Does your child have a poor appetite? If the answer is yes, then you are not alone. This problem appears to be rife in the Down syndrome community and obviously causes parents and children a great deal of stress. We know that providing a nutritious diet is the best option but what if our children just aren’t interested in eating?
Children can be fussy eaters and appetites do wax and wane, but food refusal and fussiness is often put down to behavior or stubbornness, which may not necessarily be the case. Viewing food challenges through this lens only can have a detrimental effect in the long run, if underlying issues aren’t addressed.
Appetite is a reflection of our overall health and when it’s poor, indicates that something is out of balance and needs addressing. This article will shine a light on the most common physical reasons for poor appetite and ways in which you can tackle them.
If your child has a high sugar diet, it’s quite likely that they also have a low tolerance for other foods. A high sugar diet doesn’t necessarily mean one that is filled with cakes, biscuits and sweets. Commercial breakfast cereals, yoghurt, milk, sauces, dips, bread and fruit juice often contain very high amounts.
Food stimulates receptor sites in the digestive system which then triggers appetite, desire and reward for food. Sugar stimulates this response almost immediately, which can become extremely satisfying and addictive. So much so, that scientific studies have shown that when given the choice, rats would choose sugar over cocaine.
It’s not easy to wean a child of sugar but it is possible. The first step is to take a look at the foods you are currently providing and if you feel that sugar levels are too high, start to slowly reduce the daily amount.
Include recipes with sweet vegetables such as pumpkin and sweet potato, add fruit puree to plain yogurt for example and look out for recipes that can replace firm favourites, so you can control the amount of sugar that goes into the food.
I wouldn’t recommend going cold turkey, as your child will go into withdrawal and you could find yourself in a lot of trouble. You may like to pick up one of Sarah Wilson’s “I Quit Sugar” cookbooks for assistance, most of which can be found in your local library.
I’ve heard numerous cases of children who were fussy eaters until their mineral status was improved. Zinc, magnesium and iron deficiency are all linked to poor appetite. In fact I had a call this morning from a mum to say her young daughter’s appetite has dramatically improved since the introduction of zinc supplementation.
Children with Down syndrome and autism often appear to have low levels of these minerals, so arranging for a blood test and supplementing if necessary is a very worthwhile endeavor, not just for the potential appetite improvement but for overall health and well-being.
STRESS, HIGH CORTISOL AND BLOOD SUGAR REGULATION
Do you feel hungry when your stressed or busy? I know I don’t. Many of us hold tension in the gut which really kills the appetite, inhibits the flow of gastric juice and slows down peristalsis. If your child is highly sensitive and of a nervous disposition, then this may certainly be playing a part in their food challenges.
When we are in fight or flight mode it’s not possible to rest and digest. The last thing on our mind is food, we only want quick fuel in order to survive. The adrenal glands produce cortisol, adrenaline and glucose to feed the brain quickly when were in stress mode, what children crave in these moments is sugar, it’s a physiological response that feels like a survival strategy.
Children with Down syndrome and autism can be highly sensitive. with nervous systems that struggle to keep up with and process sensory input. If your child fits this picture, you can start to understand why even colourful or textured foods could tip the sensory input into overload. It’s quite simply a self preservation strategy.
We can assist our children by allowing time to relax before meals, reduce other sensory input like loud music or the television and simple strategies like laying the table and placing a relaxing candle in the middle. There are many other ways to address sensory overwhelm and stress in our children, a huge topic that will have to wait for another day and another article.
If your child has digestive problems such as IBS, indigestion, constipation or diarrhea, it’s likely that underlying issues such as candida, parasites or unbalanced gut bacteria, will be contributing to poor appetite. I know that for many of you, your child has or is experiencing gut issues such as these, which seem difficult to treat with both conventional or natural medicines such as herbs and probiotics.
The very best way to really get to grips with what’s going on in your child’s gut is to have a comprehensive stool analysis. This is not a cheap treatment however is one of the most worthwhile investment’s you can make towards your child’s health.
Stool tests determine the levels of beneficial, as well as harmful microbial levels in the gut. A GP can order a test that looks for parasites, however for a more comprehensive look at the factors contributing to gut problems, you would need the expertise of a Naturopath or Integrative Doctor.
These natural health practitioners can arrange a test for you, analyse the results and provide a treatment plan for your child. Make sure before booking an appointment that the practitioner is specifically trained in how to interpret results, as I’ve heard of parents who’ve been left high and dry with results and poor interpretation.
Low levels of hydrochloric acid
Hydrochloric acid (HCL) is produced in the stomach and assists in the breakdown of foods, especially proteins, it is also necessary for the absorption of important nutrients such as B12 and zinc and also helps maintain healthy pH levels in the stomach.
It appears that children with Down syndrome can have low levels of HCL due to gene over-expression, which causes issues with digestion and the production of a hormone called motilin, which helps control the contraction of the intestines (peristalsis). Both motilin and peristalsis are involved with the signalling of appetite.
It is possible to order a test that determines HCL levels, however, if your child suffers with indigestion, bloating or reflux after eating protein, this can be a strong indicator that levels are low. Ironically the mainstream medical approach is often to prescribe acid blockers, which can only make the condition worse.
If you are open to supplementation, there’s a possibility that this issue can be overcome by introducing a specialist multi-nutrient formula to address the underlying genetic over-expression, which is at the root of this particular problem.
The other options are to include sauerkraut juice, or digestive enzymes with each protein meal, or 1/2 tsp of diluted apple cider vinegar 10 minutes beforehand (this amount would suit a 4-5 year old, less if younger). It is possible to purchase betaine HCL supplements, however I feel that this would only be appropriate in extreme cases, with diagnosis and treatment overseen by a healthcare professional.
Digestive enzyme supplements replicate what the body should be doing, which is producing enzymes to break down proteins, fats, carbohydrates and associated nutrients, they also assist with stimulating hydrochloric acid and pepsin production in the stomach.
Supplementing your child with enzymes will certainly assist in taking the pressure of the stomach and small intestine and can be a great treatment option for helping to alleviate constipation, food allergy, bloating and nausea, which result from poorly digested food.
There are many brands of digestive enzymes available, you may wish to check out the following, Tri-Enza, Vital-Zymes, DigestEnz, Enzymedica or Nutrivene digestive enzymes.
Where digestive enzymes take over the bodies role by supplementing, herbs actually stimulate the body into producing digestive enzymes an juices, therefore improving overall digestive function.
There are many herbal options that are safe and effective for children, Iberogast being one of the most well known. This formula is recommended by naturopathic practitioners for a variety of digestive issues. It’s suitable for babies and children.
Iberogast is available in most health foods shops and even pharmacies. This formula does contain Milk Thistle which is contraindicated in Down syndrome due to it’s sulfur content, the amount found in this product is however minimal and therefore in my opinion still makes the product suitable.
If your child is 12 years old or over then Swedish Bitters, which are also freely available, provide exceptional digestive support and appetite stimulation.
If you are looking for an effective home remedy, then loose leaf peppermint and crushed fennel seed tea is a great digestive stimulant and it tastes good too. Ginger is another excellent digestive tonic. Organic liquid ginger drops can be purchased freely online or in health foods shops and may be mixed with honey to improve the flavour for children. You can of course make a tea using fresh ginger and hot water.
A child who struggles to eat, can be a very stressful experience for a parent, especially if you’re cooking great meals that are being neglected or worse thrown on the floor.
It’s worth considering that your child’s lack of food co-operation may be due to lack of appetite or other factors mentioned. This article provides lot’s of ideas to get you started with improving digestion and appetite, which will hopefully bring positive results. It may seem very overwhelming, so I suggest taking things step by step in the following order.
1. Take an honest look at sugar consumption
2. Check for nutrient deficiencies
3. Consider sensory issues and stress levels
4. Support the gut
If nothing is changing and you’re worried about it, then it’s important that you find someone who can listen to your concerns, if you believe that your child’s food aversion is more than more than just fussiness, and look at some of the possible underlying causes mentioned above and start a treatment plan.
Motilin and MMC in SIBO and hunger signaling. http://ajpgi.physiology.org/content/310/4/G228
ACV and increased mineral absorption https://www.ncbi.nlm.nih.gov/pubmed/8909697
Iberogast herbal drug treatment for GIT disorders https://www.ncbi.nlm.nih.gov/pubmed/12618546/
Sugar addiction and behaviour https://www.ncbi.nlm.nih.gov/pubmed/?term=PMC223590
Sugar and opiod addiction https://www.ncbi.nlm.nih.gov/pubmed/?term=12055324
Zinc as an appetite simulator https://www.ncbi.nlm.nih.gov/pubmed/21846317
Zinc deficiency can cause lack of appetite https://www.ncbi.nlm.nih.gov/pubmed/21624198
Magnesium and loss of appetite https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455825/
Appetite in children with iron deficiency https://www.ncbi.nlm.nih.gov/pubmed/11448591