Diagnosing COVID-19 in younger children can be tricky, given that they’re not usually able to verbalize how they feel. But a new case report suggests that parents and pediatricians should be on the lookout for a seemingly unrelated symptom: a new food aversion.
That’s the conclusion from the report, which was published in the journal Pediatrics. The report specifically looked at two children under the age of two who develop a sudden aversion to solid foods immediately after they were infected with COVID-19. In both children, it took between six to eight months to see an improvement.
The first child was 16 months old and developed a food aversion after choking. Four months before that, she had a few days of a low-grade fever and increased fussiness, along with drinking less than usual. The baby tested positive for COVID-19 and, after that, refused to eat solid foods. Instead, she only drank large amounts of whole milk—up to 1.5 liters a day.
The second patient was a 17-month-old boy who developed a fever, shortness of breath, and an upset stomach for a week. He tested positive for COVID-19 and refused to eat afterward. Whenever he was fed, he would vomit within five minutes, although he had previously had food with no issues since he was five months old and had started on solid foods.
“We believe the presence of acute food aversion in preverbal children, in the appropriate epidemiological and clinical context, should trigger testing for COVID-19 because it may be the first and only symptom of infection and for pediatricians to provide anticipatory guidance for parents after acute COVID-19 infection in young children,” the report’s authors concluded.
Have a child who suddenly developed a food aversion? Here’s what you need to know.
The symptoms of COVID-19 in children are similar to what they are in adults, Daniel Ganjian, MD, a pediatrician at Providence Saint John’s Health Center in California, told Verywell. Those include:
This isn’t just a random symptom that’s detected in a case report.
“I’m seeing it as well,” Ganjian said. “Oftentimes, when kids get sick with viruses—including COVID-19—they don’t want to eat for a week or two.”
There are a few potential reasons for this, he said, including a decreased appetite due to feeling lousy and a possible loss of taste and smell.
Luckily, it doesn’t usually linger—Ganjian said most children will return to their usual eating habits after a week or two.
If your child develops a sudden aversion to eating, talk to your pediatrician and mention if they’ve had a recent COVID-19 exposure. Your healthcare provider should be able to guide you from there.
Experts say you shouldn’t jump to conclusions that your child has COVID-19 if they suddenly develop a food aversion, though.
“I’m far from convinced,” Jeffrey Hyams, MD, a pediatric gastroenterologist at Connecticut Children’s who deals with children who have food aversions, told Verywell. “Is it plausible? Sure. But, if that’s the only manifestation, we have no way of knowing if it’s COVID-19 or not unless they get tested for the virus.”
Hyams pointed out that the first child in the study had a serious choking episode, which is a “very common association” for a food aversion in children. The second child also had “emotional distress,” which can also lead to a food aversion, he said.
“If a child only develops a food aversion, I would not automatically assume that they have COVID-19,” Hyams said.
Ganjian said it’s important to take other factors into account, including additional symptoms your child may be experiencing.
“Do they also have a fever, cough, runny nose, vomiting, or diarrhea?” he said. “If so, call your pediatrician. They’ll determine if testing needs to be done.”
Hyams said it’s also crucial to think about potential exposure. “If a daycare worker or family member recently tested positive, it would be more plausible that the child is infected,” he said.
Additionally, loss of taste and smell—which could lead a child to not want to eat—does not seem to be as common with the Omicron variant, which is now the dominant variant of COVID-19 circulating in the U.S., compared to previous variants, according to Hyams.
However, Ganjian stressed that food aversions in children that persist shouldn’t be ignored.
“Talk to your pediatrician about it,” he said. “You may need to try different tactics, like changing up food, offering it more often, and feeding your child smaller portions. Kids less than two years old can be picky eaters.”
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