Please help us figure out DD’s eating

[Essayer]

DD is 4, and about to start reception this September. She was born on the 25th centile and is now on the 6th. DD has no interest whatsoever in eating. There are three types of issues -

1. At family meal times she chews each morsel - we have counted - between 80-110 times, till it is effectively just saliva at which point she swallows.
2. She then spends about 5 minutes between the swallow and the next bite laughing, joking, asking to go to the toilet, standing up in her chair, asking for toilet (even if we have ensured she’s used loo just before), then comes the next mini bite. That is then chewed slowly 80 to 110 times. At this point DH, DS and I have finished our meals and are waiting with her. Eventually she declares she is no longer hungry as she is conscious that playtime is running out/she’s missing out on things. As a result the actual food she takes in is very little.
3. She has a peculiar aversion to anything that is soft and white (cream, mayonnaise, melted cheese), anything that is a salad item and anything that is sweet (such as cakes). She has a limited group of things she will eat - broccoli sweetcorn cucumber green beans carrots rice chips pasta salmon chicken but more - owing to points 1 and 2, hardly 2 spoons go in. Most other foods she refuses to try and declares “I don’t like it”.

We are really worried about her eating. She takes an hour in the morning to get through 2 bites of toast. She will happily live off milk which we try to lessen all the time not solely to make room for other stuff but also because it sets off her eczema.

for context - her brother DS8 - also was born on the 25th centile, is still tracking 25th centile and is a genuine lover of food/cuisines/tastes. He enjoys cooking, concocting dips and recipes with me, and trying any new flavour or taste. I’ve tried involving DD in all of this but no.

any advice?

Do you think if the milk causes her eczema it could also be causing tummy ache and causing her to not feel hungry? I understand why you don’t want to stop it with it having calorific value, but it might be worth a try

These are classic allergy symptoms. I'd switch to oat milk and see how she is in 6 weeks. It could be she is just put off by all food because her stomach constantly hurts.

My DD has ARFID. I’m not sure where in the country (assuming England) you are, but GOSH and Evelina have clinics as well as some local CAMHS. You might need your GP to refer to a dietician or paediatrician for a referral to them, but I would start the process.

Given she drinks milkshakes, what about trying some of the nutritionally complete milkshakes?

Plenty of children with ARFID eat less than your daughter and also have lots of energy. I’ve no idea how they manage it!

A dietician told us that it’s perfectly okay to break the normal table manner rules and let the child watch an iPad or tv to distract them from the fact they are eating. I know it goes against what you probably do, but it’s also worth considering.

Yes. I recognized most of that list as being relevant to my now 33 year old son. He also had/still has very complex food difficulties.

Kindly OP, the list you made in the previous post could point to ASD (or possibly OCD). I'd say it's at least worth investigating.

@MargaretThursday , thank you so much. I have a 16 year old DD, she has many of the same issues as you. We have also realized there are things that help and those that don't. Most of all, we let her serve herself, as having a full plate also inhibits her appetite (I have a bit of the same thing - I'd rather have two smaller servings than one very big one).

My DH was a fussy eater but now as an adult, he doesn't have texture/food touching issues. My DD, I think, will always have them to some extent. We also tried to do approach her issues in many different ways but in the end, she eats what she eats and when she does. There are foods she will never eat and other she'll sometimes eat heartily and other times not at all. She seems to go off foods quite easily. Since mid-childhood, she's been eating 5 meals a day, all of them pretty small. None of them have ever included a packed lunch! Food touching, temperature issues, texture issues galore in those packed lunches. I'm glad we were never forced to pack her particular lunches for school as she just wouldn't eat them. No reheated foods for her, either (texture).

We also don't have "normal" family meals every night. Unless it's a food she definitely loves, my DH and I will eat the family food and she'll have raw veggies, cheese, bread and cream cheese. I won't lie; her issues have made me question if I am a particularly bad cook, especially if something else is causing me stress. Still, I don't think it's that.

She cooks for herself several times a week, mostly pasta with simple sauces. Despite all these food issues, she's at the 50th percentile now and always has been, so she's getting enough calories.

@Essayer , what you said about family meals looking and feeling different because they are not single ingredients but composed resonated with our experience! We now have no expectations that DD will fully eat family meals, but that she will eat how much and of what she wants while we eat the family meal.

Your DD eats a good variety of foods, it's a good start! I agree with PPs, maybe a referral from the GP to see whether the issue is with texture, appetite or something else, would be worth exploring.

She seems to go off foods quite easily. @Slavica

I do too. It's often something simple - a hair in food can be enough to put me off something I love for weeks, months at times occasionally for always.
Silly comments can also do it. My df once jokingly said he'd found a fingernail in a sausage, I still can't eat fat sausages 30 years later. It sounds totally silly, but I do honestly try to get round it.

I don't like eating it even if I've cooked; it's nothing to do with being a bad cook or not making it nice. I'll actually find myself looking at food thinking it looks and smells delicious, but I know if I try and eat it I will probably end up vomiting. It's actually really frustrating because I want to eat it.

As mentioned upthread what about swapping the milk for a non-dairy alternative? For nutrition alpro fortified soy milk rather than oat, though, if she'll have it

I used to absolutely detest what I termed "lumps in wet". If I had to eat food I didn't like, I ate tiny bites, chewed them to oblivion and stopped eating as soon as possible. And preferably obtained some milk or similar to keep me going. This would have been maybe 10 ish. At 5 I just wouldn't have eaten anything.

I've got the hang of food as an adult but honestly when my grandparents thought they could get me to eat by not feeding me. I just didn't eat for 3 days.

I wasn't a great eater as a child. We had to have hot school lunches which I hated so barely ate in the day. I didn't like certain textures though I ate better at home. I still grew but was thin. It used to drive my mum mad- sometimes she'd try to get me to sit til I'd eaten whatever it was I didn't want but it didn't go well. Now I love food and eat well.

Don't swap cows milk for soy as the proteins are so similar. Use oat, pea or almond milk.

Nearly no nutrition in almond, so should be avoided in this case! If soy still causes a reaction, which it may not, fortified oat is second best.

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Hi everyone
thanks for the various bits of advice and experience! I think we will begin by speaking to her GP, inform her school and also make some alterations to what we are offering, and how, and think about the expectations we are putting on her.

I second the advice to suspect a milk allergy. It can be associated with eczema. Weirdly, children and adults alike can often find food they are allergic to very appealing.

I'd bring her to an allergist.

Yes to this.

She has a list of healthy foods. Just give these to her. Maybe the more she can trust that her favourite food choices will predictably appear at the table the more she will relax.

But since she has eczema, I'd be alert to he link to milk.

Yes to this.

I would just base her meals around things she likes, but have tiny amounts of other foods alongside to try.

Both of my dc went through phases of "fussiness" for several years but they grew out of it. They both now love to cook and eat pretty much anything.