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how to help my terrible eater?(12 Posts)
My 7 years old DS has mild CP, some oral motor issue (can't move his tongue a whole lot but able to manage chewing without choking) very very slow eater, doesn't have any particular fav food, in general a slow child. His whole life he had managed on only half the calories needed but now it is more and more apparent that he is not going to thrive with this eating pattern and growing body needs.
I am able to link bits of information now more clearly, his appetite is low, he eats very slow, doesn't chew properly, food sits in the tummy for longer, low appetite, puts off the food. This happens bloody every single day every single meal. One meal even snack takes 45-50 mins. All available help, OT, SALT, GP had been tried out from my side. They did say immature eating but not going to do anything unless he is well below his weight range or choking. I have tried every which way even private. No answers!
Recently, I have noticed he has horrible nausea related to smell and sight of food or anything for that matter. If the bin lid is opened he starts gagging, if I am eating something and he is gagging just looking at me, fridge door is opened he is gagging. Earlier he had felt that way but not reacted so badly, he didn't know what nausea is, didn't know how to describe it. But now he knows and keeps on asking what is that bad smell etc. A week ago he went to nice smelling waitrose with me and gagged just after entering (I usually don't take him to supermarket with me because of previous vomiting incidents). He has vomited in my car a many times if I carried a biscuit with me for him. Is it possible for a child to have persistent nausea?? GP looked at me blank when I took him and just ordered blood tests and on followup gave him iron drops. I am at my tether end, can't spend whole life fighting an already lost battle for yet another meal with him. Only thing he happily eats is cucumber! Any wise words?
Try to work outwards from cucumber. He likes cucumber, would he try a similar textured food (eg unripe melon), similar looking (eg courgette lightly cooked), same taste different texture (eg cucumber purée), same thing different taste (eg with lemon dressing)?
Can he eat more if he holds his nose or smells something he likes?
Does location make a difference? Eg better in front of the telly or in the car
Does who serves it change things or cutlery/plates?
Is he well hydrated?
How are his iron levels?
Is he able to talk about it and be active in finding a solution?
He is not averted to other foods, gets excited about pizza, pasta, sausage, chips, fish etc but after few bites he declares that he is full up! it is the low appetite rather than food choice. IYSWIM? Once a few bites are in he is not anymore interested. Cucumber he doesn't say no to!
I will keep a check on water intake, it is low I think. His iron is borderline. Yes, in front of telly will do! But I am not very keen to encourage that. I will try talking with him to find solution. He does understand in theory that food gives energy but says he gets energy with few bites only, gets very emotional with the subject. Trying to encourage him to count calories, carb, protein etc too.
My 9 yr old DD has mild CP - the slow eating thing I can totally understand. It can take at least an hour to eat a small portion for dinner! She has also been very emotional and anxious about food at times.
At 7 yrs old she did get into a pattern of feeling nauseous at most meals and became quite anaemic and underweight so our paed recommended a course of Omeprazole which did really help to break the cycle. She also couldn't eat outside the home without feeling sick but again this is really improving.
Have you had any input from paediatrician or GP? I know it's tough to deal with so hopefully you might get some further advice
ASD related but our DS gets a lot of his calories from drinks we make up at home. Chocolate milk made with full fat milk, cream and extra skimmed milk powder for protein. Fruit smoothies with rice protein powder and Seravit (prescription vitamins). His weight was falling off for over a year but adding more fat to his diet has helped him gain quite a bit. He is nearly back to the centile he used to hover around. Also consider 5-6 small meals a day rather than 3 as snacks and supper are great times to boost calories. Maybe also consider food chaining to expand range. Also the vomit/gagging might be a sensory food aversion? It's so stressful this eating lark isn't it? You are not alone.
You may not want to encourage the eating in front of the TV but if you want to begin to solve the problem it could be a route to try!
Parenting children with special needs often means chucking away the traditinal parenting handbook and doing what works.
Good luck anyway.
Yes we have done eating in front of TV with my asd child. It used to calm him down and relax him. He still sat at the table - the TV was in the dining room. Hes reached the point now where he hoovers up food! But this aversion (nausea etc) sounds like a sensory issue. Lots of children especially sen have sensory issues. My son for eg hates noise, busy places, activity. He loves balancing, spinning, swinging. Look it up - it's fascinating.
Oh and coincidentally my daughter has a supplement (milkshake) called ensure to up her calories. If you want to investigate sensory issues ask for your ds to be seen by an occupational therapist.
Thanks all for great suggestions! I will look into ensure supplement drink (have heard about it before too). Sensory issue is already reviewed by OT (he sees one in the school for handwriting, self-help etc), he keeps fidgeting while doing desk work too. They never had any helpful advice for eating though. But I never realised nausea could be related, will check with the OT.
I have used TV while eating when he was younger, as it was his obvious choice. But it was more like he is focused on TV and I am feeding him (until he was 5 years old). I had to rethink this because he wouldn't eat anything in the school (obviously no TV there and nobody to feed while he is watching), he remained mostly hungry from 9-3:30. He has no active participation in eating while he is watching. It is more like that he is so focused on TV and i can do whatever in the background like feeding him. Now, on bad days I do take TV support, he watches and I feed, but don't want to make it a permanent habit. Also, he chews better when he focuses on chewing rather than on screen. I guess I really would like his participation in his nourishment SEN or not, he is able to do it too but constant nausea keeping him back. It is too hard to watch him dry heaving at any sight or smell food related.
I am sure that it could be given by gp as my daughter has a repeat prescription of it. However, hers was given initially by a hospital dietician. Apologies for the late reply btw. I hope that you see it! If you have no joy with your GP you could try complan which you can buy over the counter, as this is similar. Also, some speech and language therapists specialise in feeding (as speech and feeding are linked by the mouth which slt know lots about). If you can see a slt who specialises this may help. Or an ear, nose and throat person. Just to check if all is well and there is nothing physical causing the retching.
Mixing your own supplement drinks gives you more freedom and you avoid the panic when the preferred supply is out of stock. All the diet people have avoided prescribing until we try other things. Might be best to see if there is an Acute Paediatric Dietitian in your area as they know more about this than community dietitians. Good luck
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