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Help with 6 year old not eating

90 replies

Summertimewoes · 20/08/2024 10:50

I’ve posted in AIBU as I need as much traffic to get some help !

This is going to be very long - sorry !

My 6 year old dd had a near choking incident four months ago and since then has been barely eating .
She has an active phobia now of swallowing .
She lives off certain crisps, mini Oreos , vanilla ice cream , the cheese part of dairy Lea dunkers , one bite of waffle with Nutella per day , one or two pieces of pasta with ketchup .
If we are out in a cafe , she will eat some donut or some cake .
Sometimes before bed she is so hungry and will accept a chopped up banana- will only eat two pieces .
she will have two innocent smoothie and one Ella’s kitchen fruit pouch per day as well .

Backround is she was diagnosed with sensory processing disorder at age 5.
she’s on a private waiting list to assess for autism .
She is what you would call high functioning . Very bright in school, masks incredibly well , and Then can’t cope once we are at home .
School has seen no issues whatsoever up until June when she could no longer mask as she was so hungry all the time .

I’ve been to the gp three times , sent to children’s hospital to rule out any physical problems with swallowing ( none )
She attends OT for past 18 months for sensory regulation. ( private )
She Is seeing a child councilor ( private ) weekly but seeing no difference.
Gp has referred her to a dietitian and a psychologist but not sure how long we will be waiting .
I had been referred to a child psychologist - Public - who said there was nothing they could do - this is the HSE so our public healthcare system .
Ive emailed private psychologists who either are not taking on new patients or say she’s too complex .

Her OT thinks she is showing signs of PDA and is experiencing burn out.

Her behaviors are very difficult at the moment but we are doing low/no demand in the hope she will regulate and the eating will follow .

Here’s my question (after all that !)
Has anyone got any experience with this ? I can deal with the behavior ( just about ) but we are extremely worried about the eating . I’m not sure how she is surviving.
I’ve tried different approaches with food but maybe there’s something I havevt tried ?

Our healthcare system in Ireland is broken , no one knows what to do with her and we basically don’t know where to turn .
Gp mentioned Arfid so I’ve been researching a bit on that too .

Anything else I can do to encourage eating , get some help ?

OP posts:
Createausername1970 · 21/08/2024 20:08

Summertimewoes · 20/08/2024 11:04

Thank you ! Unfortunately we tried that . Even bought a new nutra bullet contraption and made milkshakes with her in the hope I could add stuff to it but she refuses any smoothie that’s not the innocent brand .
Although she was a picky eater before this , she would still eat huge portions of what she liked - bolognese, pesto pasta etc - we were actually worried about her weight at one stage as she ate such vast amounts .
Now she’s lost half a stone since end of April and I’d do anything to see her eat a bowl of pasta

Thanks for your reply ☺️

Can you refill a used branded bottle with a smoothie you have made? So she thinks it's the brand she likes?

My DS went through a phase of only eating certain brands, but had no clue at that age that the Cadbury hot chocolate jar actually contained a supermarket brand.

HamBagelNoCheese · 21/08/2024 20:01

At this stage don't worry that she's only eating crap. Working on what she is eating can happen later

BeSpoonyAquaHare · 21/08/2024 11:03

That’s fair enough - if OP thinks her daughter will be able to tell then it won’t work. It might work with the innocent brand but a new flavour, then she might just accept that it’s supposed to taste that way. But as I said, innocent smoothies have a lot of nutrients on their own so if she’s happy having them as they are it’s still good.

MistyFrequencies · 21/08/2024 10:45

Sirzy · 21/08/2024 10:33

I would suggest not trying to trick in any way with different things in known packs - that is more likely to lead to loss of that food and even worse not trusting you to prepare food

Agree with this. They KNOW and they will never trust you again.

Sirzy · 21/08/2024 10:33

I would suggest not trying to trick in any way with different things in known packs - that is more likely to lead to loss of that food and even worse not trusting you to prepare food

Round3HereWeGo · 21/08/2024 10:30

Keep innocent smoothie bottles and fill them with homemade smoothies that you can hide extra stuff in?

BeSpoonyAquaHare · 21/08/2024 10:20

I’m so sorry OP, that sounds very hard.

I don’t have any advice on the therapeutic side and it sounds like you’re doing all you should be there.

In terms of upping her nutrients and calories here are some you could try:

Cake - would she eat carrot cake or courgette cake (especially if she doesn’t know what’s in them?). You can use the nutribullet to blend the carrot or courgette to a paste so they weren’t visible. You can also make cakes with sweet potato, there are recipes for things like sweet potato brownies online.

Muffins - attached is a recipe, these look bloody worthy from the ingredients list but they’re actually delicious and packed full of good things that even my picky 3yo doesn’t notice.

pancakes - would she eat these? If so you can make them with banana and ground almonds and that, along with the egg, is a good source of calories and vitamins

smoothies - would she notice the taste difference if you bought big bottles of innocent smoothies and blended some extra hidden fruit and veg into it (spinach, carrot etc) and then returned it to the bottle? If not then the smoothies are decent anyway so don’t worry too much.

Would she try something like hummus? It has a very easy texture but it’s a good source of iron and protein. Peanut butter too - it’s a great addition to toast or pancakes if she will have those things.

Help with 6 year old not eating
Onionbhajisandwich · 21/08/2024 10:20

My son went through a long phase of this after he had a sickness bug. At one point he was living on a couple of mouthfuls of ice cream each day. We managed it using a couple of things. Firstly we had a food diary that we would right down everything that he ate - he would write them in and draw a picture of the food. Secondly when we were out and about I’d give him a sandwich to hold. He was so hungry he would inevitably end up taking small bites of the sandwich. Every time he tried to give us the sandwich back we redirected his attention. It wasn’t an easy process and took quite a while to overcome the challenges.

We also gave him unrestricted access to a cupboard filled with snacks - he was allowed to help himself without asking and I think that made him feel a bit more in control of the situation.

Summertimewoes · 21/08/2024 10:12

GarageBand · 21/08/2024 08:31

I have a PDAer who has a restricted diet, although I would say it’s quite in ARFID territory.

Mine will avoid a specific food for a few months or years if he has it once and it’s not quite right ie soft biscuits, over or under ripe fruit. So what she is doing makes complete sense. She’s had a shock.

She’s eating something, so that’s great. Remove the pressure. Leave food she will eat around the place for her. Throw out what you think should happen at meal times and do whatever you need to do to get her eating whether that is TV, on her own in a hiding place etc etc.

Getting something in is the most important thing, then getting enough calories in, then getting macro nutrients and micro nutrients.

The paediatric dietician recommended to us that mine had a daily multivitamin, but also daily calcium and iron supplements. If sweets are okay it might be worth giving those a go.

Hariborange do a tablet that has both iron and calcium in it, but even I think it’s absolutely disgusting. Haliborange and others do separate chewy sweets for iron and calcium.

If you start using fortified supplement milkshakes or the like do make sure you don’t double dose.

It is sole destroying with all the healthy eating campaigns on knowing that your child is subsisting off of sugar and processed food but baby steps and no pressure are your friends.

Someone upthread mentioned about using oral stimulation aids. Given it’s the swallowing part I wonder if there’s anything that can be done that is more throat based, but I don’t know anything about that. You are into SALT territory, or SALT/OT combined.

Thanks , that’s very helpful. It’s so hard like you say when we know so much about healthy eating and there’s nothing I can do!

Funnily enough , she used to love jelly sweets but won’t eat them now ( or won’t let her sister eat them in case she chokes) but will eat two sambucal gummies a day .

Yes I will look in to the iron and calcium supplements

I have a gp app on Monday so il mention again about an slt

Thank you

OP posts:
Summertimewoes · 21/08/2024 10:07

OneFastDuck · 21/08/2024 08:07

Could you buys some of the large innocent smoothies in bottles and reuse the bottles. Put homemade ones in.

Would she eat homemade biscuits? Cam do veggie muffins. I'd be so worried all she's eating is processed junk. Is there nothing fresh or homemade she'd eat? How did none of those things become her safe foods?

There was a course local to us a friend used for her autistic son. It was playing with food and lots of games with veggies. Holding things in their mouths- whole carrots sideways then moving onto lickong different flavour ice etc. It worked really well for her. Maybe see if there's anything like that near you?

I am very worried that she’s only eating crap . These became her safe foods when she didn’t eat any kind of food for nearly a week and only drank one smoothie and two fruit pouches per day .
Even to get her to where she is now has taken time and a multitude of different approaches

She has no problems playing with food , licking food. She will often ask for a “normal “ dinner like bolognese and then chew it until it’s basically water and then spit out

OP posts:
Summertimewoes · 21/08/2024 10:03

HamBagelNoCheese · 20/08/2024 20:40

May or May not be something you've tried, but I wonder if distraction might help somewhat - sit her in front of a favourite TV program/film with a plate of her chosen food - is there a chance she may eat a bit more absent mindedly when the focus isn't actually on eating?

Edited

Thanks, this is what we were advised to do as the table was causing too much pressure .
It’s not working but she is enjoying a lot of tv 😐

OP posts:
Apileofballyhoo · 21/08/2024 09:53

Summertimewoes · 21/08/2024 07:47

Thanks for that . I’ve an app with gp on Monday with her so I’ll going to say again about the slt

I meant to say too, Low Demand Parenting is supposed to be a good book.

Lovelysummerdays · 21/08/2024 09:48

I have a picky eater but not quite the same. We make flapjacks together ripe banana, massive amount of smooth peanut butter, oats and honey, cook in the pan for 20 minutes. Mix chocolate with a bit of cream to drizzle over the top. It’s doesn’t set hard it’s really easy to eat I cut into bite sized squares and they go as school snacks, leave a plate out in the kitchen or sitting room and she grabs one as she goes past. They are very easy to eat and more ish but also nutritionally dense, lots of fat and protien. Too easy to eat I have to have a lot of discipline or I’d look like a house.

June2008 · 21/08/2024 09:43

My DC went through a phase of not eating due to a fear of vomiting. (About age 6/7.) We got to the point where she was refusing almost everything. She lost a lot of weight. Our GP was very understanding but there was little other support. We were advised to simply let her eat what she wanted, which was oreos and breadsticks. That was it for weeks and weeks.
I remember getting upset which upset her further and simply had to back off (going against all our instincts) We tried everything. In the end we just had to let her just get some calories in. Nutrition became secondary.

She slowly, and we're talking months, probably years, started to eat a slightly more nutritious selection.

She still has a limited diet. She's just left school and will eat 7 meals. That's it. However they do include fruit and vegetables. It's restrictive and can be a bit frustrating even now but that's part of her and she's happy and healthy.

OwlsDance · 21/08/2024 09:37

OP, I probably won't be much help, but I had a near chocking incident as a child, although I was a bit older - probably 9 or 10. I didn't really have much sensory issues, although I suspect I do have ASD. I've always been a not very good eater even before then.

I had a massive fear of chocking, and I would take absolute ages to eat a meal because I had to psyche myself each time I had to swallow, even if it was liquid. I would often spit out food when no one was looking, especially if it was something like meat. I lost quite a bit of weight. My parents were not understanding in the slightest.

I did eventually grow out of it - I can't remember how long it lasted, but I think I was 11 or 12 by that time. There wasn't anything specific that helped, it was probably just exposure, having to do it day in and day out, so over time the fear has diminished. However, for you DD having a well educated compassionate parent is far more than I had - keep doing what you're doing, you are doing a great job.

LoveSandbanks · 21/08/2024 09:32

My oldest was medically underweight at around 6 but due to lack of appetite and asd. We were told to give him what he wants as long as he was eating something. He had cheesecake or donuts for breakfast.

Your daughter might not eat cheesecake for breakfast but whatever she will eat let her. If that’s chocolate let her eat it, petit filous let her eat it. Let her help herself from the fridge/cupboard. Fill it with her favourite things and take all the stress/anxiety away from food. An asd/afrid child will starve themselves so don’t believe that bollocks about eating if they’re hungry.

itsgettingweird · 21/08/2024 09:26

S*ummer
*
If she eats cake have you looked at oat muffins? You could even make those (oats, banana and dark chocolate) and the. Add some butter icing or something on top to make it into a cake.

I know when we've had children before with very limited diets and eating small amounts (I work sen Ed) we have made sure the small amount they do eat is high calorie and high fat). So if they eat mash potato it's mashed with butter and cream.

Also has anyone mentioned the powder you can add to foods to increase the calories? You could perhaps add it to the pouches she will eat?

For some the solution has ended up being a NG tube (the feeding tube via the nose). I'm not sure of the medical science but frequent amounts of food into the stomach does something about the hunger signals.

Not recognising hunger signals can be related to sensory processing in the same way as not recognising being full.

But I agree that a psychologist who specialises in ND and disordered eating would be best here. I'm wondering if you need to look further afield and do online consults?

DeliciousApples · 21/08/2024 09:12

Would she eat if her pals are eating?

Could you have a kids party for some reason and invite friends round and serve sandwiches, cake etc and sit them all down to eat and she can join in if she wants to?

Thecatatnight · 21/08/2024 09:12

I think some posters don’t realise that if you have a child with potential autism/ sensory issues that they are very sensitive to the tastes & textures of certain foods. So swapping the packaging won’t work. A homemade smoothie tastes very different & has a different texture to an Innocent one. For eg. my DD will only eat certain brands of foods & we’ve tried all the usual tricks but she can always ALWAYS tell if it’s different! It’s really annoying!

Summertimewoes · 21/08/2024 09:05

Octavia64 · 20/08/2024 20:20

Advice:

Multivitamin supplements. Try loads until you get one she will tolerate.

There are a lot of meal replacement drinks out there as well - complan is what my DD uses.

It takes a long time to work on this. We did rewards charts, cooking, trying something new each week. None work fast but they all help.

I’ve tried all the multivitamins , she will at the moment take the sambucal.

We were advised not to give meal replacement drinks as it will fill her and we need her to feel hungry to get her back to eat .
We did a few weeks ago , go against this advice and picked up pedisure but she wouldn’t touch it !

OP posts:
MistyFrequencies · 21/08/2024 09:05

Hi
Also solidarity here, my boy (Autistic) ate only chicken nuggets and innocent smoothies for more than a year. Then stopped drinking the smoothies when they changed to a paper straw! Its so stressful. Im also in Ireland. Two suggestions only, as you have so many good ones up thread
a) contact the Central Remedial Clinic in Dublin and ask to refer child to their Complex Feeding Clinic.
b) phone and write to Dietitian service you are referred to, advise of your childs weight loss. I have the national prioritisation sytem for Dietetics and weight loss as significant as hers should mean she is Priority 1 and seen within 4 weeks.
c) Nutrigen Vitamin Sprinkles. From Holland & Barret. Tastless, you can put them in/on anything, only vitamin my boy couldnt detect so didnt refuse.
Good Luck x

Summertimewoes · 21/08/2024 09:03

HateThese4Leggedbeasts · 20/08/2024 20:16

I would follow arfid groups as pp said.

I follow an Instagram account called evie the explorer who has given me tips on managing restrictive eating in dc. Plus kids eat in color too helped me plan strategies around food.

The key for us was hugely reducing pressure on eating. Always having a safe food (and enough to fill up on) at every meal but putting different food in the table or plate in miniscule quantities and not commenting on whether it was eaten or not . Eg one sliver of a carrot next to the safe food.

My dc was not as extreme as yours but has very gradually improved willingness to tolerate new foods after we have some difficult phases with eating in the past. I also suspect some ND is relevant here too.

We never suggest one more bite at meals or hide foods/trick dc into "trying" something as I found that added pressure and was counter productive.

I do casually talk between meals about the things "kids eat in color" teach, eg green foods help fight germs etc which sparked some interest.

It's a long road and very difficult to manage.

Thanks , I do follow kids eat in colour but will follow your other suggestion too !

She doesn’t eat at the table at the moment, it was causing to much pressure- for everyone!

She won’t eat more of the foods she likes unfortunately. She used to absolutely love plain pasta and i had to limit the amount she ate!
Now we are lucky if she will eat two pieces .
She has a genuine fear of swallowing .
We just don’t understand how she can eat something like an Oreo or Pom bear without thinking and as soon as it’s a “normal “ food she seems to just clam up 😓

OP posts:
Summertimewoes · 21/08/2024 08:58

PuddingAunt · 20/08/2024 20:16

Only suggestion i have, is it possible to arrange a different eating situation eg at aunty's house, at a picnic, with friends/ cousins.
My tricky little one used to eat whatever her cousins were having, so i would get a Sunday roast into her. Then it was back to plain pasta and a frozen frube... hugs to everyone who has a fussy eater.

Yes we do find it we’re out with friends and we are walking around with them she will eat while distracted - but unfortunately it’s something like Pringle’s and even with that I’m happy something is getting in to her - just such a stressful situation

OP posts:
Purplestorm83 · 21/08/2024 08:51

Also could you somehow open the innocent smoothie packs and put something else inside them without her noticing? Or maybe “lose” the straw so it has to be poured into a cup (in front of her) so she might accept other smoothies?

Purplestorm83 · 21/08/2024 08:49

Have you tried playing with food? For example if she likes craft, making pictures with dry pasta as a start, then maybe mandalas with dyed rice? Could then move on to cooked pasta e.g. have a laminated picture of a face and using cooked spaghetti to make hair? Or a sensory type thing with a hidden (washed!) plastic toy that she likes hidden in cooked pasta for her to find, she’s exploring the texture/sensory aspects with no expectation she will eat. You would probably need to do it too and make it a game etc.

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