Food fads and food refusal are common in preschool children, but only in a minority is the behavior severe or persistent.
When this happens it is often because the parents are unintentionally reinforcing behavior that would otherwise be transient.
Usually, children whose parents are concerned about their eating habits are healthy and growing well. Picky eating is more common in those who have had less chance to experience a wide range of foods, or when parents are very anxious about the correct amount and type of food the child should have.
Some parents offer alternative (and sometimes unsuitable) food, or take other steps to persuade the child to eat, which reinforces the behavior.
Parents should be encouraged to ignore the feeding problem as far as possible, to refrain from offering the child alternatives when they do not eat what is first offered, and to stop using other special ways to persuade them to eat.
Pica is the eating of items that are not foods (e.g. soil, paint, and paper). It needs to be separated from the exploratory mouthing of objects in children aged 1–2 years.
Pica is often associated with other behaviour problems, autism, or learning disability. Parents should be reassured that the problem is a recognized disorder that usually improves. They should take common-sense measures to keep the child away from non-edible items, and reduce stressful situations.
With this approach the problem usually disappears; if it does not there may be a wider problem requiring specialist assessment.
Spitting up (burping up) is the effortless return of swallowed formula or breast milk through the mouth or nose after feeding. This is normal as long as it is not excessive. Almost all infants spit up, because infants cannot sit upright during and after feedings. Also, the valve (sphincter) that separates the esophagus and stomach is immature and does not keep all of the stomach's contents in place. Spitting up gets worse when an infant eats too fast or swallows air. Spitting up usually stops between the ages of 7 months and 12 months.
Spitting up can be reduced by
Vomiting is the uncomfortable, forced throwing up of feedings. It is never normal. For a more complete discussion, see Vomiting in Infants and Children.
Vomiting in infants is most often the result of acute viral gastroenteritis. Viral gastroenteritis is an infection of the digestive tract that causes nausea, vomiting, diarrhea, and cramps. Vomiting can also be caused by infections elsewhere in the body, such as ear infections or urinary tract infections.
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