Why has my child stopped eating?

Appetite can fluctuate from day to day: even healthy children go through periods when they don’t have an appetite. The reason for loss of appetite is rarely medical in origin. However, some conditions such as acid reflux and constipation, thyroid problems and iron-deficiency anaemia can cause a loss of appetite, as can some medications.

Illness, in general, sometimes puts anyone off their food, so coughs, colds and sore throats can put children off eating for a couple of days, and that’s quite normal. The eruption of a new tooth may cause a lot of pain in the mouth, making it too sore to eat.

Growth spurts can also affect appetite. When your child's growth slows, which it does for older toddlers, their appetite decreases in line with the slight decrease in nutrition requirements. Similarly, a change in activity levels, or exerting less energy can lead to less food being needed.

The mealtime battleground

Alongside the developmental changes, some behavioural and emotional factors can also cause loss of appetite. As toddlers start to enforce their independence by voicing likes and dislikes, mealtimes can become an area of conflict. While developing personal tastes and preferences is healthy and perfectly normal and expected at this age, battles at the table are not. Some children might even go off a previously ‘favourite food’ or become very selective. This can cause a lot of anxiety, but it does often resolve after a short time, provided you stay calm and don’t engage in a battle.

The loss of appetite could also be simply a response to eating too many snacks or drinking large quantities of milk or juice between meals. Snacks are useful, but if too much is eaten, there might be no room for dinner and it’s helpful to save juice or milk for meal times, and only drink water in-between.

Top tips to fuel your child’s appetite

Young children are often able to gauge their food energy needs quite well, being guided by internal appetite cues. Overt persuasion might even have adverse effects by increasing refusal of eating. Some of the following ideas might help:

Serve small portions. Children have smaller stomachs than adults. They do not eat as much at meals. Five or six smaller meals or snacks may better meet your child's nutrition needs.
Try to make the meals as nutritionally-dense as possible. This means making small meals that are more concentrated in essential nutrients. Scrambled egg, soft cheese or smooth peanut butter on toast or oatcakes, followed by a yogurt or fruit and custard is far more nutritious than jam and butter on toast and a biscuit, and makes an ideal teatime meal for a small appetite.
When teething and sore mouths are a problem, offer foods that are softer but still contain lots of protein such as baked beans and scrambled egg or chicken soup with broken up bread floating on top. On the other hand, your child may prefer something hard to bite on, so fingers of cheese on toast or French toast soldiers with peanut butter are ideal.
Be more active. Encourage your child to go outside and play, or go for a short walk: the fresh air and physical activity can jump-start your child's appetite.
Focus on the foods your child will eat and give them a small choice. For example: ‘Shall we all have peas or carrots with our dinner today’. This autonomy can be very empowering for a small child. Even better, they could help you buy and prepare the food, using some of their own choices at the shops. Most children love cooking, even if it’s washing vegetables!
Finally, don’t panic and get stressed. Calmly remove the food without any comment. Babies and young children won’t starve. If they are hungry and ask for food before the next meal, offer a drink of water and a small amount of fruit.

How do I know if my child is eating enough to be healthy?

Health visitors weigh toddlers and young children at regular intervals, to check if your child is growing along the expected centile. If your child is generally well and active, there’s probably nothing serious to be concerned about.

When to seek further help.

Most loss of appetite declines within a week or two so if you ride the storm, it will probably go away. If poor eating is prolonged, get a vitamin and mineral supplement from a pharmacy. You can get advice on choosing a suitable one from the pharmacist.

However, for more persistent loss of appetite, or if you're concerned about your child’s growth and development over a longer period of time it’s important to speak to your GP.