Background Selective eating behaviours have been reported mainly in children with mental retardation and adolescents on strict vegan diets.

Aims To draw attention that prolonged food selectivity, along with parental indifference can lead to life-threatening complications from malnutrition.

Methods Analysis of food selective behaviours in two adolescents referred to Dept. of Paediatrics, Haematology and Oncology, Medical University of Gdansk, Poland in 2007 and 2013 respectively, suspected of aplastic anaemia.

Results Both adolescents presented with pallor, weakness and fatigue. A 17-year-old male with autism, encephalopathy and psychomotor retardation exhibited cachexia, contractures of joints, peripheral oedemas, massive bruising and bleedings, and trophic skin changes. A 13-year-old female suffered from dizziness and infections. CBC in both patients showed severe anaemia, leukopenia and thrombocytopenia. In myelograms, megaloblastic dysplasia was found, confirmed by serum vit. B12 deficiency. The boy had also deficiency of ferrum, folate, hypoproteinemia, dyslipidemia and electrolyte disturbances.

Upon interview, both patients demonstrated selective eating behaviours, and extremely restricted diets for over 10 (male) and 2 (female) years. The boy ate only chocolates, bread, milk, french fries and tea. The girl didn’t eat meat or animal-based products. Both children required blood cell transfusions followed by vit. B12 supplementation and nutritional support.

Conclusion

1. Severe prolonged food selectivity in children, along with parents’ indifference and/or unawareness, can lead to life-threatening hematologic complications.

2. Physicians should consider food selectivity among the causes of nutritional and hematologic deficits in children.

3. Parents need to be taught how to avoid nutritional deficiencies in children with selective eating patterns.