4 year old will NOT eat. Anything. - Mothering Forums
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#1 of 26 Old 05-20-2010, 11:09 AM - Thread Starter
 
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My neice is 4 and is the pickiest eater. She says she just doesn't like food. Any food. My sil is at her wits end. She doesn't know to do and her 1.5 year old is beginning to go down the same picky road.
Sil has tried everything and it continues to get worse. She bargains, bribes, refuses, forces, gives up, is creative and cannot find a way to get her daughter to eat. She tries to make any food her dd wants and she will take one miniscule bite, make a face and that's it. She doesn't have any favorite foods or food she will eat just to get by. She literally takes one bite and that is it.
Any suggestions, help, experience. It is almost like she is anorexic but she is only 4- is that even possible?

Oh and she is 27 lbs (on a good day).
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#2 of 26 Old 05-20-2010, 11:15 AM
 
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Has she consulted her pediatrician?

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#3 of 26 Old 05-20-2010, 11:25 AM - Thread Starter
 
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Yes. She has been a picky eater all along. They say when she is hungry-she will eat. But she won't. She literally gets dizzy and complains that her tummy hurts but won't eat. She may have a cracker.
She nursed for 1 year and would eat all homemade baby food pretty well. When she stopped nursing she stopped eating- she would only drink. She will down any liquid without breathing until it is gone. My suggestion was to not let her drink until she had some food first. But she doesn't care enough to eat and will go without drinking until her mother can't take it anymore. It is very stressful and she's not even my child...
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#4 of 26 Old 05-20-2010, 11:28 AM
 
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Will she drink smoothies?

If yea, I would start there to atleast get some nutrients in her. In the meantime, it may be worth seeing a specialist. 27 pounds at 4 years old sounds a but scary to me.
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#5 of 26 Old 05-20-2010, 11:35 AM
 
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Oh, I wish I could remember the name of the book or author... there is a book that would be perfect for your sister.

The premise is that you divide the responsibility of food as such:

Parents - decide what food to make, what goes on the table. They are not short-order cooks (though of course they will consider their chidren when meal-planning - but not CATER to them).

Children - decide what food on the table they will actually eat, and how much.

This removes a lot of control battles. For the parent's part, they need to stop cajoling and nagging and bribing and threatening. Just sit down to dinner. It works best if the food is all in serving dishes on the table for everyone to see and perhaps be tempted by. I tend to try to save dishes and just serve from the stovetop, but I have personally seen my 4 year old take some interest in food when it's displayed on the table. Nothing miraculous, but she might ask to sniff a dish or lick one bite, and maybe even take a bite or two. Over time she might get used to it and actually fully eat it.

Anyway, the parents don't try to force a kid to eat anything. The kid is in charge of her own mouth and can fill it as she pleases, based on the choices the parent has provided.

According to the anecdotes, at first they usually go hungry. The children are used to the power struggle. Assuming no very serious health problems (like serious metabolic disorders or something), this is fine. The child will get hungry and start to relax if the parent stops trying to force feed etc.

The child decides how much food to eat, and which specific food that is offered to eat. For example, the child might just eat the brown rice but refuse the green beans. Fine. No need to make a fuss. The child will not like green beans because they are forced to eat them. They may, however, experiment down the road. Also the parent is free to "sneak" certain foods into liked foods (like blending vegetables into spaghetti sauce) if they want, but they can't force, cajole, bribe, etc. If the kid eats the spaghetti sauce and they don't know there's spinach in it, fine

Parent also decides "when" to eat. Of course the parent must plan appropriately for the child, and set a reliable schedule and include snacks at reasonable points. But the point is that the child cannot demand a snack 10 minutes before dinner is served. They'll have to wait for dinner. They should be able to rely upon consistent meal and snack times. Their hunger will adjust.

Also, it's pretty critical that the kid eats meals with a parent, if not the whole family, and at the table and not in front of the TV. This increases their awareness of and interest in food. Also it increases the amount of time with the focus on the food - in front of the TV is pretty much about shovelling it in, and keeping your attention on the show (hey, you're hearing this from me because we've done it). At the family dinner table, the pace is slower, you talk, you digest. My 4 year old is more interested in food she sees us eat. Proximity to the food and its smells seems generally to help her get used to it too, she finds it less offensive.

We're using this method and while I can't say it's wrought utter miracles - my kid is still picky - it IS better, less stressful, and she's eating a wider variety of foods. When we catered to her she would eat crap exclusively - we'd ask her what she wanted and she'd pick cereal or frozen pizza every time. But now that she's not consulted (we only consulted her because she's so picky and didn't eat anything!!!) she eats a wider variety of things. She still doesn't eat aspargus or anything, but you know what? She'll eat the pasta with the asparagus picked out. Meaning, she can cope with being given a dish with some ingredients she doesn't like, and just work around them (if they are large enough to work around, that is).

Hopefully someone can come along and give the name of the book, because I got the recommendation on MDC myself.

Homeschooling mama to 6 year old DD.

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#6 of 26 Old 05-20-2010, 11:43 AM
 
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Sorry, I didn't see the update that she only drinks - was typing out for a while.

Hmm.

The method I described above may still work, but not sure. My kiddo did not start eating solids until at least 13 months, and when I mean "start" I mean just bites and nibbles, not actually consuming a significant amount of any food other than baby food maybe. That may or may not have been disordered, I don't know. But I didn't wean her, I'm not criticizing your sister or anything (1 year of nursing is really wonderful) but I think 1 year is too early to wean for the species, it seems like babies need about 2 years of milk. Anyway, it just makes me wonder if she was weaned before she was ready, and then she was cajoled, bribed, forced etc. to eat food at that point - because of course she needed to eat since she was weaned, right? But I wonder if this is still an issue of control with food that started when she was 1. Of course there may be a medical issue, though.

Please note: if someone supplies the name of the book and your sister reads it, she should be prepared that the author is not quite as sympathetic to parents as would be appropriate. It really annoyed me. I can see from her point of view that she has seen real abuse of children related to food, but most of us get into this control/bribe/force pattern because we're worried about our children and want them to eat! And we love them! However, I still felt the book was worthwhile to read, but taking the attitude toward parents with a grain of salt. (Given that the parents are the target audience for the book, it's utterly nonsensical that the author is so unsympathetic to them).

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#7 of 26 Old 05-20-2010, 11:55 AM
 
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This is a big issue at our house! We finally had DS evaluated by an occupational therapist, who diagnosed extreme oral defensiveness (among other muscle tone, balance, and auditory issues) This is a part of his sensory processing disorder, and refusing food is one of his "coping" techniques. (Obviously, not one of his better ones!!!)

In your shoes, I'd recommend your sister take her to an OT who is familiar with feeding issues, and see what they say. Our pediatrician said the same thing, that DS would eat when he was hungry, but because sensory processing disorder is not yet in the DSM, he wasn't really looking at those issues. Most kids WILL eat when they are hungry, mine honestly will not. (believe me, we've tried!)

If the OT says it's not a sensory issue, then there are some good books out there. I think the one a previous poster was suggesting might be Child of Mine, which has some good information in it, and might work well for a kid who doesn't have sensory problems. Another book that I have found useful as we make progress in this area is called, Food Chaining. I don't recall the author, but I'm sure it's on Amazon.

Good luck to your niece! I know how much stress this can but on daily family life, but there are ways to make it better!!

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#8 of 26 Old 05-20-2010, 11:58 AM
 
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Parents - decide what food to make, what goes on the table. They are not short-order cooks (though of course they will consider their chidren when meal-planning - but not CATER to them).

Children - decide what food on the table they will actually eat, and how much.
I have read three or four books on kids and food in the past few weeks and they all boil down to that:

Parents decide what and when.
Kids decide if and how much.

My daughter isn't a picky eater. She will eat anything at all. My concerns were more about how much.

Anyway, pretty much every book says to stop talking about it and just put the food out. They all recommend that three times a day, everyone (or whoever is available for meals) sits down for meals (and for snacks, too). Everyone has the same thing on offer (at least one thing she's had before and liked, and maybe one new thing - so if she will eat pasta, then pasta and a veg on the side or something). Don't comment, just put the food out. Let the kid sit there a while. Eat. Don't comment on what they eat, don't make fake comments about what you're eating (kids can read "ohhhh, yummy yummy broccoli!" for what it is - you trying to get them to eat something). Then get up, clean up the table, and that's it till the next meal or snack.

If she's filling up on liquids, make sure that she only drinks when sitting at the table (and the drinks would be water or milk or very watered down juice or whatever). It's a lot less fun to fill up on liquids if you have to actually sit still at a table while you do it.

She could have an actual problem or she could just be very hung up in the power struggle to the point where she (the child) just can not let it go. Obviously I have no idea because I'm not there, I'm just telling you what I read (seriously, could have saved my money on the books but I'll try to find the titles for you). For at least a little while, totally take the emotions and praise and threats and power struggle out of it and see what happens. It's not like she can eat less.

The books:

Your Child's Weight, Helping Without Harming - Ellyn Satter
How To Get Your Kid To Eat, But Not Too Much - Ellyn Satter
The No Diet Obesity Solution For Kids - Miriam B. Vos

There were two others, but I can't find them right now. One of them makes the point that parents of over-eaters and under-eaters are really striving for the same thing so the solutions should be the same. I have more on this, but I have to go. HTH!
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#9 of 26 Old 05-20-2010, 12:06 PM
 
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I wonder if she has sensory issues. I'd have her evaluated for that, and for any potential medical problem, and feed her calorie and fat dense smoothies.
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#10 of 26 Old 05-20-2010, 01:24 PM
 
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Originally Posted by maybemom05 View Post
I think the one a previous poster was suggesting might be Child of Mine, which has some good information in it, and might work well for a kid who doesn't have sensory problems. Another book that I have found useful as we make progress in this area is called, Food Chaining. I don't recall the author, but I'm sure it's on Amazon.
Child of Mine, yes, that's the one. Kind of a lousy title since it doesn't describe anything about the topic other than that it involves children.

Homeschooling mama to 6 year old DD.

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#11 of 26 Old 05-20-2010, 01:28 PM
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Yes. She has been a picky eater all along. They say when she is hungry-she will eat. But she won't. She literally gets dizzy and complains that her tummy hurts but won't eat. She may have a cracker.
She nursed for 1 year and would eat all homemade baby food pretty well. When she stopped nursing she stopped eating- she would only drink. She will down any liquid without breathing until it is gone. My suggestion was to not let her drink until she had some food first. But she doesn't care enough to eat and will go without drinking until her mother can't take it anymore. It is very stressful and she's not even my child...

She could get all of the necessary nutrients from smoothies. Only wanting liquids is unusual even with picky eaters. Has she been evaluated to see if she has any type of sensory or physical issues? I'd get her evaluated and in the mean time offer her a full range of liquid nutrition until they know what kind of therapy might be needed. Also making food an issue will make the problem worse. Food should be available without any drama (like bargaining, bribing, refusing, forcing, giving up or games). Since the family knows how to make homemade baby foods, incorporating that into creating complete nutrition in liquefied form shouldn't be too hard. She's probably too old for early intervention to do the evaluation, but they would know who to contact to have one done. Often after 3 years old it's the local school board. Also if they haven't weaned the younger child yet they should probably hold off since breastmilk is complete nutrition.
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#12 of 26 Old 05-20-2010, 02:37 PM
 
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Since she drinks liquids, would she drink homemade broth (chicken/veggie) ... or something like Ensure?
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#13 of 26 Old 05-20-2010, 05:38 PM
 
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Definitely suggest this child be assessed by an occupational therapist who specializes in feeding. A child who will get dizzy because she won't eat is not a child who will 'eat when she gets hungry'. They need to demand that their ped give them a referral because the behavioral stuff they're trying isn't working.

I would assume that she's not eating because she can't, not because she won't. The fact that her brother is showing the same tendencies makes me think it's sensory not behavioral.

My dh has lifelong food issues because he had oral sensory issues as a kid. It's not fun, but it's something that can be worked on. What they can't do is force her to eat.

Two books to recommend:
Just Take a Bite: Easy, Effective Solutions to Food Aversions and Feeding Problems
Feeding with Love and Good Sense (this is a more general book on good practices, their child may already be beyond what this book can do for them)

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#14 of 26 Old 05-20-2010, 07:37 PM
 
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I'd get her evaluated for sensory issues.

In the meantime, try smoothies or Pedisure (or both.) Smoothies were our saving grace for a while after ds weaned (he'd drink that and eat chicken, that's it, for 2 months.)

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#15 of 26 Old 05-20-2010, 11:42 PM
 
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Agree with the others, she needs an eval asap. Even if it turns out she doesn't have a diagnosis they can help.
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#16 of 26 Old 05-21-2010, 12:10 AM
 
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Normally I would say to offer the healthy food and allow her to eat when she is hungry, but this sounds like an extreme case where something else may be going on. I agree with the people who said to have her evaluated. 27 pounds seems very small, I believe it is at the very bottom of the average range for a four year old, but if she is also a small child or has always been at that percentile then the pediatrician may be right and just serving the food without any comment and taking it away may help the whole family feel more relaxed about food.
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#17 of 26 Old 05-21-2010, 12:19 AM
 
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Will she graze if food is just out? Your sil could try the muffin try thing, where there is a variety of healthy, bite size snacks available all the time.

I hope your sil can find some answers soon.

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#18 of 26 Old 05-21-2010, 12:49 AM
 
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i think most kids will eat if they are really hungry but in cases like this it seems like there is a bigger picture or underlying issue.

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#19 of 26 Old 05-21-2010, 09:51 PM
 
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Definitely have her evaluated. If she is cool with Smoothie will she drink soup through a straw. My daughter will only drink soup refuses spoons. So I put it in a straw cup. Pea soup potato soup corncowder.yummmmmm
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#20 of 26 Old 05-23-2010, 11:05 AM
 
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I agree. I think there's way more going on than a power struggle about food. Get a feeding study done and see what's going on. It could be sensory or it could be something physical.
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#21 of 26 Old 05-24-2010, 03:35 PM
 
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I'm thinking the same as the last few posters- have an OT eval done for a sensory disorder, and maybe a work up for a digestive problem like celiac or something along those lines. It sounds like this girl is avoiding food for a reason- and as a parent of a child with sensory integration disorder you are not going to be able to just twist her arm or bribe. My daughter has a friend with oral defensive SPD and it needs therapy and intervention. They can teach your SIL tools and techniques to desensitize her before she gets sick, and help her parents realize they're not crazy!
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#22 of 26 Old 05-24-2010, 03:53 PM
 
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take her to a naturopath or chinese doctor

kids with low zinc can often exhibit low/no appetite. My bff's son was so extreme in his pickiness it was scary, once they found out he had low zinc and started supplementing he picked up sooo many new foods!

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#23 of 26 Old 05-24-2010, 05:10 PM
 
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What an interesting thread! i have no experience with this in my kids. But I do have an adult friend who does the same thing and it's been this way all her life. She's stick thin, and she just doesn't *like* food! She gets hungry and will nibble on really plain, fairly unflavorful foods like crackers. As she's gone through life (she's 31 now) she finds more and more foods that she can tolerate. Also, as she's gotten older, she's found she's having more and more gut troubles, among other things that always seem to have something to do with food. when she's having pms and on her cycle, she really doesn't feel like eating ANYTHING - which of course isn't a solution. she smokes pot to give her some kind of appetite during pms and her cycle. She is so sensitive to food that she can smell things cooking from very far away and completely looses her appetite.

I'll be interested to see if the child in question gets any resolution through alternative treatments.

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#24 of 26 Old 05-25-2010, 04:58 PM
 
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I have read three or four books on kids and food in the past few weeks and they all boil down to that:

Parents decide what and when.
Kids decide if and how much.
I couldn't agree more with this.

I also agree that a sensory issue may be the case. If it's not and she's just good ol' fashioned picky, I'd stop the catering business and supply healthy, high-fat meals and snacks for her to graze on, without bribes or making it an issue if she takes or leaves it. Also, if she's drinking milk or juice throughout the day, it can really interfere with appetite.

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#25 of 26 Old 05-25-2010, 06:03 PM
 
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Sensory issues are a possibility, so is an underlying GI issue. Food refusal is very common with eosinophilic esophagitis and can be the only symptom, along with failure to thrive when it gets extreme. I've got one kid with each and it's no picnic. I'm afraid the idea that kids will eat when they get hungry is bullshit. Not eating solid food can lead to constipation which leads to a reduction in serotonin created in the intestinal tract which further reduces appetite. That train can go straight to failure to thrive land and it's not a fun trip. My son didn't eat a bite of solid food for five weeks last winter and it was anorexic snowball that just got worse and worse. No solid food increased his constipation, which further killed his appetite despite being on a large dose of Miralax daily.

The idea that some kids "just don't like eating" but are perfectly healthy is possible but unlikely. There are tons of physical issues that can cause a child to not eat, including anemia, food sensitivities, food allergies, autoimmune disease and sensory processing disorder. Refusal to eat solid food is a huge red flag for potentially serious problems -- oral motor problems, diseases like EE, sensory problems, etc.

I recommend a book called Food Chaining It discusses medical issues and sensory issues related to poor eating and how to increase your child's dietary repertoire.
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#26 of 26 Old 05-25-2010, 07:14 PM
 
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My son has an eating issue. He's been in and out of Feeding Therapy (none of it really worked but I'm hoping to find yet another feeding therapist.)

My son does have sensory issues and is on the autism spectrum.
Some pediatric Speech Therapists are trained in Feeding Therapy. Have your SIL call her health insurance to see if there are any in her area that take her insurance.

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