Usually children tend to become very choosy while having their meals, making the lives of parents miserable. So, if your child is a fussy eater, then worry not, as Dr Ibrahim advises on how to tackle fussy eaters.
Query: My four-year-old son is a fussy eater and does not put on weight. At present, he weighs only 15 kgs. He does not take any healthy food such a fruits and vegetables, however, he loves junk food such as chips, juice etc. He loves to eat noodles but there is nothing healthy about it. How should I make him love healthy food and make him eat meals with the family?
Dr. Ibrahim: Children are normally averse to healthy food items. The kind of habits we develop in our child early on continue till they grow up. A child that is given fruit when he or she is a toddler will love fruit even after growing up. The best thing is to avoid junk food as much as possible when the child starts taking food. However, if they develop aversion to healthy meals, the following few tips can help. Also parents, especially the mother has to work hard to change her child's habits. Here is how:
‑Know your child's appetite. Some children eat a lot, others have a small appetite. If your child does not eat large portions of food or is not hungry, do not force him. Likewise, do not force your child to clean his or her plate or eat certain foods. This will make your child associate meal time with anxiety and frustration. Serve small portions to avoid overwhelming your child and give him/her the opportunity to independently ask for more.
‑Know your child's choices. You may have to cook food that your child likes. If your child likes juice, do not let him have it throughout the day. Make it a special treat for meal times.
‑Make the food interesting. Serve vegetables with a favourite dip or sauce. Cut foods into various shapes with cookie cutters. Serve a variety of brightly coloured foods to trigger enthusiasm and interest.
‑Try to avoid buying/offering junk food from weaning up to school years. If a young child will not have access to these foods, they will not want them. It is in these young years that taste for junk food develops. Don't try to introduce the idea to your child that these items are treats or rewards. However, if your child is already in a habit of eating such food, then limit his intake as much as possible. If you won't buy them, he won't have them.
‑Reduce snacks between meals. If your child will not eat between meals, he will inevitably be hungry at meal times and might compromise on whatever comes his/her way.
‑Lastly, do not fret. This is a common problem and the child outgrows it eventually. Yours will too.
Q: My eight-year-old daughter gets pain in her legs every night after she goes to bed. The pain is quite severe and she makes me massage her legs to get relieved. My family doctor has done X-rays of her hips and knees and they are fine. I do not know why she is having them as she did not get injured either. Kindly advise me.
Dr: The details that you have provided and the fact that the X-ray has come normal indicate towards the fact that your daughter is just having growing pains. It starts at three years and may carry on till eight years of age. This ache and discomfort results from jumping and other physical activities that active kids do during the day. A child can never sit still like adults do. Growing pains always concentrate in the muscles rather than joints. Most kids complain of having pain in front of their thighs, calves or behind the knees. Although they often strike in late afternoon or late night, they can also sometimes wake a sleeping child. The intensity of the pain varies from child to child. It is not necessary that the pain would be in both the legs. It can be in one leg as well. Most of the children do not experience the pain every day.
Kids who have pain due to any serious medical disease for example, Osteomyelitis, Septic Arthritis or fracture would not even let the parent touch the spot because movement tends to increase the pain. Plus, the pain in these medical conditions is persistent and the area of the pain will have redness and swelling. It will be hot; the child will limp and will have weakness, loss of appetite and tiredness. He/she will also show uncharacteristic behaviour.
A child having just the growing pain responds differently. They feel better when they are held, massaged and cuddled. If still you think that your child is having something other than growing pains then go to a paediatric orthopaedic. He might recommend some blood tests, MRI and CT scans for further investigation. At this point, it just seems to be simple growing pains.
Q: Is there any link between Hypothyroidism and Autism?
Dr: There is no connection between Hypothyroidism and Autism. Autism is abnormal development in three main areas namely, communication, relationship and behaviour. Children with autism experience delayed speech development. If they do speak they often repeat words. They also have problems in non-verbal communication; such as they may not make eye contact while speaking or to show that they are listening or point towards things that they find interesting. There is another form of autism in which a child may speak correctly but might struggle with the finer point of social language use. Other major symptoms of autism are violent temper tantrums that may be an expression of extreme frustration and unhappiness. Early detection of autism greatly improves the outlook.
The symptoms of thyroid problem are growth retardation, constipation, cold intolerance, less energy, increased sleepiness, and delayed bone age. It can be diagnosed through lab investigation and corrected by taking thyroid hormone replacement medicine.
Dr. Ibrahim Yusuf MBBS DCH M.D MRSH (LON) is a specialist in child and newborn diseases. For instant paediatric advice email your problem at firstname.lastname@example.org