Anorexia in children – Causes and Solutions

12/05/2023

According to statistics from the Vietnam National Institute of Nutrition, among children examined at the Institue, the proportion of those who are diagnosed with anorexia disorder is 37%, while the rate in the US is 25 – 45%. There are different causes leading to Anorexia, and if not intervened promptly, long-term anorexia will cause children to lose weight, malnutrition, and many other unwanted consequences.

What is anorexia?

Currently, there is still no unified definition of “anorexia” recognized globally, and no standards set out to evaluate what anorexia is.

In Vietnam, anorexia is defined by the Vietnamese Ministry of Health as when a child does not have sufficient food according to nutritional needs, leading to delayed growth. This definition is similar to a term for an internationally recognized eating disorder called Avoidant/Restrictive Food Intake Disorder (ARFID). According to the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) of the American Psychiatric Association, children with ARFID are children with problems. in eating habits and weight loss and malnutrition. Children with ARFID have difficulty accepting certain foods due to sensory or psychological problems, they are not interested in eating and do not have enough food, which leads to loss of weight or catch up with growth rate, nutritional deficiencies and some other psychological disorders. Anorexia as commonly understood in Vietnam is often confused with the term “anorexia nervosa” which is anorexia due to stress on appearance and weight in both adults and children, leading to common consequences are loss of appetite and essential nutritional deficiencies.

In Vietnam, anorexia is defined as when a child does not have sufficient food according to nutritional needs, leading to delayed growth. (Photo: Freepik)

In Vietnam, anorexia is defined as when a child does not have sufficient food according to nutritional needs, leading to delayed growth. (Photo: Freepik)

In addition, the Vietnamese Ministry of Health also gives a definition of picky eating, a milder manifestation than anorexia as follows: “A picky eater is a child who does not eat certain foods, leading to lack of certain micronutrients”. According to the Ministry of Health, about 25 – 35% of children at the age of starting to walk and go to kindergarten are considered by their parents to be picky eaters. This fact is so common, however, without timely nutritional intervention, children will be at risk of protein, energy, and micronutrient malnutrition, from which anorexia will become more and more severe.

Below are some signs of anorexia and picky eating in children according to the Vietnam Ministry of Health:

– Children refuse to eat the entire portion or the meal lasts long (more than 1 hour).

– Children breastfeed less and eat less than usual.

– Children hold food in their mouth for a long time and refuse to swallow.

– Children do not eat certain foods such as meat, fish, eggs, milk, vegetables, and fruits.

– Children refuse to eat, run away when they see food.

– Children have nausea reactions when they see food.

Causes of anorexia and picky eating in children

– Due to physiological and health problems

Children may temporarily lose their appetite as they grow or after recovery from sickness. Some problems that children may encounter that reduces appetite during this period include: teething, sore throat, tonsillitis, illness, fever… These are normal symptoms and caregivers should not worry too much and avoid putting psychological pressure on children about eating.

Due to psychological issues

Unrealistic expectations of family and society: Nowadays, a number of families face pressure on how to raise their children to be plump and taller than normal in order to avoid judgments and criticism from outsiders, thereby forcing children to have more food than they really need and makes them scared of eating. The unpleasant feelings of being forced to eat will make the problem of anorexia worse.

One of the reasons for anorexia in children is due to the force from their parents to push they eat more than their actual need and make them afraid of eating. (Photo: Freepik)

One of the reasons for anorexia in children is due to the force from their parents to push they eat more than their actual need and make them afraid of eating. (Photo: Freepik)

Eating behavior of family members: Children at this stage like to imitate the eating styles of those around them. The eating habits of parents, siblings in the family, or friends in class are examples for children to build their own eating habits and preferences.

Personal fears: Some children have bad experiences that leave negative impressions during eating such as choking, difficulty breathing, and vomiting, thereby causing picky eating with certain foods. Some children are given complementary foods too early when their eating reflexes have not yet fully developed, leading to choking, and gradually the child will lose interest in eating.

Psychophysiology of children at their ages: Children at this age also have psychological and physiological problems, and also have periods of “three-year-old crisis”. Children will be more stubborn, and react more strongly when forced to eat because of their need for autonomy. Especially when children are attentively doing something or busy playing, they will show an offensive attitude not willing to eat.

Due to incorrect feeding practices

Early weaning: Normally, babies should be fed solid foods from the 6th month, when they are old enough to have appropriate eating reflexes to have foods such as porridge. Feeding your child solid foods too early increases the risk of vomiting and choking on food, thereby making the child afraid to face meals during the day.

Feeding children new foods incorrectly: Babies are often afraid and do not like to eat new, strange foods. If the caregiver does not know how to handle this stage of fear of new foods, the number of foods the child can reliably eat every day will be limited, thereby leading to undereating and malnutrition.

The stage of fear of new foods is part of the reason why children undereat and lack nutrients. (Photo: Freepik)

The stage of fear of new foods is part of the reason why children undereat and lack nutrients. (Photo: Freepik)

Overfeed children with drinks and candies reduces their appetite and prevents them from eating foods rich in energy and nutrients.

Let children eat snack too close before main meal can also affect his/her appetite.

– Due to long-term malnutrition

Children do not have sufficient food compared to the demand at their age. Malnutrition over a long period of time will cause them to lose weight and become malnourished. Malnourished children will lose their appetite for food and, if not treated promptly, they may be at risk of death. In addition, there are a number of micronutrients that affect children’s appetite such as Zinc, B vitamins, Lysine.

Tips for children’s anorexia

There is no treatment method of anorexia for all children, so caregivers need to record children’s eating history and determine the cause of anorexia. Below are some tips for anorexia in children:

– Only feed children complementary foods when they turn 6 months old, do not give them complementary foods too early or too late.

– Organize children enough food and meals according to their age’s physiological needs. Children can be fed many meals a day, however, there should be enough gap between meals. Especially do not let children eat snacks before meals. As it makes them feel full, lose their appetite, and refuse to eat other foods rich in nutrition.

– Feed your child when he or she feels hungry. Do not force him or create a bad impression about the meal.

– Limit your child’s eating time to 20-30 minutes. After meals, do not let children come into contact with food, so they will not lose their appetite at the next meal.

– Let children exercise, play or bathe before eating, helping them feel hungry.

– Let children eat with friends and family, encourage them to eat, and set an example for them in eating.

– Children should be allowed to feed themselves, hold their own food, and support them when needed.

– Introduce a variety of new foods slowly.

– Vitamins and minerals can be supplemented if meal quality is not guaranteed.

– Take your child to the doctor if there are medical symptoms such as illness, fever, cough, diarrhea, no weight gain for two consecutive months, long-term loss of appetite, less physical activity.

Besides, it’s suggested that parents could refer to some specialized nutritional products for children with anorexia and malnutrition such as Hanie Kid. This product has been clinically proven to help your child gain weight after 1 month. Especially, the product also possesses a 100Kcal High Energy formula and also rich in protein and HMO fiber, good for digestion, clinically proven to help babies gain weight after 1 month. In particular, the 100Kcal High Energy formula, also known as F-100, is a product for treating malnutrition in young children recommended for use by the World Health Organization (WHO) and the Ministry of Health. F-100 means that 100ml of the preparation provides up to 100Kcal. F-100 product was researched by scientists and included in the standard treatment regimen for malnourished children. Children with malnutrition and anorexia can use energy-dense products and nutritional supplements based on the F-100 product recommended by the World Health Organization (WHO). At the same time, a number of other micronutrient supplement products can be used to help improve the child’s growth rate and stature.

Furthermore, Hanie Kid products also contain Nano Calcium, K2 Vitamin and 37 nutrients to allow children grow taller. Hanie Kid product is clinically proven to help babies gain weight after 1 month and is recommended by nutrition experts and trusted by many parents of anorexic and malnourished children in Vietnam.

Anorexia in children causes serious health consequences. Therefore, parents are required to take prompt action to give care and treat anorexia in order for children able to develop comprehensively, keep up with growth momentum and have outstanding stature in the future.

REFERENCES:

  1. http://1000ngayvang.viendinhduong.vn/vi/dd-cho-tre-6-den-24-thang-540-ngay.nd91/phuong-phap-xay-dung-thuc-don-cho-tre-bieng-an.i452.html 
  2. Bộ Y tế (2015), Nuôi dưỡng trẻ nhỏ (Tài liệu dùng cho Cán bộ y tế công tác trong lĩnh vực chăm sóc sức khỏe bà mẹ – trẻ em tại các tuyến), tr.15-26, 136-140, 150- 161, 162-167.
  3. American Psychiatric Association, American Psychiatric Association DSM-5 Task Force. Diagnostic and statistical manual of mental disorders : DSM-5. 5th ed. ed. Arlington, VA; 2013.
  4. Misra M, Shulman D, Weiss A. Fact sheet. Anorexia. J Clin Endocrinol Metab. 2013 May;98(5):35A-36A. doi: 10.1210/jcem.98.5.zeg35a. PMID: 23650344; PMCID: PMC5393464.

 

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