Lack or loss of appetite is known as anorexia. Infantile anorexia occurs when the baby refuses to eat adequate food for at least one month and shows growth deficiency. They also do not communicate hunger and lacks interest in food.
The baby’s refusal to eat need not follow a traumatic event or be due to underlying medical illness (1). Infantile anorexia is also different from anorexia nervosa, which occurs in adults and adolescents often due to fear of gaining weight. Infantile anorexia can be concerning to parents, but it can be managed and treated.
In this MomJunction post, we explain the causes, signs, and ways to manage infantile anorexia.
When Does Infantile Anorexia Occur?
Infantile anorexia may begin at any point in time during the first three years of the baby’s life. However, some research studies state that it more commonly arises between nine and 18 months of age. It could be because the phase marks the transition to spoon-feeding and then to self-feeding (2). However, not all babies develop infantile anorexia during the transition phase.
Signs Of Infantile Anorexia
- Consistently refuses food for at least a month
- Never communicates hunger
- Throws food-related tantrums
- Stops eating after a few bites
- Does not gain weight
- Shows weight loss
- Is malnourished
- Gets distracted with play during mealtimes
Some babies also exhibit sensory food aversion (SFA) along with infantile anorexia. In this condition, the babies might only eat a certain food that has a specific taste, temperature, consistency, texture, and smell. They do not try new foods and are very particular about the kind of food they eat.
When the baby is coaxed to try new food, they might make faces, spit, gag, or vomit. Such babies refuse a particular food group increasing risk for nutritional deficiencies. However, when offered their preferred food, the children eat it without difficulties and usually do not show growth failure, or even mau become overweight (3).
Causes Of Infant Anorexia
Research suggests that the cause of infantile anorexia is often related to the baby’s emotional needs and parental conflict. The following are some salient points about the likely reasons behind the development of infantile anorexia(5).
- As the baby grows, he/she begins to develop autonomy, which is the condition of self-governance. In this phase, babies want to make their own decisions, including their choice of food.
They deliberately refuse food in order to gain maternal attention towards their needs.
- Factors like maternal depression and maternal eating disorders can also cause infantile anorexia in babies. Depressed mothers have shown less positive engagement while feeding the child. All this can harm the emotional condition of the baby, and the baby might decline eating food(6).
- Babies growing up in dysfunctional families or babies non-optimal caregiving system may increase the risk of infantile anorexia (7).
Emotional reasons and parent’s behavior towards feeding are significant reasons behind infantile anorexia. If you suspect your baby has anorexia, then it is good to see a doctor.
Treatment Of Infantile Anorexia
Timely treatment of infantile anorexia is essential for preventing severe nutritional deficiencies in babies. There are three major treatment pathways that can help the baby come out of infantile anorexia (3).
- Encouraging the baby to identify and convey the inner cue of hunger as well as satiety.
- Encouraging the baby to consume different types of food and providing whole foods.
- Ensuring adequate energy and nutritional intake.
The nutritional care for babies with infantile anorexia focuses on designing a refeeding plan that satisfies the following areas (3).
- Providing the required energy levels for healthy physical activity and new tissue deposition and formation
- Providing an appropriate diet for the age and developmental requirements
- Encouraging the baby to self-feed
- Gradually making the baby less dependent on liquid calories and nutritional supplements
While making these changes, the baby should be monitored for any changes in body weight, any other digestive issues, such as diarrhea or constipation.
If the doctor detects parental conflict as a cause of infantile anorexia, then the following measures might be suggested (8).
- If constant friction between the mother and the baby is the main cause, then the father’s intervention may be recommended. The baby’s father can work as a compensative or balancing factor between the mother and the baby. It might encourage the baby to try a wider array of nutritious food.
- The mother is counseled about the issue with the child and asked to tolerate the difficulties of the weaning phase.
- If the mother is too anxious or there are emotional issues with the parents, then the parents might be referred to psychiatric counseling.
The treatment of infantile anorexia can involve the use of multiple modalities for a complete recovery and prevention of relapse.
Tips To Help Your Infant Feed Better
You can follow these tips and note if you see any positive changes in your baby’s feeding habits (4).
- Let the child feel hungry by himself/herself.
- Space out the meals throughout the day. Give them food at a gap of three to four hours and give only water in between.
- Introduce finger foods.
- Give them small portions of food and let them ask by themselves for a repeat serving.
- Encourage them to sit on the dining table till “mommy” and “daddy” have their tummies full. A baby who learns to sit patiently may eat better.
- A single meal session should not last for longer than 30 minutes, even if the baby has not eaten enough.
- Appreciate your baby when they eat by themselves but do not use the consumed food quantity as a measure to encourage or discourage the child.
- Do not allow any distractions like electronic media, books, toys, etc., while feeding them. It might only work temporarily and will not help the baby learn or understand the inner cues of hunger and satiety.
- Do not bribe a baby by saying that you might gift them something if they finish their meal.
- Discourage them from playing with food.
- If they throw a tantrum or try to jump out of the chair, then warn them. If they continue the behavior, give a “time-out”. Time-out is when your child is removed from the place where the misbehavior happened. Your child is away from all the fun things, and they do not get any attention from anybody in the family during a time-out. It is a zero-attention time. Time-out works to change problematic behavior since children don’t usually like to be bored(9).
Can Anorexia Be Genetic?
Studies show that anorexia runs in families. Researchers have also identified a couple of genes might be associated with anorexia. Mothers with anorexia might be more likely to have babies who develop infantile anorexia. However, it is not necessary that every mother who is anorexic will have a baby with infantile anorexia. Discuss with your doctor if you have a fear of your baby developing anorexia(10).
Various studies have proven that infantile anorexia is related to behavioral, psychological, and social issues related to feeding and parent-child interactions. Offering the baby his/her favorite food all the time, scolding, distracting, punishing, etc. might work for a few days, but it is not a permanent solution. Making the child understand that eating is a necessary routine, and not a compulsion is necessary. Be patient with the baby and seek help from a pediatrician.
Do you have any experience to share? Let us know in the comment section below.
2. Gonca Ozyurt et al., Father’s role in infantile anorexia; The Turkish Journal of Pediatrics
3. Catherine J. Klein et al., Infantile Anorexia; ICAN: Infant, Child, & Adolescent Nutrition
4. Altering Parents’ Behavior Often the Key to Correcting Infant Feeding Disorders; Medscape
5. Chatoor I, Infantile anorexia nervosa: a developmental disorder or separation and individuation.; U.S. National Library of Medicine
6. Loredana Lucarelli et al.,Maternal psychopathology and child risk factors in infantile anorexia; International Journal of Eating Disorders
7. Loredana Lucarelli et al., Infantile Anorexia, and Co-parenting: A Pilot Study on Mother–Father–Child Triadic Interactions during Feeding and Play; U.S. National Library of Medicine
8. Leonardo Sacrato, Alessandro Pellicciari, and Emilio Franzoni, Emergent factors in Eating Disorders in childhood and preadolescence; Italian Journal of Pediatrics
9. What is Time-Out?; Centers for Disease Control and Prevention
10. How Eating Disorders Are Inherited; American Association for the Advancement of Science