Selective feeding of children: when to worry and how to intervene

Fonte: shutterstock

It had happened in 2022 and the news had gone around the world: in Bristol, England, a 17-year-old boy developed severe vision impairment as a result of an extremely selective diet, which for some years led him to eat only French fries and, occasionally, a few slices of white bread with ham or sausage.

As reported in the Annals of Internal Medicine, the boy met the doctor at the age of 14 due to persistent fatigue. Blood tests showed one vitamin B12 deficiency, for which he had received a prescription for a supplement and a set of food advice, which, however, he had not followed. The following year, the visual disturbances began, which progressively worsened to practically complete blindness, caused by irreversible damage to the optic nerve. Throughout this period, the diet had not improved: only fried potatoes, bread and a few slices of ham or sausage, with an aggravation of vitamin B12 deficiency, to which copper, selenium and vitamin D deficiencies were added.

Read also: Supplements and vitamins for children

The importance of vitamin B12

For the doctors who have followed his case, it is a demonstration of how a particularly inadequate diet can also be dangerous for eye health. On the other hand, vitamin B12 in particular is essential for the development of the central nervous system, with a valuable role in the production of new cells and the regulation of metabolism. Not surprisingly, its deficiency in vegan diets - remember that this vitamin is contained only in animal products and we cannot make it for ourselves - is one of the main reasons why many pediatricians are skeptical of the choice of this diet for small children and all guidelines on the subject recommend, in case of a vegan diet, careful supplementation with vitamin B12 supplements.

Read also: Vegetarian or vegan diet for children and teenagers: 11 tips to avoid taking risks

The Bristol case and the concern of Del Paeseni's parents

For the parents of children who, even in Del Paese, eat only a few foods, rejecting the vast majority, the story of the boy who went blind was a source of concern. "In reality, I don't think it should be too alarming: it is an extreme situation. But it must solicit parents or deal actively and promptly with the problem of food selectivity, which on the other hand is often neglected "comments the doctor Giuseppe Morino, head of the Food Education Unit of the Bambino Gesù Children's Hospital in the city.

It is also on the same line Alberto Ferrando, pediatrician president of the Ligurian pediatricians association, author of the book How to feed my son: "The case of the English boy is sensational and serves to send an alert to parents, so that they acquire greater awareness of how the family eats and try to regain a healthier diet, mainly plant-based (including dried oleaginous fruit) and with little red meat ".

In this article

  • When selectivity is normal
  • The risks of selectivity
  • How to behave?

When a minimum of selectivity is normal

In reality, a minimum of selectivity can be physiological in some moments of life. "For example - explains Morino - at the time of weaning, or between two and three years, when the child begins to show oppositional behaviors, saying no to anything, including what is on the plate. "In addition, it is necessary to take into account, always around two years, a certain neophobia, fear and avoidance of new foods such as meat or other dishes.

"What is important, in these circumstances, is to avoid triggering a role play in which, in order to get him to eat, the child is given only what he wants, because this risks aggravating selectivity" comments Ferrando. Of course it is normal for parents to worry when their child does not eat, we are evolutionarily "programmed" for this to happen, "but it should not be forgotten that if a child skips a meal today, nothing happens".

Read also: Picky children at the table, here's what to do

Selectivity in adolescence

Even in adolescence it can happen that a certain selectivity is established at a certain point, in relation to unregulated behavioral styles (for example the habit of going to fast food) and a sense of inadequacy for one's body. Also in this case it can be a passing moment, but the signals (prolonged avoidance of certain foods, weight loss, difficulty in eating with others) must be kept in mind to prevent refusal of food from being a simple "physiological moment" turn into an eating disorder.

The risks of selectivity

If the attitude of refusing more and more foods, greatly restricting the variety of food, continues for a long time, however, the situation risks becoming critical, because extreme selectivity can pose health risks. "The main problem is that very caloric foods, rich in carbohydrates, such as pasta, potatoes and pizza, are often favored, at the expense of foods rich in fiber, vitamins, minerals and in particular vegetables and fruit" says Morino.

Obesity or excessive weight loss

"This can lead to obesity, even if in some cases the limitation leads instead to effects on the opposite side, that is to a excessive weight loss. In both cases there is a condition of malnutrition, with nutritional deficienciesthe".

Arfid, a real disease

And sometimes selectivity is a manifestation of a real disease, called Arfid, an eating disorder characterized by the fact that the affected child he avoids food, is not interested in it, or selects it very carefully, eating only foods of a certain color or texture.

Read also: Arfid: the new eating disorder of children who avoid or select food

How to behave if the child is selective

What to do if the child is selective at the table? He answers in this podcast Gloria Barraco, nutritionist and researcher. She is the author of the book "Freshmen at the Table. The first nutrition manual for non-resident students and beyond."
He runs a blog where he talks about health and biological rhythms

Selective children, what to do

What to do if a child begins to refuse food (which he may have liked until the day before), restricting his diet to only a few foods?

  • Preventing the risk, starting with weaning
  • Lead by example
  • Stay calm, but act in a timely manner
  • Continue to propose the foods that the child refuses

"The first thing to do is to try to prevent this risk, offering the child a diet that is as varied and balanced as possible starting from the moment of weaning "says Ferrando. He strongly underlines how this moment must concern not only the child but the whole family."Parents are the first to set a good example, putting healthy meals on the table with a great variety of foods ". Thus Ferrando tells of" pulling the ears a little "to those parents - they are above all dad - who tell him" but I don't eat fruit and vegetables "." Oh no - replies the pediatrician - fruits and vegetables are essential for a child's healthy development, therefore the great must strive to set a good example, immediately ".

If, in any case, there are refusals and restrictive choices, it is necessary keep calm but react in a timely manner. "The foods that the child refuses must be continually proposed again, certainly in a non-obsessive way and certainly without forcing him to eat them. But it is very important that they do not disappear from the table".

Often, after a selective period, the child first returns to taste and then to eat other foods, but if this does not happen - for example because the temporary difficulty with food is linked to a negative event, such as the death of a grandfather, the separation of parents, a disease - it is the case to go to a specialist.

Rebuilding a relationship with food

"In these cases it is necessary help the child to rebuild a relationship with food, which for some reason has been interrupted "states Morino, explaining that for the Child Jesus they have developed a multisensory familiarization path with food, to which the child approaches "playing" with the different senses - sight, smell, touch - until you get to taste. "The path aims to tickle the curiosity of the child and foresees that the little one is involved in the choice of food, therefore at the time of shopping, in the decision on what to cook, in the preparation. Then at the time of the meal it is necessary that all prepare together a beautiful colorful table, placing in the center of the plate small portions that the child can touch, manipulate, bring to the mouth even without the use of cutlery ".

Read also: Weaning, the bungling baby learns first

"The important thing - underlines Morino - is that everything happens in a serene way, but with a precise rule: there is no alternative to the meal on the plate. It was decided together, it was prepared together and we eat it together. If the baby does not eat it, it will not be offered after a glass of milk, yogurt or other. "Again, as when the baby gets used to new flavors and new textures during weaning, repetition is essential. "To introduce a new food into your diet it will not be enough to propose it once: you will have to do it over and over again, even dozens of times, experimenting with different preparations".

Read also: Food-selective children: they are more sensitive

  • child diet
  • podcast
add a comment of Selective feeding of children: when to worry and how to intervene
Comment sent successfully! We will review it in the next few hours.