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My child refuses to eat since the beginning of CoVID-19 lockdown… What can I do?

Dr Coline Stordeur, child psychiatrist and Séverine Petit, dietetician

Reference center for endocrine growth diseases

Reference center for rare disease – Early-Onset Anorexia Nervosa

Center of Excellence for Neurodevelopmental Disorders – Robert Debré Hospital, Paris

Due to the CoVID-19 pandemic and consequent confinement, you worry because your child is eating less or almost nothing ?

Make it less dramatic! If your child did not have any eating disorder previously, everything should quickly get back to normal. Children are well aware of their parent’s anxiety and the current situation is totally novel and stressful for us all. Routine and family organization changes together with the ongoing confinement measures can affect them (and you too). It can cause anxiety and/or defiant behaviour and can have an impact on their appetite. Loss of appetite is often a demonstration of acute stress in young children.

So, what can I do ?

First, it is important to check if this behaviour is not a symptom linked to a recent infectious disease. Check if there is no fever or other flu symptoms (runny nose, sore throat, pharyngitis, body ache or even diarrhea). If your child has pain, fever or is coughing in addition to reduced eating and/or drinking, then call the paediatrician for medical advice by phone/videoconference. During this period, it is often difficult to have access to your primary care physician, because most of them are receiving many adult patients. Don’t panic.

If appetite loss is an isolated symptom, with your child forgetting lunch or not finishing his meal anymore, then it may be an acute stress symptom.

How can I help my child if she or he shows signs of acute stress ?

Our answers in 10 points.

1. Reassure your child and do not force him to eat by yelling at him. Check the post How to help your child anxious about Coronavirus ? on our website. Reassure yourself too!

2. Foster communication, let him speak and ask questions but do not force the discussion on coronavirus if he or she does not wish to raise the subject at the moment. Ask him what he already knows about the subject in question and complete with simple answers.

3. Use a playful approach during meals: encourage your child to participate and help in the preparation of meals, ask to help you finding recipes and planning weekly menus.

4. Favour your child favourite food even if his diet will not be as balanced as usual.

5. Do party meals sometimes (homemade pizza, waffles, …) and try new recipes! Try to make meals a more pleasant moment than usual.

6. Install flexible meal rules. For example: “we come to the lunch/dinner table even if we do not want to eat, we taste a bit and we stay at least 15 minutes”.

7. Make your meals a peaceful moment. Do not listen to news during the meal, do not watch tv or use your phone. Try to engage your child in conversation about his friends, or what he or she wants to do in the afternoon or the evening.

8. Both parents should be consistent on rule application. Try to not argue during the meal for example by saying “you see, he is not hungry” when the other parent orders “eat!”

9. Keep routines or create new habits that favour a regular rhythm of life, with fixed mealtimes during weekdays, slightly different on weekends. Try also to have a fixed schedule for sleeping during the week.

10. If eating difficulties persist even after following the advice given here, do not hesitate to call a health professional (paediatrician, psychologist, child psychiatrist) by phone or videoconference.

Translated by Dr. Vincent Trebossen (psychiatrist)

48 Boulevard Serurier, 75019  Paris France

©2020 by Dr. Benjamin Landman. Child Psychiatry, Robert Debre Hospital - Paris