Help with 6 year old not eating

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.

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?

Try homemade smoothie in innocent bottle maybe? 🤔

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?

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 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.

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.

I've been there too unfortunately, almost identical situation where my son witnessed me choking (unconscious, stopped breathing etc) and was terrified of swallowing after that. His weight plummeted, he's also autistic and we were very worried about him. Anything he ate took forever as he'd chew it until it was almost liquid...

CBT made a huge difference, he now eats much better and faster, although he still struggles a bit with certain foods but it's now completely manageable.

Good luck, is a horrible situation to be in.

So sorry you’re in this situation.

We have the same.

do you know what ARFID is? My son has this. Maybe google this. And autism. Last year he had a choking incident as well and then he stoped eating, he lost a stone in weight. We paid privately at the London eating disorder clinic and he had CBT and they diagnosed him with ARFID. Since he’s out weight on - still eats a limited range of foods but he’s gone back to normal amounts now.

We found that they don’t treat younger children - most eating clinics under nhs are 8 plus or even older

Posting in solidarity @Summertimewoes.

My 11 year old, currently mid-assessment for ASD, and Dyspraxia, diagnosed ADHD has had restricted food intake since age 3. We’ve now got to a reasonable intake over the course of a week but it’s Spag Bol (every 2nd night), interspersed with plain meat with rice and broccoli. Weetabix for breakfast, lunch is some grated cheese and a carrot during the hols/eeekend - at school he eats nothing. It’s taken since the end of the pandemic to get to this range. During lockdown he reduced his food down to boiled rice and raw carrots. He lost loads of weight and I was sick with worry myself.

Pre-pandemic we had worked to increase his range and I was surprised to find a reward chart worked here. I made a list of food up on the wall and he got a tick each time he tried one (even a mouthful) and a star when he’d tried something 3 times. His brother did it alongside which was encouraging. When they got 15 stars they each got an Alexa (massive motivation for them at the time!!). Bloody lockdown set us back a lot but it did improve again over the last couple of years. I can’t tell you how happy I was when he started eating fries (no potatoes at all before then), though he eats them sideways and never more than half a dozen.

Holiday mealtimes this year were extremely challenging and we try to keep it low demand but it’s really fucking hard.

I hope you have a breakthrough soon OP. I really feel for you

I have a child with ARFID, ASD and SPD. ARFID sounded likely to me with what you wrote. In all honesty, there isn’t really much available to treat or help. It’s mainly CBT and chaining foods to try to less restrictive.

There is a good Facebook group about ARFID that can advise you further with regards to what to go for an assessment depending upon where you live.

I don't have any experience but might it be worth booking her in with a private dietitian even just to get better food into her that she will eat if she is eating so little they could at least advise a plan say a high fat/protein diet of foods she will accept ? That sounds really hard and your poor DD the poor little mite x

Do you think the sensory issues are what caused the choking incident a few months ago?
some children really struggled with oral discrimination and tracking foods in their mouth, which can lead to choking.
If she’s showing PDA traits then the more you present food as a “demand” the more she’ll avoid.

I wonder whether her confidence might increase from building oral motor strength - sucking, blowing games, facial vibration, tough chew necklaces to practice chewing/having things in her mouth without fear of it being food, thick milkshakes or smoothies through those bendy curly straws.

If she associates food with a scary experience, it might be helpful to explore regulating activities before the offer of food and give lots and lots of choice, low fuss approach. Has your OT put together a sensory diet of heavy work activities? Has your daughter got a visual timetable in place?

The Mealtime hostage facebook group is a good source of support

https://fromthelarder.co.uk/gluten-free-fairy-cakes/

Fairy cakes above are made with ground almonds, good for protein and calcium and there's plenty of eggs in there too, and butter for even more calories. I don't put in the full amount of sugar.

When DS was little I just rang around speech therapists till I found one who'd do private sessions. I'm in Ireland too.

Is there no other liquid easy to swallow things she will accept? Yoghurt? Soups??
Can she really tell the difference between the brands or is it simply what comes out of the Innocent bottle?
Will she eat more of the acceptable foods?

Not the same situation as yours - but when my daughter had issues with food in the short term the advice was to just give her what you know she will eat (but in bigger portions if she is losing weight).
Stop all conversations about food and talk about something else during meals.
Take all the pressure off for now pending a referral.