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!

That's interesting what people are saying about iron - the nutritionist I mentioned is very hot on iron.
www.instagram.com/family.snack.nutritionist/profilecard/?igsh=NG9jNDZueHh4c3h3

She also recommends offering balanced snacks - she calls them mini meals -one iron food, one fruit or veg, and one fun food.
It can be tempting to let them fill up on any snack for the calories but if there are no vitamins/minerals they aren't going to be much better off, and if they snack at random they will have no appetite for meals.

If he doesn't eat much other protein he needs it.

Combining the idea of nutritional shakes with reading labels, I had to do the same research for an elder family member who didn't eat enough.
It turns out that the fortified shakes by medical companies are not that different from a) diet shakes (as another user said, if they are the type of "meal replacement" and b) milk and fortified milk powders for babies and toddlers.

Basically the ingredients are various types of milk powder, whey, oil, sugars or glucose syrup and an a-z of vitamins and minerals, sometimes with added dietary fiber.
So if you can get a prescription for them, try that, or as replacement look at the other types of liquid milks and shakes, they are not that different and at a lower price range (all kind of sports, diet and baby food). If it's a smell and texture issue, these also offer various options and one of them might work, and by using powdered versions, you can also edit them as you wish.

I am not saying they are identical to what would be prescribed, but they are not that far off and also useful as alternatives and to plug the gaps.

From a normal diet, you wouldn't have all necessary vitamins and minerals each day, either.

Your DC might also be a natural vegetarian. Fast food burgers, sausages etc have a lot of fat, salt, other flavours going on to overcome a natural aversion, but it will come to play with home meals.

(It does exist, it's thought to be an evolutionary advantage to stop a whole tribe getting wiped out by a bit of dodgy meat if at least one of the tribe survives because they don't eat meat.)

You can give a gentle iron supplement/tonic suitable for children (I recommend Spatone in their juice once a day). Then you can stop worrying about him eating meat and just provide protein in other forms. Eggs are a complete protein, and perhaps yoghurt too? Baked beans on wholemeal toast is apparently a nutritionally complete meal, but I would need some cheese on top.

And a final thought: hypertasters can appear to be picky eaters, but they just want plain food. Does he have a very good sense of smell - if so, he might also be a hypertaster/hypersensitive to food taste.

One of mine hardly ate at a certain point, refused to eat at school so would go all day with nothing and refused breakfast, even now as an adult he won't eat breakfast til he's been up a few hours (but I'm the same so can't argue with that one!) I found he liked ovaltine light hot chocolate which is an instant drink you just mix with water but is fortified with loads of vitamins and minerals, I gave him that before bed or mornings at the weekends if he wanted it and would make milkshakes with haagen dasz/quality icecream that was full fat natural products or yoghurt drinks like yop. Also added lots of butter to his mash or jacket potatoes, just basically up the calories of anything i made and let him have anything he would eat or drink (I suspect a lot of his calories did come from drinks.......forget the diet/no sugar stuff).

He's still quite slim but he did grow to a 6'2" vegetarian now in his 30s and no fillings despite always having full sugar drinks.

Do take him to be checked by a gp as this sounds like AFRID. Dd went through something similar after a house (and country) move, in her case it was sparked by all the upheaval and the change in brands making food not taste right.

we got her onto one of those gummy multi vitamins, and then gradually extended her diet. The big bit of advice we got about food was to serve new / reintroduced food alongside (but for the love of god not touching!) current safe foods, and to think about extending in little steps. So if she eats plain cold white rice, we tried her on tepid rice, before next putting some sauce on a plate next to it. We never ever make food an issue, she isn’t made to finish things and honestly I don’t comment about the ‘new’ foods.

we are a couple of years into this now and she is eating a bit better but still not a huge amount or variety. She gets by though, and isn’t deficient as far as we know.

I feel your pain OP.

Definitely take him to the GP - we got referred to a dietician and that took months. It has helped - even if it's just by making me feel less useless.

They will look at what centiles he is on for height and weight, and try to close the gap. My DD is a tall teen, but below the first centile for weight.

Home made nourishing shakes were recommended.
They sometimes work - DD likes the Oreo one - it has cream, ice cream, full fat milk etc in it. It has about 500kcals per glass.

There are lots of others too but it is hit and miss. And expensive if they don't like it.

It's all about the calories, so nuts, avocado, adding cream, cheese and oil to everything. Nothing to be fat or sugar free.

But a dietician will help and talk to you both to come up with ideas if your son won't eat the suggested foods/drinks.