A healthy balanced diet is important for the proper growth and development of any child. For children with arthritis, there are issues related to their condition that may influence what and how much they eat.
When a child is experiencing a flare, the body releases appetite-suppressing hormones explains Kristi King, MPH, RDN, CNSC, LD, senior pediatric dietitian at Texas Children’s Hospital. Alternatively, some side effects from certain medications may cause increased appetite, excessive thirst, dry mouth and stomach upset.
“A child with JA also may be dealing with emotional issues, such as stress and anxiety, both of which can lead to an increase or decrease in appetite,” says Keith-Thomas Ayoob, EdD, RD, FAND, associate professor of pediatrics at Albert Einstein College of Medicine.
We asked King and Ayoob for tips parents can use to help their child deal with these eating challenges.
- Serve your child small meals throughout the day at regularly scheduled times (e.g., breakfast, morning snack, lunch, afternoon snack, dinner and a healthful dessert). When children have a low appetite, small meals aren’t as overwhelming as three larger meals.
- Even if your child doesn’t want to eat, encourage him to take a few bites. You may consider combining multiple foods so he has a variety of taste sensations, e.g. offer a fruit plate with a few apple slices, grapes and strawberries and a dollop of yogurt or peanut butter.
- Ensure the foods you serve are nutrient-rich. If your child is struggling to maintain or gain weight add healthy fats, such as olive oil and avocado to boost calorie content. Avoid the urge to let your child eat anything just to put on weight.
- Avoid food battles so eating remains an enjoyable activity. Sometimes placing more attention on the situation will only make a kid dig his heels in even more and turn down food.
- Encourage your child to sit at the table for meals and snacks so the focus in on eating. Try to avoid or minimize TV watching at this time.
- Consult your physician or a registered dietitian to determine whether your child could benefit from a nutritional supplement.
- Keep healthful, nutrient-rich foods easily accessible at home and on the go.
- Devote at least half of the plate to fruits and vegetables at all meals and snacks. Fruits and vegetables are low in calories and high in fiber, which helps children feel satisfied on fewer calories.
- Hunger can be confused with thirst. Making sure your child is well hydrated may help to normalize his appetite as well.
- Encourage your child to drink water and limit sugary beverages like soda, juice and punch.
- Include protein and a fruit or vegetable in every snack (an apple with low-fat cheese, low-fat yogurt and fruit, peanut butter and celery) to help fill your child feel satiated without excess calories.
- Discourage grazing (letting kids eat whatever and whenever they want throughout the day). This can lead to an unbalanced and/or high-calorie diet.
It can be difficult to differentiate between arthritis-induced appetite changes and normal growth spurts. Your child’s clothing is one indicator (short pants could mean he/she is getting taller). With a growth spurt, you may also see your child’s appetite increase over a few days and remain steady before decreasing again. Whether your child has a low or high appetite, limit distractions, such as playing electronic devices during meal time so he or she can focus on nourishing their bodies. If your child is gaining weight from long-term steroid use, consult a dietician who may be able to suggest new and different food choices. Make physical activity a priority as this may help your child to burn excess calories. Involve the whole family in nightly strolls, bike rides or active outdoor games.
“Food battles usually stem from kids craving control, particularly since they can’t control their arthritis,” says King. “Involving the child in grocery shopping, cooking and planning meals will make them more invested in the process — and more likely to eat what they helped prepare.”
The most important strategy for managing your child’s nutritional health is being aware of fluctuations. If you notice a significant difference in eating habits that persists for one to two weeks, talk with your child’s doctor and/or consult a registered dietitian.