Children present with this symptom quite commonly to the clinics. Often it is associated with lack of energy levels and other symptoms such as pain, weight loss, constipation or diarrhoea.
A lot of children tend have eating behaviours which cause concern among parents but who are other wise well. This is particularly noticeable in the toddler age group which can range from 15 months to 4-5 years of age.
The assessment of these children is to identify any underlying features of concern. Often constipation tends to reduce the appetite in children and this can become a vicious cycle. Most children generally have good energy levels and seem to show good growth when plotted on the WHO growth charts (red book).
The aim of the consultation in these children is to ensure that adequate information is gathered about the symptoms and appropriate investigations are planned. These children may need routine investigations such as blood tests initially followed by follow-up plan after some additional advise to help improve the feeding behaviours. A few of these children need further investigations to identify more serious pathology.