Need help with eating...

[mamafish9]

Hi mamas,

I don't usually venture over here, I hang out in the allergies forum. This time, I need help with my *other* child!

DD is 6yo, and she doesn't eat. Or rather, she eats enough to not be hungry. She's 35lbs, which is way off her growth chart. She's been that way for a long time. I think it's gotten a little more extreme lately though, because she's getting taller.

And it's gotten to the point where I believe it's a health risk. She just recently got whooping cough, and I think the lack of reserves is really affecting her recovery. She had flu earlier in the winter, and she came close to needing the hospital - she looked like a cadaver . When she's healthy, she eats enough to be OK - but there's no buffer.

My husband ate 4 foods at her age (and 3 of them weren't "real" food ), and he had lots of power struggles with his parents over food. Not only do we not want to parent that way, but as he well remembers, it's not his parents who won .

We've talked about nutrition and the good things in food. She eats a reasonably good range of food, although protein is a bit of a struggle (and meat is pretty much a non-starter). However, short of mac & cheese, there are few meals where she will eat a lot. She definitely has some texture issues with food, but mostly I think she just doesn't value eating that much.

This year she is in kindergarten, so now there is some time structure in our day - she has to finish eating in time to go to school. That seems to have just made things worse. We tried a timer for a while, and she ate in 15 minutes for a few days while that was new and interesting (that is how long she will have to eat lunch at school next year, so we framed it as "practice").

I'm a fan of natural consequences, but she's not the one that suffers - we are, when she's cranky. I was volunteering in her class yesterday, and for the last hour (of a 2.5 hour class), she was really grumpy with her friends, because she was hungry.

We aren't fans of bribery & threats, and what few we have tried in this area have been very ineffective.

Ideas, thoughts?

[PeachBaby]

I don't have personal experience with such an issue, but I did read about a couple things that I wonder if it would help. I don't know if it would work for your case or if you've already tried it. I read about letting the child help prepare the meal and make it an enjoyable experience for them, then they might be more willing to eat it since they can be proud of having made it. And maybe make fun, interesting food themes or maybe fun, creative dishes (such as animals, boats, etc).

[seim.ge]

Has your daughter ever had to be on a feeding tube or anything like that? Her behavior sounds very similar to what I experienced as a nanny to a chemo therapy patient (before my son was born). Chemo alters how taste buds perceive flavor and being on a feeding tube (especially in infancy) often makes the sensation of eating feel unnatural and unpleasant, so that little girl had a lot of issues surrounding her diet.

I don't know that this is really applicable to your situation, but here's what I learned in the classes I took:

1, never force food on a child. This includes cajoling and bribing. Present the food and do not comment on it, ever.

2, Involve the child in the preparation of the meal. If possible, start a garden. Children tend to be willing to sample foods they had a part in raising. (If a garden isn't an option, perhaps a trip to a local farm or farmers market would help.)

3, Arrange food in an attractive manner. Pay attention to color and aesthetic appeal, and take care to create a relaxed, warm atmosphere in your eating room. Do not allow electronics, bright lights or other distracting stressors in your eating area.

4, The age old rule about not playing with your food is nonsense. Food is there for our enjoyment and if the mashed potatoes need to be molded into the shape of a snowman in order to be appealing to your child then so be it!

5, Encourage any sort of contact with food. For a child who has texture issues, sampling the texture on their skin can help them relax and become more willing to try the food next time.

6, Try to make eating a social event. Consider lighting candles or dressing for the occasion. Mealtime is a time of celebration.

7, Always include one item on the dinner table that you know your child will eat. If she's really into mac and cheese, let her go crazy on it. Her instincts may be driving her to that particular dish because she needs something that's in it....and if not, there's a good chance she'll get tired of it when it is constantly available and begin to crave a little more variety. Shortage mentality fuels food selectivity; ie, if you're planning to go on a diet that will exclude chocolate from your diet you will probably eat an inordinate amount of chocolate before and after the diet just because you're thinking about it all the time.

This is all I can remember off the top of my head....I hope some of this is helpful to your situation! I remember how frustrating it was with "my" little girl. She would only eat Cheetos for months after losing her tube. We had to make her snacks look like little animals and get her to talk to them and eventually touch them.....and we'd feed the food to her doll, let her feed the food to other people and watch their response....then one day suggest giving one of her little food animals a kiss and see how she reacted to the idea. It took us a solid four years of constant work to get her to the point where she could just eat like a normal kid. She's 8 years old now and you'd never know she had a problem eating. =]

[DevaMajka]

That's rough. That's one of the things you can't really *make* someone do. I don't have any suggestions, just wanted to say that ds1 is like that with fluids. It is a battle just getting him to drink 1/4 cup of water some days.

Have you asked her why she doesn't want to eat much? I've asked ds that about water and didn't get anything helpful, but it's worth a shot.

Does she seem to agree with you that eating more would be a good thing? Maybe ask her for ideas of how to get her to eat more? That one has helped with ds for short periods of time. (he wanted a water chart- he was in charge of it, so it wasn't a reward sticker chart thing. It worked like a checklist for him, kwim?)

gg help ds...

[mamafish9]

Thank you so much for sharing all your ideas and thoughts!

Originally Posted by PeachBaby

I don't have personal experience with such an issue, but I did read about a couple things that I wonder if it would help. I don't know if it would work for your case or if you've already tried it. I read about letting the child help prepare the meal and make it an enjoyable experience for them, then they might be more willing to eat it since they can be proud of having made it. And maybe make fun, interesting food themes or maybe fun, creative dishes (such as animals, boats, etc).

Both great ideas, thanks. We have tried both - she loves to help cook, and loves to play with her food and be creative with it. But generally, that doesn't translate to eating it.

Originally Posted by seim.ge

Has your daughter ever had to be on a feeding tube or anything like that? Her behavior sounds very similar to what I experienced as a nanny to a chemo therapy patient (before my son was born). Chemo alters how taste buds perceive flavor and being on a feeding tube (especially in infancy) often makes the sensation of eating feel unnatural and unpleasant, so that little girl had a lot of issues surrounding her diet.

I don't know that this is really applicable to your situation, but here's what I learned in the classes I took:

1, never force food on a child. This includes cajoling and bribing. Present the food and do not comment on it, ever.

2, Involve the child in the preparation of the meal. If possible, start a garden. Children tend to be willing to sample foods they had a part in raising. (If a garden isn't an option, perhaps a trip to a local farm or farmers market would help.)

3, Arrange food in an attractive manner. Pay attention to color and aesthetic appeal, and take care to create a relaxed, warm atmosphere in your eating room. Do not allow electronics, bright lights or other distracting stressors in your eating area.

4, The age old rule about not playing with your food is nonsense. Food is there for our enjoyment and if the mashed potatoes need to be molded into the shape of a snowman in order to be appealing to your child then so be it!

5, Encourage any sort of contact with food. For a child who has texture issues, sampling the texture on their skin can help them relax and become more willing to try the food next time.

6, Try to make eating a social event. Consider lighting candles or dressing for the occasion. Mealtime is a time of celebration.

7, Always include one item on the dinner table that you know your child will eat. If she's really into mac and cheese, let her go crazy on it. Her instincts may be driving her to that particular dish because she needs something that's in it....and if not, there's a good chance she'll get tired of it when it is constantly available and begin to crave a little more variety. Shortage mentality fuels food selectivity; ie, if you're planning to go on a diet that will exclude chocolate from your diet you will probably eat an inordinate amount of chocolate before and after the diet just because you're thinking about it all the time.

This is all I can remember off the top of my head....I hope some of this is helpful to your situation! I remember how frustrating it was with "my" little girl. She would only eat Cheetos for months after losing her tube. We had to make her snacks look like little animals and get her to talk to them and eventually touch them.....and we'd feed the food to her doll, let her feed the food to other people and watch their response....then one day suggest giving one of her little food animals a kiss and see how she reacted to the idea. It took us a solid four years of constant work to get her to the point where she could just eat like a normal kid. She's 8 years old now and you'd never know she had a problem eating. =]

Nothing like that at all - she was born in water with midwives and has never had any medical intervention more significant than a pee test. We are testing her for IgG food allergies and celiac, to try to rule out any physical underlying cause for all this. It seems like there might be one. I don't want to make her relationship with food worse, but she needs to eat.

We've used a lot of the tricks on your list, and they've been great for getting her used to new foods (my other child is autistic, so this kind of very gentle behavior modification is familiar ground for us). But it's never helped increase the volume of what she eats.

Originally Posted by DevaMajka

That's rough. That's one of the things you can't really *make* someone do. I don't have any suggestions, just wanted to say that ds1 is like that with fluids. It is a battle just getting him to drink 1/4 cup of water some days.

Have you asked her why she doesn't want to eat much? I've asked ds that about water and didn't get anything helpful, but it's worth a shot.

Does she seem to agree with you that eating more would be a good thing? Maybe ask her for ideas of how to get her to eat more? That one has helped with ds for short periods of time. (he wanted a water chart- he was in charge of it, so it wasn't a reward sticker chart thing. It worked like a checklist for him, kwim?)

She says she's full. She seems to agree that eating enough to be healthy is important, but I think that's a difficult idea for a 6yo to grasp. And "hey girl, you're way too skinny and off the growth charts" seems like a great way to create an eating disorder . She's the least rewards driven child I know - she has an awesome internal compass, and we've totally supported and encouraged that. But I don't know how to get her to internalize the basic importance of food.

We went to the farmer's market today, she picked a bunch of yummy stuff (strawberries, sugar snap peas, etc). Brought it home, she arranged a plate of food for everyone (she's my artist!). She picked every food on the plate, so 5 of her favorites. Sat down to nice conversation, no pressure, no talk of food. She ate two strawberries and a couple bites of cheese. That's all. Said she was full.

[mom2grrls]

Does she have any other physical/medical problems? my nieces both have celiac and one of the problems was constipation. Hopefully the tests reveal something.

[mamafish9]

No - besides being very small, no other issues. When I look at the list of childhood celiac symptoms, nothing else pops out for me - normal poops, no complaints of sore tummy or discomfort, based on hair testing, her mineral levels are normal, so it seems like she is absorbing a reasonable amount of nutrients.

We've dealt with plenty of food intolerance symptoms with my son, and my daughter doesn't have sleep issues, behavior issues, rashes, belly/digestive issues, congestion, any of the things that would pop for me, other than being tiny and not very interested in food. But I want to rule out those possibilities, at least.

[bonamarq]

Well, since it does seem like you've tried all the standard advice and because you mentioned some texture issues I'm going out on a limb here to suggest something else - have you noticed if she has a poor sense of smell? I work in the field of autism and picky eating is something we deal with quite alot (not saying she has autism here) But I just read a book called Disconnected Kids and the Brain Balance program - in this book he suggests that very picky eaters tend to have poor sense of smell and thus, depend entirely on texture for food preferences and have little drive to eat... the whole book is basically about how parents can assess their own child for a brain imbalance and then exercises for how to correct the imbalance....
don't know if this is going to help but it certainly couldn't hurt - theres stuff in there about food sensitivities which also may apply???

good luck

[alegna]

My dd is finicky and doesn't eat much, but is not that skinny (just hit 40lbs) and food is really hit and miss here. I do try to think about what I put in her food and make sure to add as much fat as possible- she'll eat toast with butter, so I put way more butter (good stuff) on hers than I would on mine. When I make mac and cheese (she used to eat it... sigh, one of many things she no longer eats) I augment it thoroughly I add cottage cheese and full fat yogurt and more cheese.

My dd is very self-limiting in food choices, so I don't always have enough to work with, but she will usually eat cream cheese on a spoon (and on a bagel) Will your dd dip things? Lots of good dip options....

Re-reading to see that protein is an issue- cottage cheese is easy to add to a lot of things- I bake with it, bread, muffins, etc. I sub for most of the liquid. You can also add it to sauces (spaghetti etc) pretty easily.

Not sure anything there is helpful... good luck!

-Angela

[mamafish9]

Originally Posted by bonamarq

Well, since it does seem like you've tried all the standard advice and because you mentioned some texture issues I'm going out on a limb here to suggest something else - have you noticed if she has a poor sense of smell? I work in the field of autism and picky eating is something we deal with quite alot (not saying she has autism here) But I just read a book called Disconnected Kids and the Brain Balance program - in this book he suggests that very picky eaters tend to have poor sense of smell and thus, depend entirely on texture for food preferences and have little drive to eat... the whole book is basically about how parents can assess their own child for a brain imbalance and then exercises for how to correct the imbalance....

Hmmm, interesting thought. Her brother is autistic, and we often say that between them, they got the traits of a typical autistic kid - he has the social/relational issues and she has all the sensory ones. She loves to smell things, and reacts strongly to powerful smells, but I don't know how her basic sense of smell is. Definitely something to check out! Thanks - I'm absolutely seeking these "out there" explanations, just so we haven't missed something.

Originally Posted by alegna

My dd is finicky and doesn't eat much, but is not that skinny (just hit 40lbs) and food is really hit and miss here. I do try to think about what I put in her food and make sure to add as much fat as possible- she'll eat toast with butter, so I put way more butter (good stuff) on hers than I would on mine. When I make mac and cheese (she used to eat it... sigh, one of many things she no longer eats) I augment it thoroughly I add cottage cheese and full fat yogurt and more cheese.

My dd is very self-limiting in food choices, so I don't always have enough to work with, but she will usually eat cream cheese on a spoon (and on a bagel) Will your dd dip things? Lots of good dip options....

Re-reading to see that protein is an issue- cottage cheese is easy to add to a lot of things- I bake with it, bread, muffins, etc. I sub for most of the liquid. You can also add it to sauces (spaghetti etc) pretty easily.

Yup, we have a source of raw milk, so we add fresh raw cream and butter to everything, LOL! She will eat dairy protein (same volume issues though), so we do a lot of it. That's one of the reasons we're testing for food sensitivities, actually - if dairy is a problem, it's one of her main calorie sources.

And I wish she would dip things. Sauces and dips have always been a texture issue... But at least she'll still eat mac & cheese, that must not be fun!

[provocativa]

i think i saw you on the histamine thread which i haven't had time to get back to. i think something i read mentioned that histadelics often reject protein because it's high in histidine, which is the amino acid we synthesize histamine from. http://www.healthrecovery.com/HRC_20...er.htm#hhchild
interestingly, my youngest was a total meat eater, and then became a carbaholic after we introduced dairy, which i now believe causes a histamine reaction in her gut. days do go better here when we take tryptophan and histamine lowering supps.
we actually got to the point that i started having to say, you all have to eat your protein and fat before you can have x. because we are low income, sometimes if they waste good food there is not any later in the day. and because of their issues, if they don't eat enough before we go somewhere, when their blood sugar drops then the meltdown is collossal and often dangerous to self and others. also, my kids have to keep decent levels of certain nutrients, because with lead poisoning the lead is constantly coming up out of their bones- and if there is not zinc there to make metallothionen, then the lead can get to their brains before being excreted. interestingly i have better luck with high tryptophan proteins like turkey and egg salad. you might try zinc supps to improve sense of smell, if you think that's a factor in the pickiness. i would also leave out the healthiest food all the time. i have a niece who doesn't eat, but will occaisionally eat bacon. i'm always telling her mother that she should just leave bacon cooked and out on the table at all times (it doesn't spoil out of the fridge-chefs keep theirs out).
my point is, that as crunchy pc correct as i intended to be about food, we just can't be that way. life is HELL if they eat certain ways and certain things. we've had our power struggles, we talk about them, and i say things like yes you can have a rice cake, but only with ham and mayo. i do things like finish the meat and the veg first, and then all sit down to dinner while the carb is 'taking longer to cook for some reason i can't figure out'. oh, and i let them eat butter straight, and the fattiest fowl skin and salmon skin and we render tallow and they eat the fatty crispy parts that don't melt. however, carbs are probably better if just weight gain is a goal.

[mamafish9]

Thanks provocativa. She's on a pretty solid set of supps, her zinc is normal, and she doesn't show any other signs of high histamines. And C & B12 don't seem to make a difference, and I'd expect them to, if histamines were the issue. Underlying inflammation from dairy is a possibility, for sure.

And "eat your protein before your bread" doesn't work here. She'll just stop eating entirely. She has walked away from ice cream because of a bite of pizza she doesn't want to finish. (We just say something calm like "sure, you can have ice cream as soon as you finish your pizza", and she'll say "OK, maybe I'll have ice cream tomorrow then - with literally a bite of pizza - a food she likes fine" left).

[alegna]

She sounds a LOT like my dd. I am not willing to trial eliminating dairy at this point because I don't think she would get enough calories without it. My dd is also un-bribe-able and will walk away if negotiations don't suit her.

Let me know if you figure out any magic bullet!

-Angela

[mamafish9]

Originally Posted by alegna

She sounds a LOT like my dd. I am not willing to trial eliminating dairy at this point because I don't think she would get enough calories without it. My dd is also un-bribe-able and will walk away if negotiations don't suit her.

Let me know if you figure out any magic bullet!

-Angela

Yes, that's part of why we're going to do the food intolerance testing - pulling gluten is calorie-wise not a problem, but pulling dairy - yeeks. I can't afford for her to lose more weight while we do a trial.

I actually like that my daughter is unbribeable, I think that's good news for most of her life - but phew, it doesn't make getting her to eat any easier.

I'll come back and update once we have the results of the food tests. We've also done some genetic testing on her brother, and I'm going to start giving her a couple of his supplements that are related to fat digestion & pancreatic function - if she shares those genetics, it could explain this (although he's definitely not tiny, but he nursed a lot more than she did for a lot longer).

[kcparker]

Is she old enough that you can frame the discussion in terms of food as medicine and building blocks for her body? Discuss how the body uses different foods for different purposes (fatty acids for the brain, calcium for bones and teeth, iron for blood, etc.) Maybe if she can come to look at it as part of her routine maintenance behavior, same category as brushing our teeth or doing laundry, it won't be about pleasure or wanting to eat. It's just something we have to do to keep our bodies healthy and to keep our mood and energy levels up.

Good luck figuring out if there is a gastro-intestinal or intolerance-related root cause.

[DevaMajka]

Just wanted to share this. I asked ds if he had any advice for you (hoping that it could shed some light on his water issue). He said "Just make her eat more?" lol yeah, like that would work for either of us.

He also said what we sort of do: he has to have drank a cup of water so far that day before he can have candy/sugar. We don't phrase it as a reward/bribe, but that his body needs water to stay healthy, so he needs that before he can have something that is hard on his body. I do the same thing- I always drink a cup of water before I have junk food (regardless of how much water I've already had that day), and ds sees me do that.
But I see that that won't help you at all. Bummer!

How does she do if you give her lots of snacks through the day? Does she eat the same amount at each snack time? Or does the amount for the day stay consistent?

[mamafish9]

Originally Posted by kcparker

Is she old enough that you can frame the discussion in terms of food as medicine and building blocks for her body? Discuss how the body uses different foods for different purposes (fatty acids for the brain, calcium for bones and teeth, iron for blood, etc.) Maybe if she can come to look at it as part of her routine maintenance behavior, same category as brushing our teeth or doing laundry, it won't be about pleasure or wanting to eat. It's just something we have to do to keep our bodies healthy and to keep our mood and energy levels up.

Good luck figuring out if there is a gastro-intestinal or intolerance-related root cause.

That's actually been our most successful strategy so far, and helps to get her to eat a variety of foods. But she figures once she feels full, her body must have enough for what it needs. Even if "full" comes after 2 strawberries. And she tells us her eyes and brain work great .

Originally Posted by DevaMajka

Just wanted to share this. I asked ds if he had any advice for you (hoping that it could shed some light on his water issue). He said "Just make her eat more?" lol yeah, like that would work for either of us.

He also said what we sort of do: he has to have drank a cup of water so far that day before he can have candy/sugar. We don't phrase it as a reward/bribe, but that his body needs water to stay healthy, so he needs that before he can have something that is hard on his body. I do the same thing- I always drink a cup of water before I have junk food (regardless of how much water I've already had that day), and ds sees me do that.
But I see that that won't help you at all. Bummer!

How does she do if you give her lots of snacks through the day? Does she eat the same amount at each snack time? Or does the amount for the day stay consistent?

We do that with treats, mostly because if she's eating only a little, I want it to be higher quality nutrients than sugar. She's glad for the treats, but I've never seen it really motivate eating.

She likes to snack, but I think she actually eats less if we do lots of snacking. Hard to tell. Some days she eats a pretty good amount of food - it's so random!!

[kcparker]

Another thought - maybe she has either a teeny-tiny stomach relative to what most people have, so it truly doesn't hold a lot, or she has something unusual about her hypothalamus/appestat function. I don't know if there's a way to check into that, but maybe there's even a hormonal explanation.

MY DS1 is not very 'food-motivated' either, and DH and I both feel occasional concern that if he were ever to get very ill, he hasn't got much in the way of reserves. But we can't force them to eat...

[LynnS6]

Originally Posted by mamafish9

Hmmm, interesting thought. Her brother is autistic, and we often say that between them, they got the traits of a typical autistic kid - he has the social/relational issues and she has all the sensory ones. She loves to smell things, and reacts strongly to powerful smells, but I don't know how her basic sense of smell is. Definitely something to check out! Thanks - I'm absolutely seeking these "out there" explanations, just so we haven't missed something.

I would definitely look into whether this could be sensory. If she's hypersensitive, she might 'feel full' with a little bit. If she's undersensitive, she might not notice hunger signals. It definitely sounds like she reacts strongly to texture of foods, which suggests sensory issues to me.

Have you ever looked into feeding therapy? Occupational therapy for the sensory stuff? OT helped our ds tremendously (though eating was never an issue).

What happens when you offer food every hour?

Originally Posted by mamafish9

She will eat dairy protein (same volume issues though), so we do a lot of it. That's one of the reasons we're testing for food sensitivities, actually - if dairy is a problem, it's one of her main calorie sources.

But if it's causing her discomfort, would she be more likely to eat more if it's eliminated? Sorry I don't know enough about intolerances to really know.

Originally Posted by mamafish9

And I wish she would dip things. Sauces and dips have always been a texture issue... But at least she'll still eat mac & cheese, that must not be fun!

My sensory kid won't dip anything either, just FYI, and he doesn't have other food issues.

[mamafish9]

Originally Posted by LynnS6

I would definitely look into whether this could be sensory. If she's hypersensitive, she might 'feel full' with a little bit. If she's undersensitive, she might not notice hunger signals. It definitely sounds like she reacts strongly to texture of foods, which suggests sensory issues to me.

Have you ever looked into feeding therapy? Occupational therapy for the sensory stuff? OT helped our ds tremendously (though eating was never an issue).

What happens when you offer food every hour?

But if it's causing her discomfort, would she be more likely to eat more if it's eliminated? Sorry I don't know enough about intolerances to really know.

My sensory kid won't dip anything either, just FYI, and he doesn't have other food issues.

She's definitely hypersensitive, and not only with food (sponging ideas off my son's OT!). We've done informal sensory therapy with her, food included, and it has helped. We've assumed all along that is our main issue. But it feels like that isn't adequately handling things now.

And yes, lots of kids start eating more and more variety if foods they react to are removed. She doesn't have many of the classic food intolerance symptoms but I feel like we need to at least investigate the possibility at this point.

Originally Posted by kcparker

Another thought - maybe she has either a teeny-tiny stomach relative to what most people have, so it truly doesn't hold a lot, or she has something unusual about her hypothalamus/appestat function. I don't know if there's a way to check into that, but maybe there's even a hormonal explanation.

MY DS1 is not very 'food-motivated' either, and DH and I both feel occasional concern that if he were ever to get very ill, he hasn't got much in the way of reserves. But we can't force them to eat...

Occasionally she eats a ridiculous amount of food, so I know she has the physical capacity to do so. It's possible she gets a "full" feeling when she's not - no idea how to check that though! I'll file it away as a possibility to consider.

I think what this thread has helped me clarify is that we've tried most of the obvious "do at home" stuff. So it's time to follow that niggling feeling in my gut that something else might be going on here. Thanks for being a great sounding board!