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A Child Refusing To Eat And Drink

Question of the Week


Updated October 27, 2004

Q. My 4-yr old has refused to eat for 3 weeks and now has begun to refuse to drink. She had an IV 2 days ago because of dehydration. Today she had her third series of lab tests. This time her sugar in her urine was a 50 but the sugar in blood was only 72. Should there be any alarm for diabetes? Also if not, what is causing the lost of appetite, whining, clinginess to her mother, and has caused her to lose 7 pounds, 5 of those in the last week.

The one and only thing we have gotten her to eat has been banana pudding. We have tried fixing her plate and we all sit down to each meal like nothing is going on. No luck, just pushed the plate away, so we gave back into the pudding. We have offered her favorite foods and have tried to make cooking fun by letting her help, etc. We're just at a lost, pediatrician is thinking possibly psychological, instead of physical. Thena, Savannah, GA

A. It is possible that her refusing to eat is being caused by a psychological problem, especially if you can think of a specific thing that triggered it, like a recent move, change in daycare, or death of a family member, etc. But you should really only consider this after she has had an extensive evaluation to look for physical causes.

And weight loss is never normal in young children, and that is a sign that this is likely something to aggressively look into. If she didn't want to eat, but was still gaining weight normally, then it would usually be less concerning.

Diabetes, which does cause weight loss, would cause a high blood sugar, so that isn't likely in this case. Still, it isn't normal to have sugar in your urine, so that might be a hint at what is causing her problem. With a normal blood sugar, it is possible that she has a kidney or metabolic problem causing her glycosuria, which is the medical term for having sugar in your urine.

With symptoms like this, it is also possible that she has dysphagia or difficulty swallowing. An obstruction might also cause her to not want to eat or drink. Many doctors would do an Upper GI test or a swallowing study to evaluate a child for these problems and to look for reflux or a blockage of some kind.

A referral to a Pediatric Gastrointestinal Specialist might also be a good idea, especially if she continues to lose weight.

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