Can a toddler have an eating disorder?

VIEWPOINT Dr Su Laurent Paediatrician

Toddlers can usually find room for sweet treats

Any parent of a toddler knows that mealtimes can be a minefield.

But in this week's Scrubbing Up health column, child health specialist Su Laurent says some are attributing their offspring's dietary foibles to an eating disorder, rather than bad behaviour.

I spend a significant amount of time seeing healthy young children whose parents are convinced that their child has an eating disorder.

Some parents think that their baby has an inability to swallow solids, others think that their child will fade away unless they are offered the few foods which they like and some parents say that their child eats nothing at all, despite the fact that they are consuming a packet of "Wotsits" in front of me!

It's often easier for a doting parent to believe that a child has a medical problem rather than a behavioural one

All three situations are examples of how powerful a weapon food is and how quickly children can gain the upper hand over their parents.

All three scenarios can be helped by a good health visitor, but sadly there are no longer enough health visitors to spend the time needed with first-time parents.

The difficulty I face is that parents often have a fixed idea that their child has a disorder and it can be very hard to convince them that, on the contrary, their child is very powerful and is getting away with eating exactly what they want!

It's often easier for a doting parent to believe that a child has a medical problem than a behavioural one.

Chips - or chips

FROM BBC WORLD SERVICE More from BBC World Service

My heart sinks when I hear stories of mealtimes taking hours, of children being force-fed and parents sneaking food into their child while they're watching TV so that they won't notice they are being fed.

Some parents surprise their toddlers by popping out from behind the sofa in an attempt to stuff a spoon full of food into their mouths.

Others accept that their child will only eat chips, chicken nuggets and chocolate cereal.

Some parents surprise their toddlers by popping out from behind the sofa in an attempt to stuff a spoon full of food into their mouths

One mother told me with pride that since the last time I saw her seven-year-old in clinic he'd tried a new food: he was now happy to eat KFC chips in addition to McDonald's chips.

You can imagine the expression on my face!

These children are often overweight, and yet their parents live in fear of starving their child unless they are given exactly what they want to eat.

In these families food dominates, the parents have got themselves into a rut and can't see a way out.

'Don't give in?'

So how should these issues be tackled?

The basic principles are:

• Make eating fun
• Eat with your child whenever possible
• Stop any force-feeding
• Let him follow your example and feed himself, however messy he becomes
• Remember that a normal child will not allow himself to starve

This sort of article makes my blood boil! My daughter had a genuine medical problem but I was fobbed off by several GPs. Jenny, Notts, England Read your comments

Babies can eat finger foods from a very young age but parents are often fearful of the resultant mess and prefer to feed them off a spoon.

A baby who feels he's being force-fed has an amazing ability to clamp his jaw shut, turn his head away and even gag on food and refuse to swallow.

Offer your child a small amount of healthy food and clear the plate away after 15 minutes even if he's eaten nothing.

Don't make a big thing about it and resist all temptations to give him a snack before the next meal even if he's grumpy.

Your child won't fade away if he eats nothing for a day or two

Limit milk to a pint a day, many poor eaters get most of their calories from milk. Encourage your child to drink water or very dilute fruit juice.

Reward your child for trying something new and don't punish him for refusing to try.

A very stubborn child may refuse to eat for two or three meals but eventually will have to give in unless he's being offered snacks between meals.

Of course, as a mother of three I confess that all of this can be easier said than done.

Remember the basic principles that food is a powerful weapon and your child won't fade away if he eats nothing for a day or two.