Thirteen-year-old Nikhila Anand, who studies at an upmarket public school in Noida, fainted during the assembly. The doctor diagnosed her haemoglobin level to be very low. Reed-thin Nikhila is the fussiest of eaters, and the dining table at the Anand household is always a scene of battle between mother and daughter. Iron deficiency anaemia is one outcome of her picky eating habits.
On the other hand, Ritwick Ghosh, 12, has just been diagnosed with high cholesterol and is now being forced to do three rounds of the neighbourhood football field every morning. Rohit’s obesity is directly linked to his fussy eating habits except that, in this case, he does eat—all junk food and no vegetables or fruits at all (for more on childhood obesity, see Fat Facts, Mint, 17 July).
“One of the most common complaints that parents come to me with relates to their children’s fussy eating habits,” says Neelam Mohan, paediatric gastroenterologist at Sir Ganga Ram Hospital, New Delhi. Paediatricians and gastroenterologists at other hospitals echo this.
Rahul Nagpal, paediatrician at Max Healthcare in New Delhi, is brutally frank. He says that the more affluent the parent, the more acute the problem. “What we have seen is that the more the supply, the less the demand,” he says.
Whether it is a “poor little rich kid” syndrome or not, fussy or picky eating is causing heartburn among many Indian parents today. It is a habit that could also have serious repercussions for the child later.
New Delhi-based nutritionist Ishi Khosla says that poor dietary habits in children lead to low stamina, reduced levels of concentration and bad skin and hair. She adds that eating patterns established by age 11 usually persist into adulthood.
Dr Nagpal says that studies have revealed that children who are glucose deficient in the morning could end up with learning disorders. Picky eaters usually suffer from vitamin and mineral deficiencies that could lead to impaired growth. In extreme cases, it can result in neophobia—fear of new foods. Healthy eating habits cultivated during childhood can nip the chance of degenerative diseases, such as diabetes and hypertension, developing later in life.
The genesis of the whole problem lies in early infancy, in the weaning process, says Anupam Sibal, director, medical services, and senior consultant, paediatric gastroenterology, Indraprastha Apollo Hospital, New Delhi.
Heart of the matter
If the child is not weaned properly, then the chances of his or her becoming a fussy eater are very high. Many mothers have a tendency to overfeed their babies and this could lead to revulsion or pickiness about food. Some also tend to mash weaning foods into a paste and, later on, the child develops a disinclination to eat properly or always demand soft, easy-to-eat food.
Some parents make the mistake of making mealtime entertainment time and, to make children eat more, try to distract them by switching on the TV, getting them to play with toys or look at picture books as they eat.
Result, the child does not take lunch or dinner time seriously and demands entertainment constantly.
It’s only in rare cases that the fussy eating habits are related to allergies or organic illnesses. Teething, sore throats, blocked noses or upset tummies can always cause aversion to food among toddlers, but these are usually temporary. Force-feeding during this period can also lead to problems later. Fussy eating habits are more acquired. An anxious, stressed-out parent is more likely to make the child an anxious fussy eater. Making meal times a battleground can worsen the situation. “Ninety per cent of the time, fussy eating is a result of force-feeding,” says Dr Nagpal.
Managing the problem
It’s fairly simple problem to manage, says Dr Sibal. But parents need to understand that there are no short cuts and a lot of patience is required. Counselling could help. “There are no magic syrups available—don’t bank on appetite-stimulating tonics,” he says. Khosla stresses the need to address the problem early on. “Studies have shown that three-year-olds are more malleable than four-year-olds,” she says.
The first step is to get a clear understanding of what has caused the problem. “Then, the parent should just relax. Most of the time, the parent is on a guilt trip that the child has not eaten well, and they end up repeatedly trying to feed the child,” says Dr Sibal. The ground rules, according to all the doctors, are that the table should be cleared after 45 minutes and food should not be served again for three hours.
Dr Nagpal also says that families should eat together. Recent studies have shown that children, especially teenagers, who ate dinner with the family on a regular basis had better overall nutrition, including higher intakes of fibre, calcium, iron and other essential vitamins.
He also suggests that if the child is inclined to eat only small quantities, then parents should try to pack in more energy in the same volume.
For instance, if the child eats just one roti, substitute the wheat flour with soya or black gram flour and stuff it with vegetables.
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