July 02, 2015

Q: My family recently made the move from USA to Italy and it's been rough for my four-year-old son. We've been here for a month and he's all but stopped eating. He's lost probably 5 pounds. He used to be very healthy and had a good appetite, even a few pounds over suggested weight. I think most of the problem is some control game. He says he wants X food, then when I prepare it he refuses to eat. He keeps cutting out more and more foods. What can I do?

A: I agree that something about the move must have been rough for your four-year-old. He may be reacting to a disruption in his routine, but perhaps there have been some important relationship--possibly a close relative, friend, or babysitter--that has ended suddenly and caused him to have a reaction that would be grief in a grown-up person. But the loss of 5 pounds is a significant one for a four-year-old, and I would be concerned if he does not return to his usual self in a week or two. I would try to be as comforting and supportive of him as possible and try not to make a big deal about meals. You are probably correct that he is feeling powerless right now, and is trying to assert control over one area where he feels he has some control. Spending more time with him doing pleasant activities he enjoys and reminding him in a friendly way how much you love him may help him feel more emotionally secure. If he does not seem on the road to genuine improvement in a week or two, I would consult a pediatrician.

Answered by Dr. Elizabeth Berger