to think this food advice for 3 yo from paediatrician is ridiculous?

[JustCleo]

3 yo DD is going through the assessment process for autism at the moment. One of the many things she struggles with is food. She has never eaten hot food and will not touch it. She has a very limited range of foods which is reducing weekly because she gets fed up of the same things repeatedly. The only things she will eat are:

Cucumber
Peppers
Grapes
Pepperoni
Cheese
Crackers
Crisps
Cake

At her last paediatrician appointment I mentioned how her diet has become more restricted than previously (she used to have 4-5 more foods she'd eat) and the paediatrician didn't seem to think her diet was that bad. She said to give her cake and crisps more often to keep her weight and energy levels up Currently she has them 2-3 times per week maximum.

Aibu to think this is crap advice?

weight gain and energy are crucial for growth and development. so I'd stick with the calorific items actually.

you should ask to speak to the dietician

my son is on the ketogenic diet. 80% fat. now that's off the wall

crisps every day is pretty standard for young children. cake - make your own using better ingredients and less sugar. fir example almond flour or coconut flour. honey to.sweeten. etc etc

'Crisps everyday is standard for young children'

Um, what?? No, it really isn't.

It's bad nutritional advice, but he/she has extensive experience in autistic children and is likely trying to give you the best advice for your situation. my dd is autistic. 7 year old. If I'd continued the fight over 5 a day and nutrition, my life would be a lot harder. With an autistic child it's not a battle that's necessarily worth fighting. If I force it she has more anxiety as do I. Once they start school , it's better imo to avoid stress triggers at home because there are so many at school which you can't control that a peaceful ,predictable, reassuring home life is worth more than 5 a day.

To the op - yanbu, it wouldn't be cake and crisps I would reach for to keep calorie levels up.

I'd say that's very young for a diagnosis... where I live they won't usually accept them until kids are around 7 (because there's so much development up to that age). If they are considering a disagnosis, your child must be very extreme.

Hope you are getting good advice and support. Hope you've got an advocate or a good SENCO.

If that's all she will eat, then yes, she needs crisps & cake more often than twice a week.

What would you reach for, then?

If there's a new food or something other than the above list on her plate she is often physically sick just at the sight of it.

I don't know op, sorry. I hope someone will be along soon to have an idea. More of the other stuff maybe?

It's not that off the wall, really. As pp said, a child needs X amount of calories to generate energy to live and grow. Once that is achieved, you then look to make them 'good' and 'varied' calories. However, quantity must come first and I would imagine that cheese and pepperoni would create dangerously high salt levels if eaten in sufficient quantities so that just leaves cake and crisps.

To be fair she's getting fruit and veg, carbs, fat and protein so I can imagine he's seen much worse. Friend of mine had a child who spent about a month restricted to peas and dry toast. If you could get a different meat into her that wasn't so processed it would be better but in my experience you may just not be able to.

For some children with ASD that would be a pretty wide range ! (I work with severely autistic children and my son has autism)You've got fruit, protein and dairy in there... so not too bad .

I agree adding in more cake probably isn't a fabulous idea..but if you feel she needs more carbs, would she eat dry cereal? Dry rice crispies are a favourite in my class, popcorn is another popular option.

If she's not really underweight I honestly wouldn't worry however. My DD1 ate NOTHING but plain rice and hardboiled eggs and mash...only white food for 6 months, and only ate Heinz pureed apple baby fruit for breakfast until she was 5 (also on the spectrum oddly enough) She survived and grew though she was (and still is) very slim!

Of my class of 8, only one child eats what approaches a decent diet.. yet they are all still growing and have a terrifying amount of energy :)

Justcleo - don't listen to are there - autistic children are a differ kettle of fish to nt children.

Seriously if you dc isn't getting enough calories per week feed them more of what they'll eat. Dd lived on toast, pasta, chocolate and crumpetd for a while. since I stopped stressing and trying to force dd she has come on leaps and bounds. What she eats has trebled!- though none of it fruit/veg in actual form. Once she trusted I'd never force or cajole her and there was always bread and butter on the table she started to try more (though I can't comment in this or it will never be repeated)

Are there- hadn't read your response- im sensitive and assumed you were suggesting insisting on healthy foods- I was wrong to assume havING read your response to op - im sorry

do you think it is the texture or the flavor, you could try making kale chips, or buying dulce chips I occasionally buy apple chips (all these would be considered crisps in the uk)
as for cake again i would make it the shape and temperature she likes but i would alter the ingredients; zucchini chocolate, carrot bran, etc. i have a nice recipe for bacon cheese muffins etc.
have you offered her sugar snap peas (edable pod? similar to some of the items she is currently eating)

No I don't think it is to be honest. Your DD is not going to get many calories from the other foods mentioned and she needs the energy to grow.

My DD has ASD and at your DD's age she would only eat penne pasta (any other shape was just offensive to her) pasta sauce and chocolate pudding from a jar (baby food).
She was so bad at that point if I even ate a different food in the same room as her she was sick.

Thankfully the baby jars of chocolate pudding were loaded with calories and I gave her them as often as she wanted maybe even three a day some days as well as the pasta. She's never had a problem with her weight at all and is a super tall and slim girl now (5years)

You do sound a bit worried about giving her the 'bad' foods which to be honest so was I with the jars of chocolate pudding but after talking it through with the dietician I was happier with this.
Could you ask for a referral to the dietician they gave us loads of strategies for increasing DD's dietary intake.
We did it really really slowly for example we started with bread sticks which were fairly non offensive in the same room, then on the same table and then on the same plate but it was a long drawn out process.

Something else that really helped was buying her lots and lots of fake plastic food on the advice of the speech therapist and playing lots of eating food games and learning the names of all the different foods and then pretending to eat them. I know it sounds daft but it genuinely worked so well she got to recognise the foods and play about with them without the sensory overload of the taste of smell.
We would sit and eat fake pizza and ice cream, chicken nuggets etc and then eventually (after about 6 months of playing) dd slowly started asking for the food's we'd been playing with. DD is 5 now and she's so much better with food so your dd will get better OP and the increased cake / crisps will just get her though this temporary patch where she needs the calories but the taste of other foods is just a bit overbearing still.

I was also going to ask after your op do you give her vitamins as she has such a limited diet? We managed to give our dd vitamin drops every day but they were hidden in juice so if she likes juice it might be an easy way to sneak a bit of extra nutrician in where you can.

(sorry for war and peace!)

If she's actually in the spectrum many children with asd have glucose issues so to suggest crisps and cake is extremely damaging! OP try to see a dietician/nutritionist some are extremely helpful!

No she literally will not eat anything else. She us becoming underweight and catches every bug going.

OP it's worrying but it is better than an underweight child...that's the thinking. My friend had the same. Her son is 5 now and has started to eat more (he is autistic) but yes, it's hard.

would it make you feel better if she was eating vegetable cakes? chocolate beetroot cake just tastes of chocolate would you be more comfortable with that sort of thing? i get this goes against the grain against the idea of being a "good parent" but maybe give it a go?

My DD is a fussy eater but great with fruit, I think there might be undiagnosed sensory issues. You can use homemade cake, baked crisps and cheese to keep her calories high enough without doing too much damage. I found that my DD will eat pancakes (she won't normally touch eggs) so I add ground flaxseed (£1.99 a bag in Aldi) to the batter and she likes a cucumber "hungry caterpillar" and will have pumpkin seeds for legs and grass. Really lightly salted popcorn is another great choice as PPs have suggested.

I know an anorexia nurse. He says that it's almost irrelevant what children eat until about 12, as long as they eat enough calories to keep growing.

Well, if that is quite literally all they will eat (which with ASD is unfortunately sadly feasible) then I cannot see how you can get in enough calories to grow without increasing the cake and crisps. At least they didn't advise you to make her eat more of things you know she can't.

There is no way of varying it. She'll only eat the same particular type and brand of crackers, the grapes only from one particular supermarket. Any step away from these and she won't eat anything that meal and/or is sick.