Formula for a preschooler who won't eat?

[minkajane]

DS is almost 5 and will. not. eat. He will sit and stare at his food for hours and just not eat it. I've tried all the tricks I can think of. He's been wearing the same clothes for two years now. His 2T pants are just slightly short and still fit around the middle. Most 3T stuff is big on him. He's below the 5th percentile for height and around the 10th for weight. Over the last few months, his eating has dropped lower and lower.

Take today, for example. For breakfast, he had a few frosted mini-wheats and a couple of tablespoons of milk. No lunch. For dinner, about half a cup of asparagus soup, an ounce or so of chickadees (like goldfish), a cup of milk, and half an apple. That's what - 500 calories for the whole day?

I was thinking about getting some Pediasure or something to get some extra calories/nutrition into him, but it's expensive, so I was thinking I'd sign up for a couple of formula companies' mailing lists to get free samples and give that to him. Would that help or would something like Pediasure be better?

[Blueone]

Have you taken him to see a doctor? I remember there was one kid who was like that and all he ate for lunch was pediasure. I was really concerned (I was a teacher) because he was really lagging in energy and there was something else going on.

It could be he's just a picky eater, but I would see a doctor or get a referral to a specialist. Pediasure is good and there is the second step formulas available that seem good.

[minkajane]

Unfortunately, at the moment, we have no medical coverage for him. I know his percentiles from the WIC office. It'll be several weeks at least until we can get coverage for him. We did see a nutritionist when he was 18mo or so because his weight gain leveled out. They checked him for cystic fibrosis and asked about what he ate and said he was probably fine. That's all we've had for that.

He's not really picky as far as foods go. I haven't yet found a food that he doesn't like. It's just whether or not he's going to eat anything at all. Even when I let him pick the food and it's something he loves like grilled cheese or peanut butter, he takes ages to eat it, if he'll eat it at all.

[Bokonon]

If he won't eat foods that he likes, formula probably wouldn't work for him, because that stuff is pretty gross.

Have you tried smoothies? You could pack them full of vitamins and still make them taste good. Other than that, I would probably want a doctor's opinion soon.

[Blueone]

Smoothies might work really well! It might be he has a sensitive palate and textured foods bother him. My mom had her jaw wired shut after surgery one time and my dad made great refried bean and cheese smoothies and a lot of other types too! Try that and make an appointment already with the doctor your insurance will cover, that way you can get in really fast.

[KatWrangler]

You say you have no medical coverage. Are you sure he doesn't qualify for Medicaid? If you are on WIC, then you most likely qualify for Medicaid.

[Ruthla]

It sounds like something is "wrong". A healthy child won't let himself starve when foods are available.

I wonder if he has a food allergy or something like celiac disease- that something he's eating is hurting his stomach and making him not want to eat. Gluten is a common culprits, but any food can potentially cause problems like this. And I see he's had wheat in every one of those "sample meals" you've posted.

I suggest that you cross-post to the Allergies forum for some more advice on how to go about detecting allergies. The women on that forum are a lot more knowledgable than I am, and can direct you to which tests to ask a dr for once you get health insurance for him, what kinds of dietary changes to try while waiting, etc.

[jpamama]

Unfortnately, I agree that there will be a problem with formula - it truly does not taste good at all and once babies get it out of their system, you can't get them to touch it with a ten foot pole. If you think that he would be willing to drink something like formula, I agree that smoothies might be your best bet - you can pack a whole bunch of goodness in there and also, get it to the 'right' consistentcy that your child will tolerate. Good luck!

[seashells]

My two cents - I'd rather see my kid eat food (real nutrients) than chemical formula (not well digested by humans).

If he's not picky about what to eat, I'd be working on giving him the most high quality food available.

How is his development? (Gross motor, fine motor, self care, social, verbal).

Does he have any physical symptoms that you can think of... difficulty moving bowels, stomachaches, headaches. Does he get sick often? Eternal runny nose?

How is his energy?

Does he seem different than he used to be? For example, he used to bounce off the walls and now he doesn't... or vice versa.

Does he have some days that he eats very little, but some days where he eats a lot? That is developmentally normal and I wouldn't be worried based on that alone.

Are you and his father small? 10th percentile could be ok for him. What percentile was he last year, and the year before? If he's dropped a lot (say, from 75th from 2 years ago) that would be concerning.

How is his muscle tone?

[cristeen]

At 5, he's old enough to communicate... have you tried asking him why he isn't eating? Does he not recognize hunger cues, is it textural, what? He may not have the vocabulary to truly express what is going on, but he should be able to tell you if something makes his tummy hurt or if it's yucky or whatever.

If he's willing, I'd definitely go for something like a smoothie over commercial formula any day. That being said, you may want to look at the WAPF website - they have a recipe for homemade formula on there... and one of them is bone broth based. If he's willing to drink a cup of that a day, at least you'd know he's getting calories and fats. But, buying the ingredients is not cheap... I just bought them myself and it was about $150. He probably wouldn't need the probiotics, but he would definitely need the fats and the vitamins.

[mommy2maya]

You need to get him to a dr. I'd be calling my public welfare office YESTERDAY.

How is he as far as milestones go, and energy?

Also, you can bulk up what he WILL eat, to make it more calorie dense. Easy things like adding carnation instant breakfast packets to whole milk, or heavy cream/butter in everything.

Finding out WHY he won't eat is another thing that will help in the long run.

Just two more bites is a good book on kids not eating, and helping to get them into a good eating routine. It might be that he is just a small kid- but I'd surely want to have him seen by a dr/real nutritionist (not from WIC)/early intervention/feeding therapist. SOMEONE.

[minkajane]

Thank you for all the helpful responses. I'll try to answer all the questions.

We're reapplying for Medicaid. We found out last week that they cut it off and didn't bother to tell us, so we've had no health coverage for him since October 1st and had no idea.

His energy level is great (he's wired a lot) and I don't think he's having any behavior issues other than what would be normal for his age. He's always been on the low side of the growth chart and hasn't dropped significantly, but he's definitely skinny. His ribs and spine stick out.

I've talked to him about why he won't eat. He says it tastes good and it doesn't hurt his tummy, so I dunno. Last night, I tried to make it fun - he helped me pick out the veggies, I let him stir and pour, plus it was green, which he usually loves because it's his favorite color. He still wouldn't eat more than a couple of bites. He does seem to find what seems like excuses not to eat sometimes. Basically all of his food has to be ice-cold, because if it's the slightest bit warm, he'll complain that it's too hot. But if it's something he really wants like pizza or grilled cheese, it doesn't matter if it's hot.

Eating has been a battle with him for a couple of years now, it's just gotten a bit worse lately. Some meals I can get him to eat if I sit down and him tell him to take each bite. Others, I try to let him eat at his own pace and it just doesn't happen. He'll sit there for hours and hours.

[lil_earthmomma]

I also think the dr. is a good idea, but thought I'd offer my personal experience. I was your son. I hardly ate anything. At all. Some days my mom would chase me around with a bottle and cajole and beg just to get a bit of formula into me. (She got really bad bfing advice ) As a toddler and young child it was the same, a couple bites of food was all I would eat in a day.

Could you try coconut milk/CO? He might like chocolate coconut milk to drink, and if he likes chocolate he might eat some CO chocolate bark. (Basically melted CO, mixed with cocoa powder, a drizzle of honey or maple syrup and some chopped nuts if he likes them. Then let it solidify in the fridge or freezer and cut into bite sized peices. If he likes nut butters you could mix a bit of that into the mixture as well.)

For the record, I now love food, and my mental development did not suffer.

[littlemizflava]

he really sounds like he is a picker and not a sit and eat type. have you tried saying he can take the plate/bowl cut in to bite size pieces and letting him go play or watch tv/dvd while he eats? if he likes his food cold this would work well. having food always there that he could pick a bit or 2. i found keeping a plate with a mix of things they love on the coffee table all day. i do this in the fridge and the kitchen also.

have you tried carnation breakfast drinks?
smothies or smoothie ice pops
if he will eat a cookie or other baked goodies you can slip alot in without him knowing

[seashells]

Are you sitting down at meals with him? My DD eats much better this way and I try very hard to have all meals at the table, as a family.

Reading your update, I personally don't feel alarmed, but I'm a stranger on the Internet with no credentials whatsoever, who has never even seen your son.

DH and I both had our eating issues as kids too, so we keep that in mind when considering our DD. She is at the 3rd to 5th percentile for weight. She must have a mild metabolic issue (part or all of the reason for her low weight is her low muscle tone) but we have not elected to pursue it, at this time anyway.

One thing I dislike about our interactions with medical professionals is that they have all, in our experience, recommended substituting inferior foods in the hope of increasing weight. MIL was told when DH was a boy to feed him candy bars and other crap to increase his calorie intake. DH remembers vividly that he preferred carrot sticks. So they took away the carrot sticks and substituted candy bars, sigh. My mother was told to give me ice cream, which is the exact same advice DH and I got from DD's ped. I am not saying every doctor will tell you the same thing, and I'm not going to tell you not to seek medical advice, but I hope you make your own choice before relying on an allopath's advice to feed inferior food (they are notably NOT nutritionists). You want your son to be well nourished, with good nutrition, rounded vitamins and macronutrients. That's different from simply making him "fat" with ice cream (which of course may lead to long term, even lifelong, eating and health issues... lord knows I struggle with my own).

Regardless of your personal diet philosophy, you can decide what foods are high quality and nutrient dense, and encourage them. Avocado and olives have nice amounts of fat, and are kid-friendly. Bone broth is a nutritional powerhouse. Depending on your philosophy and your son's lactose tolerance, various dairy products can be good. Consider raw milk for its increased nutritional potential. Find eggs from pastured hens, their yolks are orange and stuffed with nutrition (including the elusive vitamin D). Anyway, I'd just try to increase these kinds of high quality foods and try to minimize more empty foods like pasta and commericial cereal (which, even if enriched, are not well processed by the body and end up as empty carbs).

BTW, for a while I had a lot of success talking to DD about which foods made her grow. By "grow" I mean more that the food will be very good for her body, not necessarily that it will help her gain weight (so, by that measure, I tell her carrot sticks make her grow - as well as other more high calorie foods - but I don't tell her that Rice Krispies make the cut). However, this backfired a bit recently as she is having separation anxiety and has now decided she does not ever want to grow up Fortunately she's not rejecting the good foods but just no longer motivated by the idea of growing, so I've just totally dropped that particular line lately. But she used to ask, with great interest, about various foods - "Mom, do avocado rainbows [her term for avocado slices] make me grow?" and would be happy when I told her yes!

[Delicateflower]

Originally Posted by minkajane

Eating has been a battle with him for a couple of years now, it's just gotten a bit worse lately. Some meals I can get him to eat if I sit down and him tell him to take each bite. Others, I try to let him eat at his own pace and it just doesn't happen. He'll sit there for hours and hours.

Have you read any books by Ellyn Satter?

[Xoe]

Get him to a Gastro Specialist as soon as you can. Skip the pediatrician if you can.

My oldest daughter was like your son right after she turned one. Everyone told me to read Ellen Satyrs books (ie: How to Feed your child, but not too much.) Good books, but she dropped way off the growth chart. She ate no food and drank almost no formula. My child was starving, and everyone, including the ped, said wait and see. Strangers would ask what was wrong with this child. When we look back at pictures of her at 2, we can see she looked almost like a cancer patient, but because we saw her everyday, we didn't know that. Until you can get medical insurance, use Ensure or Equate, or any 350 calorie meal supplement you can find and afford. (Failing that, use Carnation Instant Breakfast.) When I finally was through with everyone's advice, I took my daughter to a Pediatric Gastro Specialist. They performed test and found that in addition to GERD, she had scar tissue blockage in her stomach, most possibly from some type of stomach infection, and it had created slow gastric emptying. In other words, food and drinks were just sitting in her stomach for hours, not going anywhere, so she was refusing to eat. The Pediatric team was able to help, and she is growing beautifully. We are vegetarians, and I would have never imagined I'd consent to feeding my daughter some pre-made stuff like Ensure. (Ensure and Equate come in 350 cals. Pediasure does not have as many cals, as far as I know.) However, that stuff has allowed my daughter to survive and actually thrive. She can get it down and keep it down when nothing else will do. She's almost 5, and she does eat and enjoy normal food these days. But I'm not sure I'd have a healthy child today without serious supplementation. Those strategies in Satyr's book are great from children who are not sick and starving themselves. However, if you have a 5 year old who's wearing 2T-3T clothing, and losing weight, you probably are dealing with something other than normal "pickiness."

Help is out there. I wish you the best.

[noobmom]

I'm surprised he's still 5th and 10th percentile. My 3 yo is 10th percentile for both height and weight and fits his 3T clothes, but he's 2 years younger than your son. I guess the charts really do flatten out a lot as they get older.

I can understand why you're worried. I would try to get insurance and go see a doctor as soon as you can. I agree, skip the ped and go straight for a pediatric gastroenterologist, if you can. But, in the meantime, it wouldn't hurt to try the formula, esp. if it's free. Instead of mixing it with water I'd probably mix it with milk and think of it as a calorie supplement. But the Pediasure or Carnation would work better, I think.

Although most kids will eat if they're hungry, kids CAN get into a habit of not eating, so this is definitely something to address if you think he really isn't consuming enough calories. If I were with you, I'd keep a journal and write down EVERY bite of food and drink for 2 weeks, day-by-day. Then a nutritionist can really sit down and calculate how much he's getting. The GI doctor will probably ask you to do something like that anyway.

[minkajane]

Update

I guess DS has decided to prove me wrong. Today and yesterday he's been eating pretty well. Today, he had some leftover mac and cheese, a handful of chips, and a black bean burrito. Plus about two cups of whole milk. That doesn't sound like a lot, but it's a lot for him! There was a little fight with the mac and cheese, but the other stuff he just sat down and ate with no argument. We're going to make cranberry bread in a bit and I'm sure he'll eat a piece of that.

A big part of the problem is that I don't know what's normal and what's not. How much is a kid this age supposed to eat a day?

BTW, I sent in my paperwork to try and get DS back on Medicaid. It will take at least a few weeks. Hopefully it'll go through ok.

[kjbrown92]

You could go into a program like Fitday.com and enter everything he eats during a day, and you'll at least see how many calories he's consuming and ratios of protein to fat to carbs. You'll be able to see vitamin amounts too. I'm sure there's a website somewhere that tells how much a kid should be eating in a day.