What is ‘Parosmia', the post-Covid symptom making children ‘fussy eaters'?

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After recovering from Covid, some children may become ‘fussy eaters’ displaying an altered sense of taste and smell, experts at the University of East Anglia (UEA) say. Known as ‘parosmia’, the disorder which is common in adults who have recovered from Covid-19, is also being experienced by children. To recognise it, UEA and charity Fifth Sense have created a guide.

As per experts, the disorder causes children to experience unpleasant odour or taste, such as rotten meat or chemicals, from the food they eat.

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Also on children and Covid-19 |COVID-19 in children: Some important questions answered

In a statement on UEA website, Prof Carl Philpott said, “Parosmia is thought to be a product of having less smell receptors working which leads to only being able to pick up some of the components of a smell mixture. It’s a bit like Eric Morecambe famously said to Andre Previn – ‘it’s all the right notes but not necessarily in the right order’.

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“We know that an estimated 250,000 adults in the UK have suffered parosmia as a result of a covid infection. But in the last few months, particularly since Covid started sweeping through classrooms last September, we’ve become more and more aware that it’s affecting children too,” he added.

What is ‘Parosmia’, the post-Covid symptom making children ‘fussy eaters’?
© Provided by The Indian Express symptoms of Covid-19 in children, Covid-19, pandemic, child care, covid19 precautions for kids, covid19 precautions for child, kids care, Covid19 symptoms in kids, Covid19 symptoms in children It is important that parents encourage children to eat and maintain a food dairy (Source: Canva)

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According to the experts, there are many common triggers – for example, cooking meat and onions or garlic, and also the smell of fresh coffee brewing, but these can vary from child to child.

Here’s what to know

Causes

According to Dr Jagdish Kathwate, consultant neonatologist and pediatrician, Motherhood Hospital Kharadi Pune, parosmia is a significant symptom seen in those affected with Covid-19. “Covid can cause parosmia as it leads to inflammation to the roof of the nose leading to altered smell. It temporarily damages the receptors and nerves involved with the sense of smell. This symptom can also be seen in some people even after recovering from Covid-19, but it would be mild. Yes, post-Covid, this symptom can be seen in children, and due to a distorted sense of smell afterward, it will affect the food they eat,” he told indianexpress.com.

Agreed Dr Sreenath Manikanti, Senior Consultant Neonatologist, Kauvery Hospital, Electronic City, Bangalore who often gets complaints from parents that their children have not been eating well for weeks following Covid-19 infection. “Parosmia could be due to the longer-lasting condition called long-Covid which is still not fully understood by scientists,” he shared.

There have been some published reports of post covid Parosmia both in adults as well as children. “An article published by the Lancet on November 25, 2021, which studied long covid and had reviewed 303 manuscripts, concluded that only 12.8 per cent people had abnormalities of smell and taste. Another article published in Laryngoscope (The American Laryngological, Rhinological and Otological society) in August 2021 on smell status in children infected with Covid-19 concluded that 94.3 per cent of the children who had smell dysfunction recovered within one month and nearly 100 per cent recovered within two months. They also concluded that restoration of smell dysfunction is faster in children that in adults,” said Dr Manish Mannan, HOD -paediatrics and neonatology, Paras Hospitals Gurugram.

What happens?

“Children with parosmia may find it hard to eat food that they once loved so much including chocolate. Some children might completely give up on eating. Foods will smell like garbage or sewage or ammonia or sulphur or rotten eggs,” said Dr Kathwate.

What can be done?

One of the suggestions in such cases, as per Dr Kathwate, is that children need to be taught to use a soft nose clip while eating, in order to block out flavours. “Parents can also note foods that are triggers for their children. Smell training can also be beneficial. Children should try to eat bland food, avoid strong odours for time being, open windows, or keep the fan on while eating food. You can also make your children eat food at room temperature so that they won’t be able to smell it,” said Dr Kathwate. As per the smell experts of UEA, vanilla or flavour-free protein and vitamin milkshakes can help children get the nutrients they need without the taste.

“Smell training involves sniffing at least four different odours — for example, eucalyptus, lemon, rose, cinnamon, chocolate, coffee, or lavender — twice a day, every day, for several months,” suggested Dr Manikanti.

Treatment

“Various treatments have and are being used including various kinds of nasal sprays but I feel since this is a self-limiting temporary problem, very aggressive treatment is not required. Parents should be reassured and child should be followed up in OPD (outpatient department) without any need of hospital admission,” asserted Dr Mannan.

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