Sick baby really doesn’t want to eat and denies any food offered by his troubled family. For loss of appetite is a typical manifestation of any acute disease and many chronic ones. This obvious fact needs to be understood.
First, let’s consider the acute illnesses, i.e. those appeared suddenly as well as the majority of child infections and injuries, poisoning, appendicitis, and much more.
Acute infections, usually viral ones, are the most common ones exactly in childhood, and which the child’s body in most cases is able to cope with on his own without any outside help. If to accept this as an axiom, then the following fact will be clear: any effort of the relatives should be made in the direction prompted by instinctive actions that are proved to be correct in the course of natural selection.
And which action at the beginning of a disease is the most natural? Refusal to eat. Is it good or bad? This is ok, since the absence of desire for food is determined primarily by biological expediency and this symptom is common for all mammals. A cat and a mouse when sick do not want to eat. At the first glance, something is not logical here. It is necessary to fight the disease, energy and strength are needed, how it is possible not to eat in such a crucial moment … But this seems so only at the first glance.
The main manifestations of acute diseases (pain, stress, high body temperature, lack of oxygen) cause the standard reaction – the blood circulation is activated in the vitally important organs (brain, heart, lungs), and the vessels of the less significant organs are narrowed. Vasoconstriction and significant blood flow decrease are expressed specifically in the intestine. Its peristalsis is reduced, less intestinal juices are produced, and they become denser. It is clear that the intestine “doesn’t think” about food in such a situation.
Intestine disorders (diarrhea, pain, bloating) in children (and in adults as well!) may occur and often occur with any disease, even a special term for this exists – “irritable bowel syndrome”. It is paradoxically but easily explainable that the frequency and severity of irritable bowel syndrome is directly related not only to the severity of a disease but also to the parents’ efforts to feed the sick child.
Liver is the most important organ of the digestive system and at the same time, it is the main “fighter” with the infections. Exactly the liver is an active member of immunoglobulin synthesis – the well-known antibodies that neutralize viruses and bacterial toxins. Again, the liver is a powerful filter that stops and detoxifies poisons and tissue breakdown products. It is clear that in case of acute infection a load on the liver is high, and loss of appetite is an important protective mechanism the goal of which is obvious: to give the liver an opportunity to focus on the functions more necessary than food digestion.
The next fact becomes clear: reduction or loss of appetite in a sick child is an absolute norm. The greater the load on the body, the more pronounced loss of appetite. As the load is decreasing, the appetite is being restored. And this is one of the symptoms that clearly indicate the beginning of recovery.
With chronic and long term diseases the situation is not so straightforward. A growing child’s body is relatively quickly adapted to the changes and appetite persists. With some diseases (diabetes for example) appetite is even increased. But a tendency is distinct in this case – if the disease leads to a decrease in energy expenditure (the child cannot move or moves a little), it is reflected not on the appetite, but rather on the amount eaten food. And only with very serious, very long and very dangerous diseases there is a sharp appetite reduction or its total loss. And this is always a very serious …
Final recommendations on sick child nutrition can be expressed in two simple rules:
1. appetite is the main criterion for the frequency and volume of feeding ;
2. attempts to force-feeding are absolutely unacceptable.
It is clear that food depends on a particular disease – obviously that with an intestinal infection, viral hepatitis and a broken leg, food permissible for consumption will be different. And conclusion here is simple: if the loss of appetite is really a symptom, I mean one of the disease signs, there’s no need to fight this symptom. It is necessary to help the body cope with a particular disease, but the basic tactical and psychological problem is that active feeding a sick child does not help him recover, rather on the contrary.
A very special situation is refusal to eat connected not with body disorders but with mental ones: when a teenage girl starts to struggle with her weight and perceives this fight as the meaning of her life; when refusal to eat, along with other disorders of communication and behavior, is one of the symptoms of apparent mental illness. It is clear that in such a situation all the above discussion of the liver and intestines loses value. And in this case the parental care algorithm is not to feed the child at any cost but to eliminate the true cause of the disease with the help of a specialist (a child psychologist, psychiatrist).