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little girl playfully avoiding eating her food

Our bodies help us regulate how much energy we need to consume through appetite. It is normal for children older than 2 to have fluctuating appetites. A good indicator of poor appetite is if a caregiver has difficulty giving food to a child.

If a child with a poor appetite has a reduced desire to eat that lasts longer than several days, it could indicate a more serious health concern. If the health issue is treatable, the appetite should return when the condition is cured. This can be a common concern among children who have been adopted or those with disabilities.  

Causes of Poor Appetite

  • Low iron status or anemia 
  • Medical condition or illness 
  • Developmental delays that cause distorted hunger perception 
  • Oral sensory problems 
  • Certain medications  
  • Body or oral pain 
  • Diarrhea or constipation 
  • Stress 
  • End of a growth spurt (children eat less when they are not growing) 
  • Snacking in between scheduled meals, or lack of structured meal and snack times 
  • Forcing the child to eat more than he wants 
  • Associating the act of eating with an unhappy event 
little girl with Down syndrome laughing with parents

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Feeding Considerations 

If poor appetite lasts long enough to affect the infant’s or child’s weight, try some of the following feeding practices to ensure an adequate intake of food. 

Infants (under 1 year)

  • Place the infant in an upright position during feeding.    
  • Feed bottle-fed infants smaller amounts more often (every 1 to 3 hours). 
  • Limit feeding time to 30 minutes.  
  • If an infant is bottle-fed and tires easily during feeding, replace the nipple with a softer or smaller one (preemie nipple).  
  • Wake the infant in the middle of the night or during long naps. Do not let the infant sleep through the night without feeding until an appropriate weight is reached.  
  • If the infant seems irritable or distracted, try to soothe them in a quiet, dark room. Avoid places that are crowded and noisy. Wait until the infant is calm to feed.  
  • Discuss with your doctor changing to a high-calorie, high-protein formula. Do not concentrate or change formula without a doctor’s recommendation.  

Children (1 year and older)

  • Set an eating schedule. Offer three meals and two to three snacks at about the same time each day. Limit snacking and liquids besides water in between regular meal and snack times.  
  • Limit the intake of fluid, such as juice and milk, as these liquids can decrease appetite and the intake of solid foods. Offer drinks at the middle or end of a meal. 
  • Offer meals at a table in a room with little distraction.  
  • Provide the opportunity to eat all meals in the presence of other children, because it encourages children to eat. 
  • Model eating a variety of foods and engage with the child during mealtimes.  
  • Do not force-feed. Force-feeding may cause anxiety and resistance to eating. 
  • Limit meals to 30 minutes and snacks to 15 minutes. 
  • Offer vitamin and mineral supplements if recommended by the child’s pediatrician.  
  • Encourage the child to be active before mealtimes.  
  • Offer a variety of foods to keep the child interested in eating. 
  • Fortify or enrich the diet to increase calorie and protein intake.  

Children (older than 6 months) – if weight loss or poor weight gain is present and intake is limited

  • Make sure there is a protein source in each meal and all snacks. 
  • Add cheese to omelets, meals and/or snacks or on bread. 
  • Add 1 tablespoon of powdered milk or formula to dairy products or mix into other dishes. 
  • Add nuts, nut butters, seeds, raisins and other dried fruits to bread, yogurt, cooked meals and as snacks. 
  • Add starchy vegetables (potatoes, sweet potatoes, beets, pumpkin, carrots, corn, green peas, lima beans, plantains) to soups, stews and curries.  
  • Offer dense, fully ripe fruits (versus watery fruits), such as papaya, avocado, banana, pear and pineapple.  
  • Offer energy-containing drinks such as milk or juice in the middle or toward the end of a meal.  
  • Mix vegetable oil into dishes or when preparing meats, vegetables and grains. Oils can also be added to breads. 
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