Daughter restricted eating and fear of choking

[JunesBalloon]

I have major concerns over my DDs eating habits. She is 9. She has always been very slim but her eating has got so disordered and she is losing weight now.

We seem to be going round in circles with it. She has always been a slow eater and I don't have an issue with that but she is saying she is full after a few mouthfuls every night. Now she is saying that after watching Mrs Doubtfire she is scared of choking and that's the reason she is slow. Now it's a sore throat. She will happily eat cakes, chocolate etc while on the go but sit down to lunch/dinner as a family and the problems start. I can't get to the bottom of it but it also transpires that she throws her packed lunch away as all her friends eat quickly and she doesn't want to be left as the last one eating. I've tried small portions, letting her eat what she likes, ignoring etc etc but it always seems to be some excuse as to why she isn't eating. Is this a normal phase? Should I take her to the dr? I've explained about a healthy diet etc and she just gets angry with me

If she is now losing weight then yes take her to the doctors, even if just to monitor her weight and health for now. You may need professional input from dieticians or camhs depending on why she is not eating.

If it's just a phase though would seeing the dr freak her out more and make it worse? Does anyone have any experience of what would happen at the dr?

Yes go to the doctor, also look up ARFID which this sounds possibly. Your doctor won't know much about disordered eating in any form but your child has to eat and might need some help if you can't reassure her. Not eating quickly becomes a problem whatever the intention or cause.

Yes agree see go. Also, if she is loosing weight then try to make her food as calorie dense as possible. Plenty of cheese, peanut butter, full fat dairy products, add butter and oils to veg etc.

My DD's ex wouldn't eat in front of hardly anyone for similar reasons. He's an adult but the principle is the same. I felt he needed some sort of counselling as his fear (he said it was choking) was impacting on his quality of life and he also was very skinny. It's so hard to say where these fears start but she probably does need some kind of therapeutic input. As a pp suggested, I would give her lots of calorie dense foods but yes I would also take her to the GP.

The only other thing I can think to suggest is to see if she'd eat better if you let her eat meals alone? Either in the living room or in her room? Family mealtimes are stressed as being important because, for a lot of families, it's the only quality time they spend together. But as long as you spent time with her outside of meal times, she wouldn't be missing out as such by not eating with you. It doesn't need to be forever but maybe a bit of time eating alone will get her back on track.

She really enjoys eating in front of the tv and I wonder if that's because her mind is taken off what she is doing?

I have looked up ARFID and it makes very interesting reading. Thank you so much

It’s quite possible. I think then for a while I’d be inclined to let her eat in front of the TV, just to get things back on track. I do sometimes think that the “ideals” of parenting need to be adapted to individual children. It may be a less aggressive step than going to the GP and if it doesn’t work then you still have that to fall back on. You may even find that after a few times eating alone, she feels lonely and wants to join you again. But it gives control back to her and maybe she needs that.

Then let her eat in front of the TV, at least for now. The most important thing is she has adequate nutrition. My d is recovering from an eating disorder and I wouldn't wish it on anyone. Regardless of the reasons for food struggles it's not something anybody can do without

Yes. My child ended up in hospital as lost so much weight and wouldn't eat or drink anything at one point. CBT for the anxiety worked long time but camhs said eating in front of the tv was a good approach as they weren't then focussing on the act of eating. So we all do that now. I'd contact the doctor and camhs fairly quickly as they do actually take assessing for eating disorders fairly seriously as will see them quickly for assesment. Disordered eating of any type needs professional help really and us very stressful for parents to deal with, as making sure your child gets adequate nutrition is a central parenting role. Maybe make her lunch very small so she can eat it quickly. Good luck. We are out the other side now but it was stressful

Thank you so much for all the replies. I am so worried about her but so keen to not pass on any additional anxiety. I have always ensured we eat together and talk as I also have a younger DD who eats 3 times the amount of her big sister but also don't want to get her caught up in it all too! So hard.

If you google ‘meal coaching’ you’ll find some videos and articles you might find useful, look especially for ‘help your child eat with trust not logic’

I watched some meal coaching videos last night and they gave some very helpful tips so thank you for that.

We had the tv on for breakfast and I just let her eat at her pace with no comments and she managed 2 slices of toast (no crusts) and a yogurt. I know this isn't ideal, especially on rushed mornings but it was certainly an improvement

Well that’s great and I’m glad you picked up some tips and she’s eaten. It’s really important she gains back lost weight so try to get her intake up, using calorie dense food as suggested above as your daughter is pre-puberty and needs nutrition to support her transition from child to teenager then eventually woman. Liquid calories can help here, juice, milkshakes etc.

If you’re are on social media there are ARFID support groups, so while that disorder might not fit your daughter you’d certainly get help in getting her to eat. Don’t hesitate to dm me if you wish and I can point you in the direction of books, groups etc.

I guess I'm so used to making sure they eat proper meals etc that we don't really do snacks but I suppose all of that has to go out of the window here. It's hard as I have another younger DD who eats really well and I don't want to make a special case of DD9 and draw more attention to it.

At school put her on school dinners. The dinnner ladies or monitors will tend to keep a better eye on how much she eats. At home let her eat alone or base her intake around healthy snacks rather than a single meal.

I understand what you’re saying but in all honesty a period of restriction can quickly make a horribly special case out of someone. I’d also limit her activity for a while if she’s not eating enough (trampoline etc) it’s now known that a negative energy deficit is what loads the gun for an eating disorder and things spiral very quickly. A nine year old needs around 1800 calories and that’s conservative, there’s new research that kids need more than previously advised. Obviously that number is a guide and things like activity levels make it variable.

And absolutely don’t let her eat alone, too much scope for chucking food away.

I wonder if perhaps other children have commented on how slowly she eats and that's made her so much more self conscious? You know how most of them rush lunch to get some playtime, you can certainly imagine a little friend saying Hurry up!! You eat so slow!.

I don't agree that putting her on school dinners would help at all, in fact it could make her even more stressed about the issue.

Perhaps reconsider what you're putting in her packed lunch. Go for softer, snack type things such as those belvita breakfast bakes, soreen lunchbox loaves, individual smoothies, yogurt tubes etc. I know that's not the ideal packed lunch but you don't want her going the whole school day without eating and hey, there are plenty of dc eating a ham sandwich on white with a pepperami and a bag of crisps 5 days a week!

Goawayquickly has nailed it. She speaks up to date knowledge of ed’s in children. (V. Refreshing to see on MN)
Also, please checkout the Around the Dinner Table parents forum. So much useful advice and support.

Is she any quicker at drinking? Am wondering if something like Complan could be useful at lunchtime. It would solve the fear of choking as well.

AtleastitsnotMonday knowledge born of a great deal of pain unfortunately. Agree with ATDT, probably saved my child’s life.

Damn, name change fail.

Yes definitely sounds like arfid or some other eating related phobia. Often many GPs don't seem to Have that much experience in dealing with these issues effectively. I suggest you look up Felix Economakis online. He's one of the pioneers of working with ARFID and works with adults and children with great success. You might find some strategies to help.
I would certainly agre with restricting energetic activities and try to make sure that your daughters foods are very calorie rich at the moment. Also give her some vitamins at the moment. Probably the liquid will be best with her fear of choking.
I'd give lots of small whacky options rather than overwhelm with one big meal right now. Its less daunting to be confronted by and easier to munch at. You just need to get food into her at the moment.

Gŕr... Whacky = snacky