A child may appear to have a limited appetite for a number of reasons.
Differential diagnosis of a limited appetite in a child:
(1) parental misperception with adequate nutritional intake
(2) lack of appetite associated with conflict in the home
(3) hyperactive, with greater interest in playing or talking than eating
(4) apathetic or withdrawn personality
(5) food allergy, including eosinophilic esophagitis and celiac disease
(6) constipation or other GI motility problems
(7) oral pain
Less common causes:
(1) anorexia nervosa
(2) central nervous system disorder affecting perception of hunger or satiety
(3) occult malignancy
(4) medication
Initial management may include:
(1) ongoing monitoring of weight and height for age
(2) avoiding distractions at meals
(3) keeping a food diary to monitor actual intake
(4) identify other complaints that may give insights as to a cause
