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?

[wiltingfast]

Op if they are the only carbs she'll eat then I would be giving them every day.

I assume you can try to add to the list but the child needs the calories and carbs in the meantime.

[JustCleo]

The cake is one particular type and brand also so no way of meddling with it. Interestingly she enjoys baking with me but will never taste it.

[SnapCackleFlop]

Sorry you're going through this. It must be very hard.

If it's not a stupid question what kind of cheese does your dd like? Would there be any scope for different kinds?

What about drinks? Would things like milk (even follow on since it's at least fortified with things) be any good or drinks like complan which can be good if people can't manage a lot in their diet? Could you make up smoothies or milk shakes with things whizzed in like peanut butter or would she hate that?

Incidently, we had crap advice from a well meaning paediatrician years ago when my dd was a baby (different reason for seeing paed) - now my dd is a healthy 10 year old and none of the diet/food issues remain.

Take care of yourself - what you're going through is tough.

[HarveySchlumpfenburger]

If she's becoming underweight and she won't tolerate any variation, then you don't have any choice. Whatever gets the most calories in will have to do.

Ask for a referral to a dietician, but in the short term, I think they are likely to give the same advice.

[Cookingongas]

Just: please listen to the advice. Seriously, when I stopped resisting and started giving dd the food she liked in quantity my life and her life was/is better. Some of her most challenging behaviour was down to hunger once I gave up trying to restrict 'bad' foods, and gave her the quantity and calories she needed she and I were happier and healthier.

My dd loves cooking and baking too. After years of cooking and baking she still only tries 1/5 meals she cooks. That's amazing IMO.

[JustCleo]

She will only drink a little water so milkshakes and smoothies are also impossible. Sorry to sound defeatist, I just feel like every avenue has been considered and nothing works for her.

[JustCleo]

Even with crisps she'll only eat half a packet at best and she has cavities from the fruit (she used to eat much more) and cake.

[80sMum]

I had a similar experience: was told, by the GP and a paediatrician, to give my DD cakes and chocolate bars, in as large a quantity as she would eat. She was 3 years old and refusing meals. The Dr asked, is there anything that she enjoys eating, and I replied that she would live off cakes and chocolate given half the chance. He said, "then let her! She must eat and it doesn't matter what it is".
It did make me realise how underweight she was at the time.

[UmbongoUnchained]

Bad food is better than no food!

[GuiltyPleasure]

OP you are the parent & you know your child best. My DS (8yrs) has never eaten solid food. A doctor told me 7 years ago that if I refused to acknowledge my autistic DS's food refusal he would eat when he was hungry. It was the most shit advice ever. He would've literally starved himself. Even now he only eats specific brands of certain non-solid food (& yes for an autistic child particular brands are very significant- taste, texture, packaging) OP, give your child whatever he wants & trust your own instincts about how and when to introduce other things. Of course it's better/easier when your child has a varied diet, but the number of calories are the main thing, the goodness (although not ideal) can be supplemented

[TheFormidableMrsC]

No, sorry, I don't think it's bad advice. I speak as the mother of an ASD child whose palette is very limited and who has all of those including several bags of crisps every day. It is actually a cause for celebration if he'll eat something new. I don't give a fig where he gets his calories from, as long as he gets them. Of course I try to encourage healthier eating, but it's not happening so he eats what he eats and I know it won't last forever -and multi vits are better than no vits. Today my son has had frosties and milk for breakfast followed by a bacon sandwich. He had cheese dippers for lunch with a pack of Wotsits and some grapes, we had some home baking treats this afternoon, for dinner he had scrambled egg and a bit of toast with a banana. Absolutely awful for me who is a five a day activist. But, I pick my battles now. My eldest child (now nearly 18) had anorexia at 14, so I thank my lucky stars that my kids eat at all. Don't sweat it OP, it will come right in the end.

[TinkerbellaPan]

A slightly different view... I was a very picky child. I think back and I can't remember what I ate! No meat, no veg apart from cucumber, I would have eaten fruit I'm sure, bread and butter, cheese sometimes, and of course cake and biscuits I remember trying pasta for the first time, and was old enough to cook it myself so must have been a young teen! I wasn't fond of pizza or oven chips either. In fact I think maybe I just disliked eating!!

I was skinny at the time and I think my DM worried a bit, but I have no long lasting damage. I was underweight throughout my teens, then as my diet improved in my early 20s I gained weight and I now eat normally and have a normal BMI. I was always bright at school and still am, my diet didn't affect that at all either.

I'm not autistic, but just thought I'd share that a "crap" diet is not necessarily as damaging as you might think.

I survived on far less nutritious food than your DD, so you sound like you're doing pretty well!!

[EmbroideryQueen]

FatMomma99

Not true regarding diagnosis age and severity I'm afraid..... One of the most highly regarded doctors in this field diagnoses privately from 16+ months, but she also diagnoses on the NHS from much later. She says this is because the NHS process is so massively inefficient that in most parts of the country it takes years, plus diagnosis is much harder to get on the NHS as everything is geared towards money saving!

If you have been told they can't diagnose until age 7 I'm afraid you're being fobbed off! And btw, in my relatives area she was fobbed off with age 5!

[Bisghetti]

I agree that FatMomma99 has it wrong and three is definitely not too early for diagnosis. Early intervention before five is really critical for children with asd to improve their long-term prospects. Yes, many children are diagnosed after five, especially at the less severe end of the spectrum and especially through the NHS, which in some areas has a long waiting list for assessment, but those kids miss out on really useful support ahead of starting school. My ds was diagnosed at 4 and I know many children who were diagnosed at 3 and for whom early intervention has been life changing.

Re food, our ds (who has ASD) has had various food issues over the years, including being off the growth chart for several years because of fussy eating. I'd go with the paed's suggestion to boost calories (ours suggested eating in front of the TV so we could get more into him!). Use a vitamin supplement that includes iron if you can (difficult to get them to take it so may not work) and aim to increase calories as at least that's something you can address. Trying to avoid unhealthy food in the hope that your child will eat when they're hungry doesn't work with these kids, in my experience.

[ThumbWitchesAbroad]

A friend of mine's DS4, the only one with no discernible ASD or LDs, went through a "white food" phase aged 3. So would only eat plain bread, pasta, mash - no meat, no fruit, no veg. It lasted for a year - the doc said not to worry about it, he'd come round, just keep offering and he'd eventually get there.

HOWEVER that is an NT child.

But the point is that they need the energy and the macro nutrients, the fat, protein and carb, to build their cells and grow. The micronutrients are marginally less important at this stage.

Can you increase the cheese content? at least that does have fat and protein in it; crisps have fat and carb but far less protein, and cake has some protein (from the egg and flour) but more carb. She needs the fat, absolutely must have it, because ALL cells are made from fat and cholesterol - they form the cell membrane - so don't worry about having high fat foods. High sugar = more of an issue, especially if she already has cavities. Protein will be necessary for functional issues - antibodies, for e.g. are made of protein, as are most communication molecules in the body, so you must make sure she has protein. Does she not drink milk in any form? Yoghurt? Yakult probiotic drink, even?

[BarbaraofSeville]

The list of what she eats looks fine. The worst is probably the peperoni and it's probably a lot better diet than a lot of other fussy children, whether they have autism or not. Plenty will eat no fruit and vegetables at all and live mainly on things like beige food, ham sandwiches and sweets, crisps and chocolate. At least she is eating some fruit and veg and nutritious food like cheese.

Will she eat home made cake or muffins or does it need to be of a particular type?

If you can do home made there will be scope for including beetroot, carrot, parsnip, courgette and probably other vegetables. There are loads of different vegetable cakes and you could probably make a few different ones and freeze them for variety. Will she eat a savoury muffin, that does have a little sugar in it, with something like ham, cheese and courgette too?

Let her eat as much of these as she likes, along with the fresh fruit and veg that she does like. Have other foods present in case she wants to try them.

[grannytomine]

My daughter had an even more restricted diet and she was seriously underweight at 5. She got a bad chest and ended up like a skeleton. Dr said it she lost any weight in the next week she was going into hospital and would be on an IV to get something into her. His suggestion was to give her chocolate, one of the things she would eat. He was happy for her to have it for breakfast, lunch and dinner. She would also eat fruit and a particular brand of yogurt. Well she put on half a pound that week. When she wanted to go on a school holiday we said she had to be able to eat some basic stuff or she couldn't go and she gradually had more and more things. As an adult she is slim and healthy, doesn't eat much chocolate but still loves fruit.

It is worrying but they do need calories.

[Kanga59]

Look into getting a multivitamin - We use one sachet of Fruitivits a week

If she's underweight then it's even more important to get calories in. Plus it could have a downward spiral affect on her appetite.

Crisps are really not a big issue. Most children with a packed lunch at school or nursery will be having crisps or mini cheddars. Children need calories first, second and third. Then variety

You can make a lovely calorific cake with low sugar - Google things like paleo choc cake.

[LittleBearPad]

Feed her what she'll eat and if this means daily cake go for it. She needs the calories to grow.

[Fairylea]

I will admit I haven't read the replies as I am about to dash out, but I have a 4 year old son with severe autism and he will only eat bread, pasta and ice lollies. And that is it. Really, it. No veg no fruit no protein. Ever. We are under a dietician and they have prescribed super vitamins for him and the main aim of the game is to get him to eat something, anything. Lots of children with severe autism end up being peg fed and we want to avoid that if we can so we literally let him eat anything and everything - a whole pack of ice cream if he wants to.

To someone who doesn't understand autism that sounds ridiculous but an autism restricted diet is like no other and is very serious. You can't force a child with autism to eat heathily by limiting the foods they will eat, they will just end up ill (as happened recently when my son ended up with a urine infection and chronic constipation because the paediatrician told me to try to cut down the amount of fruit shoots he drinks in an attempt to get him to drink water - he would just rather die of thirst, he doesn't understand the link between drinking and being ill etc, it means nothing to him and his standard receptors don't work).

With a restricted diet with autism you want to encourage a positive relationship with food so they want to try more and reduce the anxiety about food.

[TattyDevine]

If she's becoming underweight and those foods are all she will eat, I think you are quite "lucky" she'll eat cake and I wouldn't worry about giving her more.

Ideally she'll eat home made, so you can play around with the ingredients a bit? If you can sneak some quite nutritious foods into the cake then that's a win for variety and vitamins.

Banana cake, some almond or coconut, apple, etc.

She does need calories and energy, and if she's underweight, this is the way to get it.

A lot of the anti sugar thing seems to be about preventing childhood obesity (though it's a bit about diabetes which can happen in even skinny people if they have the wrong kind of fat apparently something to do with it being visceral) and obviously teeth are important but if you have a non-nt underweight child these rules don't trump what your paed says.

Good luck, it must be tough...

[mouldycheesefan]

What other advice can the paediatrician give you? If he told you not to g I've her those foods she would be even more underweight. If he told you to give her other foods she wouldn't eat them the advice you have been given is the best advice in the circumstances. I think you are very unfair to call it crap. It is a crap diet but if that is all she will eat the paediatrician doesn't have a magic wand to make her eat other stuff.

[dietstartstmoz]

My son was diagnosed at 3.5 and he is not severe, he has a diagnosis of high functioning autism. He also has a restricted diet - he eats lots of yellow food - toast, cheese on toast, ready salted crisps, chips etc.

Honestly i would not worry just get food into her, high calorie food and whatever she wants. I have really learnt to choose my battles and food is not a battle worth fighting. Can you bake cakes and make muffins? Would she eat those? She is eating fruit and veg so dont worry about the unhealthy foods.

I went to an occupational therapy session for food for ASD kids and they said if you can introduce one new food a year then you are doing well. My son is now 8 and eats a wider variety of things, he is still very fussy but I can now suggest new foods and he will usually try them.

[Shakirasma]

The dietician I saw with my ASD son who has a very similar dietary restriction to your child, told me pretty much the same as yours.

She showed me that although limited in variety, his diet did in fact fulfil elements from all food groups so she wasn't worried. She told me to make sure that he ate plenty of what he likes and to make sure he had full fat versions and to avoid sugar free stuff as he needs the calories.

He is 9 now and although his acceptable food list still hasn't improved and a lot of it is what we as adults perceive as rubbish he is physically healthy and he is happy as mealtimes are not a battleground.