This story originally appeared in Romper.

There’s a reason why foods like buttered noodles and chicken fingers are clichéd children’s menu staples: Lots of kids aren’t particularly open-minded when it comes to eating, and some of them are downright picky. But as common as this behavior can be, it’s also a little scary for parents. After all, frozen waffles and cheese sticks don’t exactly constitute a “balanced diet.” A child whose daily meals revolve around five foods can’t possibly be getting all the nutrition she needs for proper growth, can she? So what are some signs your picky kid isn’t getting enough nutrients?

While kids who live on bland, processed fare might be taking in enough calories (then again, they might not be), that doesn’t mean they’re getting all the other stuff they need to grow. Research published in the American Journal of Clinical Nutrition found that 3-year-old “picky eaters” had lower levels of carotene, iron, and zinc than “non-picky” eaters. (Interestingly, picky eaters were shown to have higher “free sugar intake,” which perhaps isn’t that surprising when you consider how processed some “kid-friendly” foods can be.)

“As a pediatric feeding therapist, I work closely with Registered Dieticians when I suspect that a picky eater may getting poor nutrition that’s impacting his health,” pediatric feeding specialist and author of kid-friendly cookbook Adventures in Veggieland Melanie Potock, MA, CCC-SLP tells Romper.

“Adequate amounts of zinc and iron are always in questions for me, especially if I see kids who appear tired, cranky or have low appetite.”

Any of that sound familiar? Read on for more info on what to watch for if you suspect your child’s diet isn’t diverse enough (and what it means). But bear in mind, not all nutritional deficiencies are easy to spot. As James M. Greenblatt, Chief Medical Officer at Walden Behavioral Care (a national eating disorders treatment provider) tells Romper, “It is difficult to detect vitamin deficiencies simply by looking at your child. If you are concerned because your child has had a restrictive diet for an extended period of time, it is best to follow up with your pediatrician who can do a simple blood test to assess what vitamin and mineral deficiencies are present.”

And when you call your pediatrician, be sure to mention if any of the following symptoms listed below are present.

Lethargy

Little kids are known for having boundless energy, but if your child is more interested in binge-watching Paw Patrol on the couch than playing at the park, it could be a sign that he’s low on iron or even anemic.

“Early signs of iron deficiency could physically present

[itself as] fatigue, lack of motivation, apathy or even depression,” says Dr. Greenblatt, “though all of these symptoms could also be indicative of different diagnoses, so it’s important to be continually monitored by your pediatrician.”

Trouble Paying Attention

If getting your kid to focus seems like mission: impossible, a lack of foods containing zinc could be partly to blame. Research published in the American Journal of Clinical Nutrition suggested that low levels of zinc in kids may be linked to deficits in attention (as well as activity and motor development). Zinc-rich foods include meat, certain vegetables, beans, and whole grains…all of which might be things your kid refuses to eat. Thankfully, zinc is present in lots of fortified cereals, too, and chances are, that’s something they’ll gladly eat seconds of.

Dry Skin

If no amount of lotion seems to soothe your child’s dry skin, don’t assume that the winter weather is necessarily the cause — a vitamin deficiency could also be the problem. As Susan Evans, M.D., wrote for DoctorOz, “Dry skin can either mean you’re chronically dehydrated, or it means that you need to increase your essential fatty acid intake, vitamin A, and vitamin E intake. Potassium and vitamin D need to be added too.” Of course you should always check with your child’s pediatrician before starting him on any supplements, but it’s definitely something to consider.

Weight Loss

“Dramatic poor weight gain, or weight loss, is a worrisome symptom in a child of any age,” Katherine Noble, M.D., of the CT-based practice Sound Beach Pediatrics tells Romper, and the causes can be simply because your child is picky, or can suggest something more serious.

“This can result from poor nutritional intake, malabsorption of nutrients, or less commonly a health condition which increases metabolic rate (a ‘hyper metabolic state’),” she says. “Poor caloric intake is most common and we discuss strategies: nutrient dense power-packed foods (proteins and healthy fats), nutritional supplements (Pediasure), and others.”

If this is something you’re observing in your child, make sure to bring it up to your doctor earlier than later.

As you may be all too aware, picky kids tend to focus on just a few different foods… and they’re not usually of the high fiber variety.

“Often, picky eaters are getting too much of a good thing, like whole milk,” says Potock.

“It’s filling and parents are comforted by thinking ‘At least he drank his milk.’ But kids who drink too much milk are often constipated, causing a drop in appetite for other foods, and making them irritable.”

Your pediatrician might recommend a fiber supplement, or tricks like adding fresh fruit and veggies to smoothies (or milkshakes, or whatever you need to call them so your kid will drink them!). But, once again, how you treat this particular symptom depends on your child’s health and age, and the severity of her pickiness.

“The best way to obtain nutrients is through our food, not through vitamin supplements because most vitamins are excreted,” says Dr. Katy. “But, for super picky eaters, I will suggest a multivitamin daily (with or without iron depending on intake of iron rich foods).”

So, as ever: When in doubt, ask your doc!

Walden’s unique ARFID Intensive Outpatient program provides highly specialized care from an expert treatment team that is trained in ARFID. It is a 10-week virtual program open to individuals aged 11-17 of all ethnicities and genders.

If you are concerned that you, or a loved one, may have an eating disorder, please reach out by completing the form on this page or email us at intake_coordinators@waldenbehavioralcare.com.