How do I get calories into my picky eater?

[BlingaRinga]

9yo DS’s diet is getting more and more restricted and he is so small and skinny it’s starting to worry me.

It’s not just that he has a very limited range he won’t eat large volumes of anything (except oven chips!). He picks at everything.

I’ve tried nutritional shakes and he won’t drink them.

I’ve more or less given up trying to get him to eat vegetables. He won’t really eat any meat protein unless it’s a McDonald’s beef burger, ham or smoked salmon, which are hardly healthy options. He basically just eats processed carbs and some cheese and yogurt.

I just don’t know what to do! Help!

Does he like the yoghurt pouches? When DS1 was at his worst he'd eat these but not like yoghurt on a spoon. There's ones now that are loaded with protein.

Take him to GP. Definitely. I had a child with severely restricted diet, ate only 4 things for 4 years, was just lucky that included protein (chicken nuggets) and fruit (purple innocent smoothies). Not really anything they cpuld do to change that but GP kept close eye on bloods etc.

My fussy DS basically lived off buttered pasta for several years of his life! it was awful, i was boiling pasta for breakfast. What i would recommend is getting iron into your DS because anemia reduces the appetite and makes fussy eating much worse. So it’s like a vicious cycle. So get some really good supplements with iron, let him eat the mcdonald’s burgers because that’s getting red meat into him at least (and give the supplementary iron + vit c around the time of meal involving red meat to help absorption)

After a few days of that try reintroducing foods that he previously liked but had abandoned. Did he used to like sausages, fish fingers or whatever but then refused them? Try them again, and keep trying. if he liked them once he will probably like them again, sometimes they just need a break from food especially when they are picky and you serve the same thing a bit too often. Use bribery if you have to just to encourage him to taste things.

And do try to involve him in cooking. It doesn’t work for every dish but every now and then you hit the jackpot. My son was given a kids cookbook and we made spaghetti bolognese from it, something he hadn’t eaten in 4 years. He tried it, liked it, and now it’s one of our regular meals.

My ds was exactly the same. He finds it hard now too but he knows that he needs protein and will buy huel milkshakes for when he can't face eating. He's 20 now and laughs at photos where he was tiny in year 6 with very thin hair. 🙈 (gp 15 years ago said he was fine and would just be a small person with a bird appetite)

I also have a very fussy eater, though with a different range of food to yours.

Firstly, he needs calories. Oven chips contain them, so let him eat oven chips.

Are there any multivitamins he'll tolerate? We haven't found one yet, but he might be OK with the chewy ones (DD won't eat haribo, and they're similar to those).

Definitely worth seeking help from a dietitian, probably via your GP. Are you able to track how much he weighs? A friend had success with getting an actual referral once she could demonstrate her child was losing weight.

You have my sympathy - every trip we do has to take DD's eating into account....

GP check but just keep feeding him what he will eat. Calories are the key even if unhealthy.
Take some multivitamins. .
My DD ate enough but has been very particular about mixed food (hard no) and often very brand specific foods. Texture very important.
He's not trying to be difficult - he obviously finds eating very challenging. DD is much improved and has gained a lot of confidence around food but still is very particular around texture.
Unfamiliar foods for a child struggling to eat are really very scary.

Does he like ice-cream? Could you mix ensure compact into ice-cream and add blended fruit?
Ensure compact are the most palatable of all nutrition shakes and are 300 cals for only 125 mls. If you can sneak that in somehow that would help. Also I hope he takes a multivitamin supplement.
I think trying to force vegetables on him is clearly not going to work. It's good he will eat some forms of protein.
Could you cook a boiled/roast ham and would he eat that in slices, with mash/chips, in a sandwich?
Would he eat pasta? You do that with ham or smoked salmon in a creamy/ cheesy sauce? Or just with cheese on top if he doesn't like sauces.

Thank you this is really helpful! I hadn’t thought about anemia (which I should have done as I have low iron myself) but that’s definitely possible.

I second this I do it for myself as I have arfid.

Never but the pre mix they are revolting but alimfast made up with blue full fat milk in the blender with ice cubes in a nice glass winner

I just looked up ensure compact and OMG the price of it! Maybe if we get desperate.

cooking a ham is worth a try though he does tend to prefer the cheapest packet ham rather than decent stuff.

Sauces on pasta are a no-no unfortunately!

Start reading labels! The calorie content between brands varies hugely. Sliced bread goes from about 60 to 150 calories a slice. A packet of crisps can have a similar range. Does he have a packed lunch air school dinners? Have you tried snacks on the go, eating walking home from school, in the car, whilst playing a board game?

There is something called Scottish breakfast patties they look like a Mac Donald's burger. In Iceland. Might work as they are thin. Morrisons do them too

www.iceland.co.uk/p/iceland-6-sausage-breakfast-patties-342g/71655.html

Your GP can prescribe Ensure/fortisips or a Dietitian

I think one thing I struggle with is he is quite happy to eat a lot of sugary or processed snacks etc so if it was “calories at any cost” I could no doubt feed him up on smoothies, crisps etc.

But this doesn’t seem at all healthy and it’s hard with my other DS as I don’t feel I can be giving one “treat” food and no the other.

@BlingaRinga argh, I didn't think of price. I used to get it on prescription so free. But they stopped giving it and swapped for a really disgusting one that I hate. Tight bastards! Lol.
I still think smuggling some kind of nutrition shake/protein shake into ice cream might work?

Fussy eater in my house which my dm thinks is divine judgement because I was one too.

My appetite still shuts down if you put a huge plate of food in front of me. And I’m still fussy, but it tends to take the form of eating lovely, nutritious food and repeating the same lunch for a few weeks until I get tired (currently I’m eating a lot of poached salmon with a salad of spinach, avocado and edame beans.) I have no appetite if I’m thirsty, but I never actually feel thirsty so I’ve learned to just drink water regularly and I encourage ds to do the same.

He has got trickier with age. I used to rely heavily on hidden vegetables when he was young, but he can tell exactly what’s in something or detect changes in brands and ingredients. I’ve learned to respect his superior taste sensitivity! Even as a child I never had much luck with hidden calories - he just ate less. And he could detect whey in milkshakes.

(Fully agree about MCD - they ruined burgers, chicken and milkshakes for us)

Our gp was never interested. Said he’d eat if hungry (nope), and was delighted he was in no danger of being obese 🙄. I’d recommend getting a nutritional assessment of his realistic food intake and supplement from there. We’ve also had advice from a speech and language therapist and an occupational therapist, who were both helpful to an extent.

Personally I made the decision that meal times would be safe, calm, relaxed, times for family, companionship etc so I don’t push new foods at dinner. Sometimes even the smell of other people’s food bothers him and he asks to eat in another room.

But we do taste things away from the dinner table. We have a protocol for that: pick it up and touch it to your lips. Then to your tongue. Then put it in your mouth and spit out if necessary, Then swallow as tiny a piece as you like. That has given him confidence that he can try things, and it’s been very helpful in situations with well meaning relatives when he can say “I tried that and I didn’t like it”. In school they did a programme of tasting different fruit and veg for a week, and he was more adventurous than many of the kids and quite proud of himself for that.

Occasionally we have a “tricky dinner” of foods he can eat but that aren’t top preferences. And a special dessert if he manages it. (Often something awful he’s seen in the shop and begged me to buy) The deal is that he can leave one element of the dinner behind, as long as he’s tasted it (these sort of rules help him because he’s autistic. It’s not how I’d want it but he likes the boundaries to be very clear). I’ve managed to get three decent dinners into the repertoire, two of which I can now serve weekly by taking this slowly. And it’s helped hold on to foods that fall out of favour, or something like your burger example that isn’t quite right.

Sounds like ARFID to be honest. Don't beat yourself up, there is a large genetic component to these sorts of behaviors.

They like McDonald's and branded food
because uncertainty about food and its taste and texture becomes an anxiety threat.

A kid like this might always ask 'what's for dinner' quite early in the day - not because they are hungry, but they need to know what sort of assault on their taste buds they might have endure later on.

They like Certainty and safety and McDonald's burgers always taste exactly the same.
There is a high need to know what to expect. They like choices and to know what to expect foodwise.

So they might eat a branded frozen burger that you think is a bit crap, but not not a lovely one you spent ages making from scratch.

Don't take it personally (which is hard too because as a mother our instinct is to feed our child and it feels like rejection when they don't take the food or respond as we'd hoped).

He's not you, you are not him, and you don't share the same experiences of food. It's nobody's fault.

Give him what he'll eat. If he wants oven chips every day then fine. If he'll only eat Dolmio sauce, Uncle Ben's whatever that's fine. It does make feeding other kids tricky (how come he gets chips again? etc).

Forcing unfamiliar tastes or variations will push him more into a corner.
Constant pressure from parents or grandparents to 'just taste it' or 'oh he's terrible about food!' comments don't help. That just increases anxiety at meal times.

Don't be staring at his plate. Or asking has he had enough or does he want more. Or 'try three more chips' ...which is hard!

At the table, don't talk about the food at all. Be light and breezy and talk about something entirely different. Hide any disappointment you might experience.

There are ways parents can learn to help out a child like this, so seek advice from professionals who deal with this issue.

Keep buying and feeding him the smoked salmon as high in protein.

I had a dc come out the other side of this.

Go for a high fat diet.

Substitute everything for the high fat version.

If he will eat pastries & pies make them.

Check he's getting enough fibre & iron.

It’s so salty though isn’t it? I don’t know how healthy it is!

If he's not eating much other salty food (and sounds likenhe isnt). I would not worry.
Fed is best !

Agree with everyone else that a Gp visit isn't a bad idea.

The McDonalds is because it's completely the same, every single time.

Personally, I'd let him have a bit of smoked salmon ad see if you can get it with other things - on pasta, bread etc. Ditto, the yoghurt is actually good - let him snack on that asm uch as he likes, whenever he likes.

It might be worth considering a compromise in the form of finding similarly consistent things he'll eat. UPFs and higher salt foods are not ideal, but it might be a short term solution. eg find the highest quality chicken nugget or fish finger you can, and see if he'll eat those. Then sure, buy them in the same brand consistently. Ditto basic vegetales... if you can get him to eat them. DD has lived on boiled carrots, tenderstem broccoli and baby corn for years and is only now starting to be wiling to try something new.

Thanks that’s helpful.

one of the things I struggle with, is that he’s not really got much interest in eating so unless I remind him he might not really eat at all.

I try to do “family style” dinners as I hear this is supposed to be good for picky eaters and he can just put what he wants on his plate. But he just…doesn’t really eat? I’ll put things he will eat on the table and he will nibble a slice of bread. I have to prompt him.

I read that as long as the nutritional groups are covered it doesn't matter what the foods are or how limited. Feed the DC what they will eat and as much as they need to be properly fed.

Cheese and yoghurt, milk and nuts are good sources of protein, so you don't need to worry about meat. Some people are natural vegetarians.
Sounds like the carbohydrates are covered.
Pancakes are a good way of getting protein and carbohydrates covered in one dish.

Is your DC more of a snacker? If so, give lots of snack meals during the day (cut up cheese and apple/grape/cucumber, yoghurt, oat biscuits, rice cakes, dry cereal, separate milk etc).The nutritional needs can be met by a limited number of foods given in small amounts in more frequent meals. Some children are hypersensitive about taste and texture.

I wish I could remember her name, but there was a nutritionist a while back who used to say to just feed them what they want/will eat and not stress as long as there is something in each nutritional group. I think it came down to avoiding a battle ground while also ensuring DC don't develop more fears around food, and also ensuring they eat enough.

Apologies I've read your posts and by default some of the other helpful posts from other posts. But have not read all. You described your son as "picky" - so can you serve individual bowls/plates of individual foods so they can eat what they fancy. When my DC was pre-school they were always so tired at teatime. So I would do individual small bowls of dips, cut veg, bread sticks, cut cheeses, cut meats (ham mostly). So basically the child could try lots of different things - lots of colour, texture, but not all on one plate.