Background: Amongst children presenting to an interdisciplinary clinic with complaints of picky eating, we aim to identify the proportion who have underlying selective feeding and to describe its implications on growth and nutrition, as well as parental coping responses. Methods: We conducted a retrospective chart review of first-visit consults from January 2020 to July 2022. Caregiver and child mealtime behaviours were assessed using the standardised Caregiver’s Feeding Styles Questionnaire (CFSQ) and by direct observation. Caloric intake and oromotor skills were assessed by dietitians and speech therapists, respectively. Medical concerns were addressed by the doctor. Results: Out of 152 children referred for concerns of “picky eating”, 128 (84.2%) were diagnosed as having selective eating, while the rest were diagnosed with delayed oromotor skills, poor appetite, oral aversion and 4 were deemed to have normal feeding behaviour for their age. Of the 128 selective eaters, 67 (52%) children had comorbidities such as autism spectrum disorder (ASD) (n = 59), attention-deficit/hyperactivity (ADHD) (n = 2) and underlying medical conditions (n = 6). The remaining 61 children were “otherwise well”. Of the “otherwise well” children, 47.5% had inadequate caloric intake and 31% had failure to thrive. The commonest feeding style among caregivers of “otherwise well” picky eaters was authoritarian (36%). The majority (80%) of these caregivers also experienced helplessness. Conclusions: We conclude that picky eating in young children is a symptom with several possible underlying aetiologies. It is associated with nutritional consequences for the child and significant stress on caregivers. Being able to recognise those who need referral for specialist intervention and multidisciplinary management (such as selective feeding and delayed oromotor skills) would be important.

Linear and annular lupus panniculitis of the scalp (LALPS) is a rare variant of lupus panniculitis, which manifests as blaschkoid nonscarring alopecia. We present a rare paediatric case of LALPS and a review of 30 published cases of LALPS. It is important to distinguish LALPS from linear alopecia areata, linear morphoea and traction alopecia, as treatment is distinct.

Lyme disease is the most common reported vector-borne disease in North America and is also highly prevalent across Europe. Although tick-borne diseases are uncommon in Singapore, there remains a risk of imported tick-borne diseases among travelers from endemic regions. We present a case series of three pediatric patients with imported Lyme disease managed at a tertiary children’s hospital in Singapore, illustrating the varied clinical presentations of Lyme disease in children. One child developed meningitis following prior antibiotic therapy for Lyme disease, although causality cannot be definitively established. This series aims to highlight key diagnostic considerations and management principles relevant to clinicians practicing in non-endemic regions.