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?

sorry just noticed has to be one particular brand of cake...

hazeyjane
Can I just say, before cutting out anything like gluten or dairy - it is vital that you see a proper, specialist dietician - especially with a child with such a restricted diet. Gluten free substitutes are often not the greatest nutritionally, dd2 is wheat intolerant, and it is hard to find palatable alternatives for her (and she is a 'try anything/eat anything' person!)
I think you will have problems finding alternatives if you rely on processed food. We use very little processed and honestly the choices are overwhelming ! Loads of things you can find but mostly in health shops which admittedly are more expensive - vegetable pasta, rice pasta/noodles , fm food with tomatoe or coconut sauces, meats etc risotto sausages, coconut yogurt , almond flour cakes etc have no wheat/gluten in them
It's a big shift though so I understand not easy , took me at least 2-3 months to come up with ideas

Anothertime. - I realise there are lots of gluten free alternatives that aren't processed, I make most of our own cakes and bread and use lots of healthier alternatives, but for a child with a restricted diet that might be trickier - I can't imagine ds eating a lot of the things that dd1 would happily try. I was just concerned that if someone starts trying to cut out things like dairy or wheat or both, without being able to replace them with alternatives then they could be in trouble!

AnotherTimeMaybe reported a very similar experience, and actually, of all the food refusal lists I think only eating 'chicken nuggets chips and oatmeal' is among the most restricted on the thread.

Yseulte we did indeed go through worse than than, only chips and oatmeal for a long time but I thought I'd give a positive spin
How your DSis is dealing with this part of autism is not very common in UK so you won't get many to see where you're coming from. I went as far as to follow biomed which is even more rare and I certainly do not expect anyone to understand either

I agree with what other PP has said, this is not for AIBU
I got the best advice from other MNers in SN boards who did the gluten and dairy intolerance test for DCs

OP again good luck

Giles - clearly marzipan is made with a lot of sugar; but at least it contains some protein, which you'll not find in any other brand of icing, except buttercream and that will be minimal. So my point was not "yay, a high protein food" but "yay, extra protein on top of the small amount from egg and wheat in the cake already".

ANY extra protein in this extremely limited diet has to be a bonus. Marzipan therefore is one.

hazeyane agreed you have to have a plan first before cutting out
Also good to do a test to see if they are intolerant and if any inflammation has been caused already before proceeding

Can you try introducing similar flavours but different items so she doesn't go off the first?

If she likes marzipan, then maybe some almond biscuits? The look completely different but marzipan taste. But ready made ones so you can be prepared to offer and bin for a while! But maybe just offer on a plate at table, give something she does like and see if she tries

Can she be bribed also? Like one crumb gets a sticker. 2 crumbs, 2 stickers. 5 stickers gets something small she wants like new pencil/ colouring book/ toy animal or book or similar. Try on different food gradually, just one new food every 2 weeks, so she has time to see it and attempt crumb tasting or pieces even.

Also at 3 almost 4, shes old enough to help
Decide on new foods I think. So talk over how your going to try stickers per crumb, and maybe ask what 5 things she is prepared to try licking or just a crumb to start with. Maybe take her to supermarket and let her have free range with basket on what she wants to start with.

Oops I left out a vital ingredient - honey, instead of sugar, lots of it.

I have 2 dc with ASD 10 year age gap, honestly I have learnt not to become so anxious around food.If my ds ate the range your dd ate I'd be V happy bunny.High calorie intake is important &you seem to have all food groups covered.Learn to sneak crafty bits of extra nutrien in where U can...When making a cake or macaroni cheese pop some old fashioned Marvel in as well full of vitamins so nutritionist told me...also tip if dd likes homemade pasta tomatoe sauce make big batch & freeze in those bendy muffin trays, 1 muffin size enough for 1 portion &makes really quick meal.I know both my ASD dc had when hungry and faddy wanted food quickly...good luck

sorry if my post didn't make sense in parts.....I also bought a warming bowl that you put hot water and stopper underneath for adults. Sounds extreme but when your ds is about to be admitted to hospital due to wait loss and 1 way to get him to eat more is keeping his food warm it's worth the £12 and couple years of fuss....ours has just gone in bin he is now very tall and thin but temp isn't such a prob

Justcleo, you must be really upset about this. One of our roles as mothers is to insure we cook and they eat. It seems like a simple transaction . But food and mealtimes become an emotive battle ground. We make healthy food they turn their noses up at it!
I know when my autistic son refused and restricted his diet at around 2.5 it drove me mental. I worried , I stressed , I watched every bite , " has he had enough?" " why won't he eat?". " why won't he eat that chesse " . It was another indicator of my failure as a parent. If I had to listen to another parent saying " well my child loves pasta with pesto" my head was going to explode.
My suggestions are ,

1. do not mess with the quality or brand of food she is eating ( you know she will tell the difference straight away and refuse it!)
2. do as they suggested and up the quantity of food ( whatever she wants, if that's cake take a deep breath and allow it . It's not normal parenting advice but we are not normal parents.)
3. DO NOT MAKE FOOD AN ISSUE. Take a step back. Ignore it when she just eats one cucumber stick. Food is all about control for normal kids , with ours they also have sensory issues at work, this makes a volatile mix.
4. get a good dentist. One who will support you and is knowledgeable about early treatment and prevention. it not unusual to have food issues at three lots of kids do. As she gets bigger (if she eats a bit more) it will all change again. My son ate a banana a day for years , and now runs screaming from them!
   Just let her eat. Don't feel bad , you are having a difficult time. You are not a bad mum cause your daughter will only eat crisps and cake! Find some support from non-normal mums, there are lots of us out there! Sending you a hug.

Ds(7) has a limited diet and is waiting for ASD assessment and saw a dietician a few months ago. She recommended liquid vitamins mainly to make me feel better as his diet is very limited but is nutritionally balanced (thanks to the invention of the Kids Smoothie in a small carton!).

Her suggestion was to encourage eating at the table with others and making it as fun as possible, allow him to eat his favourite savoury food and just focus on keeping him at the table, then introduce manners like getting drinks for everyone, but then give him a side plate for "experiment food" to look at, perhaps touch, and maybe one day try eating. So far he is much happier, seems to enjoy meals, impresses grandparents with manners - and the range of foods hasn't increased but hasn't decreased further, which was a huge worry last year.

He probably won't get a ASD diagnosis as he can interact socially just fine when he wants - basically the opposite of dn who has ASD, but who eats everything...

Good luck OP. Apparently about 1 in 2000 children don't "eat when hungry enough", which is a useful fact to counter those irritating people with.

Not quite the same, but in the case of both a relative and a friend, when the calorie intake needed increasing and the fat increasing because they were so underweight, they were encouraged to eat things like fish & chips etc in the short term. Sometimes needs must, and if your child will only eat crisps & cake for higher calories, then so be it. That is of course if won't eat anything else to up their calorie intake.

We've not had our sensory diet appointment yet - am actually quite disappointed as I was thinking they would expand DS's diet range! But thank you for the clarification. (Was it helpful?)

zzzz, TBH I am now feeling a bit sick.

I know it's stupid, but I had this hope there would be a magic wand on the diet front and they would be able to really help expand his horizons over food. Because I try really hard on that front and it's upsetting.

But more importantly, the sensory problems he has are fairly profound, and he is agoraphobic as a result. I tried to say that to the paed who said I needed a parenting course. I have done one! We are seeing DK next week to ask for more help with how to balance his panicked inability to cope with the world outside the front door; I am especially upset if the sensory diet would have been relevant to my worries about his inability to leave the house much other than go to school. He was diagnosed summer 2014 and he has had two referrals in two geo areas now for the "sensory diet". Because I thought it was food I didn't push too hard. Now I find his distress, anger and sometimes even violence if we take him out after school (and I am talking supermarkets here, not funfairs) could be down to sensory struggles he has had no specific help over, and I asked for help over, and he has twice been referred for such help before his retreat became so total without anyone telling me that is what they were doing.

IMO the importance of early intervention is over egged and the importance of kindness and empathy barely acknowledged.

DS' intervention has involved being allowed chewies, understanding on the sensory front at school, and one to one sessions every week with a Family Support Worker with specific training who tries to build resilience and coach him in picking up on facial expressions, social cues, appropriate physical distance etc (and that does all seem to be helping, I have to say). He's never had formal interventions along ABA type lines, and the ed psych who gave the Early Bird course I did said she's not a fan of those either - but diagnosis can mean a lot more understanding of the child and help from the Advisory Teaching Service (who are absolutely brilliant). So I suppose it depends what you mean? I'm really grateful for the help he's had at school, at any rate. We're also lucky in that his class teacher now is also the SENCO and is very good. She makes him feel very safe there. But my son has been really distressed over coping with the world outside home and school for a while now, and I didn't really chase up the appointment because despite his diet being restricted it's not that bad these days and I was more concerned about the agoraphobia. And the bloody paed told me there was no help for that, no CAHMS support for that, only a parenting course I had already done. While referring him yet again for a "sensory diet" which it now transpires is help for that.

On the plus side, I do now know what I need to chase up. The sensory diet ref, and a new one for a nutritionist!

Sorry to hijack, OP.

Better crisps and cake than nothing at all.
And calories and energy are two completely different things. Cake provides plenty of calories but probably not much energy!

Oh Lord, OP, I really AM sorry for the epic hijack. Didn't realise what a rant, and what a long one at that, it was till it posted.

She eats better on the move but I have to be careful because she gags and chokes often. If she has grapes which were bought more than two days prior or from a different supermarket she can tell the difference and will gag and want it out of her mouth but be too upset to do remove it.

We had this.doc said he just wanted to give one less stress.as long as enough calories are consumed because weight gain fats,carbs are essentials at that age.
Dnt give up trying new things every week.vegetable chips,granola biscuits.also what bout nutri drinks if she needs a few more essentials.cheese on toast.peppers with Julius.

She will only eat fresh cake too. Even when she liked toast she could tell if the bread had been bought more than a day ago and would reject it! She will very occasionally have some milk with her cake but mainly because she likes to blow bubbles in it. She has tried hot chocolate but it almost made her sick. She won't drink juice or anything else other than the bare minimum of water.

Sleeponeday, I have just finished a sensory skills workshop, which is possibly similar to the sensory diet. It was helpful for me (and I already knew quite a bit from my digging and reading on the SN boards here and being pointed elsewhere over the years). It was mostly about the 7/8 different senses (the 5 usual - touch, taste, smell, sound, hearing) and proprioceptive and another (basically how your body is aware of where your body parts are in space - so your hand is up in the air relative to your body and being able to walk without looking at your feet all the time - and your sense of balance regulated by the inner ear). I think, roughly.

What was good about it was giving a few ideas related to each of things that make that sense more alert or more calm, and how you can try to calm a very hyper/alert person or "wake up" a very under alert (sleepy, zoned out etc) person to get them to the "alert state" where they should be for a particular activity (as it was mixed parents and teachers, they tended to use the analogy of being in the state of the "teachable moment" a bit).

If it helps, I can give some of that here or in a PM? (Apols for any delays in responding - I have yet to scan them for school (sending to teacher) and work is very busy too this week so it's not intentional).