My son is starving himself

[churndash]

Because of many food issues in my own family, I swore I would never argue about food with my kids. I let them choose what to eat and for the most part, it's worked really well.

My son was always the pickiest eater of the three, but he still had a well rounded diet. Over time though, his eating has become pickier and pickier until it reached the point where he eats almost nothing.

I think it started when he had a very bad bout of diarrhea. He didn't want to eat because his stomach would hurt so much afterward.

Today, his entire intake was half a peanut butter sandwich and a single apple slice. That was it. Over the last month or so, I'd say his average daily food intake is 1000 calories, sometimes less.

I have tried begging, bribing, punishing, yelling, sobbing, getting down on my hands and knees and promising him the moon. I have tried letting him pick the food or cook the food or sneak things in, protein shakes, Boost, Ensure.  Nothing works. NOTHING. Everyone keeps telling me "just make him eat" but how do you MAKE him? I am so sick of hearing "just make him".

You can't. I can't. Not unless I physically pry his mouth open and hold it shut. He will not eat. He says no. No matter what I say, he says no, he won't eat. He is tired and lethargic all the time. He has always been skinny and below the charts in weight. Now he is so thin that his size 7 jeans fall off of him.

The doctor does nothing. He just says "oh he's always been skinny". My son was tested for celiac and malapsorption, all negative. In the diarrhea, the dr. just says it might have been a bug or his diet lacking fiber.

I am sitting here sobbing. I am certain that my son is starving to death. A body cannot function on so few calories. He has lost weight. He is too tired to play.

I would give him any junk food, any candy, any anything if he would just eat it. Tomorrow I am taking him to the ER. I am just not going to leave until they do something.

The worst thing is that I have completely lost my head over this. Tonight I just lost it. I cried and sobbed and yelled at him and just said all kinds of horrible things. He's in his room crying. I just don't understand why he won't eat. His stomach hurts every day - probably from HUNGER!!!

I asked him if he liked having a stomachache and liked being too tired to play and he said no of course not so I said then Why, why why won't you eat?!?!

I am beside myself and I don't know what to do and we are both crying and I'm afraid that I've hopelessly destroyed him physically and mentally. I don't know what else to do. Please don't tell me to just make him eat. He won't eat anything. Not even candy or junk. I would give him any food in existence if he would eat it. He won't.

[marinak1977]

Hoping for you and your little guy to find a good solution for him to eat and be healthy.

[bandgeek]

I'm so sorry.  I think you, as his mom, knows him best. If you think he needs to be seen, take him in.  There will be people and doctors that say "Oh a kid won't starve himself" but sometimes they do!  That's how some of them end up with feeding tubes!  You may get turned away from the ER with no real answers, and if that happens, start keeping a detailed log.  How often you offer food, what you offer, what he does eat and the calories, how often he complains of pain, how much he sleeps and "rests" each day.  If he's sleeping 14 hours and laying on the couch for another 4, that's a problem.  If he's only eating 1000 calories, that's a problem.

I've had some similar issues with my son, but not as severe and we're able to work on them on our own for the most part.  It's still SO frustrating that the doctors don't take me seriously.  It's not NORMAL for a child to refuse food for 18 hours straight on a regular basis!  Then to curl up in a ball on the floor and cry for an hour.  Then finally take a few bites of food and be FINE.  Then repeat the whole process again the next day.  *sigh*

I hope they listen to you.  I know a little girl who was 43" and 23 lbs before they finally took her mother seriously.  She was a skeleton!

[churndash]

Thank you, bandgeek. I too, get tired of hearing things like "oh when they are hungry enough they'll eat". Because my son, like yours, has easily gone 18 hours without eating.

Last night he fell asleep at 8pm, didn't eat anything until after 12 noon today, when I finally got him to eat the half sandwich and apple slice. He didn't get up from the couch at all except to go to the bathroom. He went to bed at 8 again tonight.

I tried to get a dr. appointment and the nurse just said it was probably a stomach bug and to take his temperature and give him tylenol if he had a fever and to wait til after the holidays.

But I know something is wrong! You just don't go from being a happy, energetic kid who is a picky eater but still eats a variety of proteins, fruits and grains to a kid who lays on the couch all day and refuses to eat anything without there being something wrong!

I am ashamed of the things I said to him tonight. I actually said that I was afraid he'd die if he didn't eat. I can't believe I said that. I want to wake him up an apologize, I feel so terrible. But I am just so scared and worried and at my wits end.

[MeepyCat]

Churndash, how old is your son?  It must be really terrifying to see him like this.  I am so sorry.

Kids generally don't hold off on eating for so long that they start to feel bad (barring eating disorders), so my suspicion (which I'm sure you share) is that there's an underlying medical problem.  It is incredibly worrying that your son is lethargic.  Poor kid.

Off the top of my head, there are some things that I wonder:

- any chance of intestinal parasites?  Some of those (tapeworm?) can reduce appetite.  It seems unlikely that only your son would be affected, and not the rest of the family, but hey, I'm throwing it out there.

- Irritable bowel syndrome?

- Lactose intolerance? 

Good luck at the ER tomorrow.  I feel like what you really need is a set of emergency referrals - the kid needs a specialist, and someone who believes you. 

[jeanine123]

I agree that a trip to the ER would be a good idea.  I also think an appt. with a counselor who has experience with eating disorders is in order as well.

[churndash]

He is 11, Meepycat. And yes, he's always been thin, but he's never lacked energy. I do think he already has or is developing an eating disorder. It is just so frustrating when the doctor looks at you like you are just a silly mom worrying about nothing. 

[bandgeek]

Originally Posted by churndash 

I am ashamed of the things I said to him tonight. I actually said that I was afraid he'd die if he didn't eat. I can't believe I said that. I want to wake him up an apologize, I feel so terrible. But I am just so scared and worried and at my wits end.

I don't think that's too terrible.  Sometimes kids need to hear the truth.  If all of this is behavioral, maybe hearing the consequences will help.  It might not be and it could be physical, in which case telling him that won't help at all, but you can't take it back now.  Apologize tomorrow.  Tell him you are sorry but you ARE truly concerned.  Have a heart to heart with him and try to get to the bottom of it as much as you can (emotional stuff AND physical stuff).

I would start the log now, of the last couple of days, or for as far back as you can remember accurately.  So at least you have something to show them.  Even if you don't have data for as long as it's been going on, give them an estimated date of when this behavior started so they can see it's not just a stomach bug.

[LynnS6]

It's got to feel very scary to feel so powerless. 

I agree that taking him in to see someone is a good idea. If you have his weight records from the last year or so, bring those with you. I think keeping a food diary (food offered, food eaten) for a week or two after the doctor visit tomorrow is a good idea. Make sure you describe how little he's moving as well.

One book suggestion: Just take a bite: Easy, effective answers to food aversions and eating challenges.

I would ask the doctors about hypoglycemia, diabetes and thyroid issues. It could be sensory/taste based, it could partly be behavioral. I would highly recommend pursuing feeding therapy.

[The4OfUs]

Originally Posted by churndash 

I think it started when he had a very bad bout of diarrhea. He didn't want to eat because his stomach would hurt so much afterward.

I am so, so sorry you're dealing with this.  Our son had a much less serious problem when he had a stomach bug with vomiting, that his sister then had so he saw her throwing up a lot, and then my Nana had and was in the hospital a couple days...then DD got an ear infection and threw up in our van right next to him a couple times shortly thereafter, and he developed this phobia about throwing up and started not eating things he normally did (because he might choke or cough and that might make him throw up), and his list of OK food started getting smaller and smaller and more ritualized.  He didn't want to ride in a vehicle, refused to go on long car trips, etc.

We had him see a play therapist for a while, and it really, REALLY helped.  He was only 6 when this happened, so I'm sure it would be different issues, but I just wanted to chiem in with the person who suggested finding him a counselor, I think that it could help him, especially if it was precipitated by an event as you said.  DS's therapist helped him work through the whole thing, and he's weathered a couple stomach bugs through the house with no problems since.

I hope that they take you seriously and wish you the strength to assert your concerns to make them take you seriously.  You know your child.  Tell them that.  You KNOW this isn't normal.  If you can make a list of what he's eaten the past few days/etc., write it all up with the diarrhea connection, and have it all ready to go so they see you're prepared and armed with information, that might help.

Good good luck for boht of you!  :hug:

[4evermom]

That does sound very worrisome:-(

This is a recent article about a boy with anorexia which talks about how anorexia is increasing in boys.

http://www.cnn.com/2010/HEALTH/12/03/young.boys.anorexia/?hpt=Sbin

[D_McG]

That is very distressing.  I hope you get some answers, soon.  I would make an appointment with a nutritional counselor or a psychologist though.  I don't know that the ER will really get you what you need :hug:

[mumm]

My son has had similiar problems.  He is ten.  When you go for so long without eating it does hurt to eat.  And then you don't want to eat again because it hurt the last time.  My son was getting quite ill- passing out, very dehydrated, etc.  Clearly he was missing lots of school and other "normal" kid stuff.  He is great now!  He is 5' tall and only weighs 50lb but his energy is great, attends school regularly, plays with friends, argues with me about pretty much everything!  typical normal kid.

But it was a hard cycle to break.  I can't really pinpoint the turning place for us.  We got him in therapy for anxiety.   We hired a tutor to come to the house to work with him on homework so that it was one less thing for me to "pick on him" about.  We left small bite types of food around easy to nibble on.  (grapes, small candies, something you or I would pop in our mouth without thinking.)  We lowered our standards about acceptable food at home.  I let him get food out of the house more (hot dogs at his siblings soccer games, drive though fast food that stinks up the car, muffins from the grocery store, etc.)  We let him waste food without comment (which is really hard for me!  But putting the food on his plate in the first place was movement in the right direction and I had to not force it.)  He still has a very narrow diet but is healthy in that he isn't sick and crampy all the time. 

It is really hard to watch your kid struggle when you know the problem!  But possibly the lack of eating isn't the real problem, just a symptom.  And you don't want to treat the symptom, you want to get to the root of it.  I feel bad for you.  I know the constant complaints of stomach aches.  Can you get him to a therapist? 

Best of luck ot you both.

[mamatoablessing]

You've gotten some good advice, OP.  I just wanted to offer my support and encourage you to trust your mama instinct.  If you feel like something is wrong, then it is.  Pursue it...don't take no for an answer.  Sounds like he might need a medical doctor to help get his body back in shape and a counselor or therapist who specializes in eating disorders or anxiety.  (((hugs)))  Please update when you can.

[churndash]

Originally Posted by D_McG 

That is very distressing.  I hope you get some answers, soon.  I would make an appointment with a nutritional counselor or a psychologist though.  I don't know that the ER will really get you what you need :hug:

I don't know that they can either. I had a crazy vision of just showing up and demanding that they put him on a feeding tube until he's gained ten pounds! I know that's not realistic.

When my ex and I split up, all of my kids spoke with a family counselor, and we've returned to her, together and separately, from time to time. I will talk to her about a possible recommendation for a specialist in child anxiety or eating disorders. I have little hope of getting in to see anyone before the holidays though.

mumm, thank you for sharing your story. It's good to hear a positive outcome is out there. I had suspected too, that his stomachaches are the result of eating after going so long without. I tried explaining to him that over time your stomach shrinks if you don't eat and it hurts to stretch it out again. I feel like he's old enough to understand the logic behind this, and why not eating is what makes him so listless and without energy,  so it must be some overriding anxiety or psychological block that is keeping him from doing what needs to be done for his health. 

[HappyHappyMommy]

Churndash, to you and your family.

First, I agree with the PPs who have mentioned to listen to your mama instincts. It was a completely different situation (my child was a newborn), but I had a sense something was wrong with my child. At her 3 day visit, the pediatrician ignored the concerns that we raised and, within 2 days, our child's condition worsened to the point that she required hospitalization. The on-call physician was awful. She was distracted on the phone and then said "yeah, I guess you should go to the ER." When we got the ER (it was a weekend), the pediatric ER doctors noted that if we had waited even 6 hours more, our daughter might have gone into shock, had seizures, permanent brain damage, or died. (We switched pediatrician the next business day!) Anyhow, that's a long wayof saying, that it can be so hard and so frustrating when a doctor ignores or minimizes concerns, but trust your mama instincts and knowledge! Your child is lucky to have you as his advocate.

I agree with the suggestions of the log; estimate the information from the past and keep detailed information going forward. And continue speaking with doctors and counselors until you can find one that can help you. It's sometimes hard to reach doctors and counselors over a holiday period, but the ER is a good option during this time.

One other thing I wanted to mention. Not to alarm you, but please be open to the fact that your son may have suffered or be suffering some trauma. Lack of eating and exhaustion/sleeping for hours on end can be signs of depression and can be reactions to trauma. Children and adults of all backgrounds struggle with eating disorders, so an eating disorder doesn't necessarily indicate trauma. That said, eating disorders are common struggles for abuse survivors. Talking about abuse is difficult for any person, but statistically, boys often less likely to discuss abuse.

I'll thinking of you and your son and your family and sending love and light your way.

[Lisa1970]

You need to take him to a pediatric gastroenterologist. You also need to stop making your food issues in to his. Stop begging and pleading. You are only making things worse. If he has an eating disorder, that is all about power and him using eating for power. You are fueling it. If it is a health issue, then it is not fair to him for you to do this.

My son has eosinophilic gastroenteritis (not entritis). It is rare. But, without extensive testing with a GI doctor, we would not have known and would have thought he was starving himself. Since you only listed 2 of the more obvious things to test for, I am guessing he has not had a complete workup with a pediatric GI doctor.

So please, please stop begging him or making food such a big issue. There is absolutely nothing that could be wrong with him where the begging and pleading and bribing would help. In fact, if he did not have an eating disorder before, then just knowing he can withhold food to get things could cause an eating disorder. I am dead serious about that. 

[churndash]

Originally Posted by Lisa1970 

You need to take him to a pediatric gastroenterologist. You also need to stop making your food issues in to his. Stop begging and pleading. You are only making things worse. If he has an eating disorder, that is all about power and him using eating for power. You are fueling it. If it is a health issue, then it is not fair to him for you to do this.

My son has eosinophilic gastroenteritis (not entritis). It is rare. But, without extensive testing with a GI doctor, we would not have known and would have thought he was starving himself. Since you only listed 2 of the more obvious things to test for, I am guessing he has not had a complete workup with a pediatric GI doctor.

So please, please stop begging him or making food such a big issue. There is absolutely nothing that could be wrong with him where the begging and pleading and bribing would help. In fact, if he did not have an eating disorder before, then just knowing he can withhold food to get things could cause an eating disorder. I am dead serious about that. 

I don't disagree with you Lisa, and I swear, this behavior (the begging, bribing, etc) is so completely out of character and antithetical to the way I have treated food and eating in our house since his birth. My usual food philosophy has always been to keep the house stocked with good, healthy food and then to just let everyone be.
 

It's really only been in the last two-three days that I've been at the end of my rope and willing to do anything to get him to eat. I know I went too far today and I won't be doing that again.

[Super~Single~Mama]

Big hugs to you Mama!!!  I hope you get some answers soon!

Definitely ask your family therapist for a recommendation - and talk to her about this for YOU too.  You need to have a safe place where you can be upset and cry about it, and get some reassurance.

I would go to the ER - even if they are unable to help tomorrow, they may be able to make referrals for you since your regular ped won't listen.  Specifically ask for what you want from them - tests, referrals, whatever it is that you want you need to ask specifically.  Tell them as much as you can, be completely honest (don't minimize the situation, as I have a habit of doing whenever I talk to someone not in my family), and tell them that you know something is wrong.  I'm shocked that your ped argued with you - every ped I've ever seen, has always said when I request a test or whenever my requested a test, they have always said, "I don't argue with a mother" - find a ped, or a dr, with that philosophy and go with your gut.  You know your kid better than anyone else, and if you know something is wrong, you're right - its the dr's job to figure out what it is.

[One_Girl]

Since lethargy is involved I think you should definitely take him in ASAP.  How long has this been going on though?  If it was a recent stomach bug and he still isn't up to his old self I suggest focusing on sugary drinks to up his energy, not on food.  Have him take a sip or two every 10 minutes or so to stay hydrated and don't go with sugar free drinks because the sugar is going to give him the fast energy so he can start recovering quickly.  My dd will get sick to the point of lethargy because there is not a lot she feels like eating when she is ill and if I don't guess what she wants she just won't eat.  I give her apple juice (capri sun juice is actually my favorite for these times because it is basically sugar) and soda first because she will sip that, once she has had a bunch of that her energy level usually pulls up enough so she will slowly eat really yummy treats that she doesn't often have.  When she gets sick I try to always give her juice and treats from the beginning so the lethargy doesn't kick in but that isn't always possible.  If you call your pediatrician and tell the office staff he is lethargic and has been for ____ days they should get you in quickly without making you go to the nurse.  I would really suggest avoiding the nurse and just making an appointment anytime you are sure your child needs a visit because the nurses tend to be so laid back even in cases when the doctor is not (this has happened to us twice and the nurse got chewed out both times).