetite loss. The loss of appetite here is temporary. It resolves upon recovering from illness. The common cause of appetite loss are-

Fever

Oral ulcers

Acute gastritis

Acute gastroenteritis

Indigestion

Acute hepatitis

Common cold, nasal blockage( infants)

Respiratory tract infections

CHRONIC 

Children suffering from chronic illness also have appetite loss. Commonly causes are-

Anaemia

Chronic kidney disease

Chronic liver disease

Congenital heart disease

Chronic infection( tuberculosis/ HIV)

DRUG INDUCED – Medicines are an important cause of appetite loss. Among drugs,  antibiotics are the most common cause of appetite loss. 

Appetite loss without illness or drugs– Some kids do not have any obvious illness but have an unexplained poor appetite. These anorexic children need evaluation to rule out any underlying illness.  Appetite stimulants can be given in these cases. I will discuss appetite simulants and ways to increase appetite without medicine in a separate post.