worried about 20mo dd - refusal to eat & ped wants me to 'limit nursing'

[MandyGail]

my 20mo dd weighs 20.5lbs - she weighed 8lbs 14oz at birth, 16lbs at 6 months & has gained only 4.5lbs since then.  She never really liked babyfoods & up unitl a few months ago, ate finger foods sparingly.  Very recently, like within the past 3 weeks, she really does not eat any foods without me coercing her, or me chasing her around taking a bite here or there. 

So I took her to her well baby visit & doc is very concerned about her lack of weight gain.  he suggested at her 12month appt that i limit nursing so that she is not full on bm all the time, but I really did not give it a wholehearted effort & at 19 months she was nursing a LOT - maybe 20 times a day or more.  So this time at this last appt he said I really had to try to limit the nursing so that she would eat some food.  

I have for the past few days only tried to nurse her after she eats some food - but i feel like she is developing a fierce aversion to food.  I am so scared that she is going to starve herself!  Its been 3 days since I cut back to nursing 2-3 times during the day & if she wakes up at night (which she has several times)  She has started (within the past week or so) gagging while eating certain foods.  

She really will not eat anything on her own, if i put it in front of her - she says no.  I have to coerce her to eat it & even then she will only eat a few bites. 

I know that weaning & getting used to this new 'schedule' would take several days - but in all of this, i feel like she is telling me that she's not ok with this & Its going too fast for her.  BUT I do agree with teh ped - that she does need to eat food too, especially if I get pregnant in the next few months (which is likely) - that my supply will drop and she will need to have her nutrition come from another source than me.   

I am worried sick over this - i nursed ds till he was 3, but he ate a good amount of food & never had weight issues.  How do you get a child to gain weight if they refuse to eat?  How do I know if there is some sort of medical issue, or if it is behavioural?  and if it behavioral, how do I get her to eat?  what sort of medical issues could be causing this?

THanks for any insight!

[LionessMom]

to me it sounds like she might have digestive issues. food sensitivities or whatever. we havent been able to pinpoint what might be wrong with my DD! but she sounds a lot like yours. down to the weight. take a good look at her and tell me if she looks like she has fat on her temples, around her knees, etc. does her belly stick out like it is full of air? is she all bone?

[milkymaid]

I am so sorry you are going through this!  I have had eating challenges with my DS as well however he is only 15 months.  My DS has reflux and possibly food allergies.  At one point he was neither nursing or eating solids.  I would suggest going to see a pediatric GI doctor, pediatric allergist and feeding specialist.  We saw a feeding specialist who gave us lots of tips to get food into DS.  We still have challenges, like he will gag himself when he doesn't want to eat.  He will keep doing it until he throws up.  It is very disconcerting :(  

I would rule out any medical issues (GI, allergy etc.) and see the feeding specialist.  Also, I would continue to breastfeed and not limit it, but just offer solids first.  

Good luck!  I  know how stressful this can be.

[carlye828]

I don’t think that taking away breast milk, the one food she will eat, is going to coerce her into eating other foods she does not like.  Has your daughters pediatrician explored any other possible cause to this, as the other ladies suggested, or does he just push ‘limit the nursing‘?  She will benefit more weight from 4oz of breast milk than she will 4oz of anything else.  Were you concerned about her weight gain before her well-baby visit?  Does she look emaciated?  You know better than anyone whether your child is healthy.  (I personally think that 99% of doctors are the most educated idiots there are.)

Food strikes are still very common in my 27 month old.  She will go for days without eating much food, and she changes her mind about her palate likes and dislikes constantly.  It may be a textural thing with a lot of foods.  My response is to nurse her more, not less.  Try not pushing food for a few days, see if she asks for some.  When my daughter  is on a food strike, she is still required to sit at the table with us for meals.  I make her a small very plate and set it out of her reach, but within her sight, to prevent playing.  If she asks for it, she can have it.  Also, I don’t let her nurse before meals.  She has to wait until after we are done eating.  

[asraidevin]

Your breastmilk will help her gain more than any solids. It's about 22 kcal an ounce, plus almost all nutrients you need. What food can compete with that?

My daughter was picky like this. I offered her the things she would eat that were healthy along side a small bite of  something new. She didn't even have to eat it. She's still pretty picky and very light. 45 lbs at 8 years. My neice is almost 3 and weighs 20 lbs soaking wet. She's also short.

I think part of it is she is enjoying the attention.

Personally, I'd let her snack all day on the few things she does like and breastfeed the rest. Keep offering new things, let her see others eating a full range of foods.

It could be a texture thing as well. She could have a very sensitive palate.

[coryjean727]

I am having almost the same problem but my DD is almost 15 months.  Shes 19 lbs 24 inches long. I chase her around with bites of food and at the end of the day I'm lucky if she ate 2 bites total.  I know she has food allergies and sensitivities.   And I have been hoping she would eat more so I can get pregnant!  I recently discovered that I was eating something with peanuts in it that I cant eat because of her allergy to it.  So its taken about a week (maybe more) since I stopped and she is now starting to eat a few bites...so hopefully her complete strike to solids was because of that.  It is starting to look like it might be... Im hoping it is...Not that she ate a lot before that....And she wont eat anything mushy like baby food. 

So my thoughts are maybe food sensitivities. Maybe not letting her choose to fill up on BM might help her eat more but I would be sceptical about it helping with her weight. 

[Carolyn_mtl]

Wow, I'm *happy* to hear other parents with these issues, makes me feel like I'm not alone.

DD is almost 17 months, about 18lbs and 29.5 inches. She has never eaten. She nurses on demand, all day and all night. Our ped is also concerned, and we have been to the feeding clinic every 2-3 weeks for the last 2.5 months. We've had her evaluated by an OT and she doesn't seem to have any issues. She just doesn't want to eat. I tried restricting her breastfeeding (that seems to be the only answer any dr will give), and we ended up with a very unhappy girl. She became clingly and insecure. If I let her nurse as much as she wants, when we sit her in her highchair and give her food, she will play with it, pull it apart, and recently, bring it to her mouth and taste it (chews or sucks, then spits it out). If I restrict nursing, even only at night, she won't try any food, it's almost as if she is worried that if she eats solids, she won't get any breastmilk. Doctors seem so clueless. I've said to them that restricting her breastfeeding seems wrong, I mean really, they are worried about weight gain, yet want me to restrict a high fat high cal food? Seems a little dumb to me.

I've noticed her interest in food has increased recently, so I will continue to go to the feeding clinic (mainly to please the ped) and watch her weight gain, but I'm starting to worry less. She will eat when she is ready, and I have no plans to reduce her breastfeeding. 

[RthyCrunchyMama]

I think you can limit nursings slowly - every 2 hours, every 2.5 etc and keep spacing them out.  This will help her to be hungry in between but also not move too fast for her.  I would then make sure she has a cup to drink from in between.  Milk with Ovaltine was the ONLY thing mine would drink other than breastmilk.  You could also pump breaskmilk and put it in a cup for her.  I would also make sure there are pleanty of foods around for her to try but don't push it.  Let her eat if she wants too.  If you push she will likely push back.  You could try some netella or something to dip food in.  Smoothies could also be a good transition.  Make a big fuss when she eats, maybe stickers?

Good luck! 

[averlee]

I think you need a new doctor.

Breastmilk is more nutritious and calorie dense than any solid food. Giving her less breast milk will possibly tip her into malnourishment. Not to mention that she may become dehydrated, constipated, clingy, and insomniac...none of which will help.

Your doctor didn't refer you to a pediatric nutritionist, which is a sign he's not properly connected to other professionals in the field. That's the first step a ped should take for slow gain.

Also your doctor didn't prescribe any nutritional supplement for toddlers. That shows he's unaware of available resources and treatments for underweight children. There are many calorie dense toddler food supplements available by prescription.

You need a doctor who knows this stuff.