To expect school to help with this?

[HopefullyAnonymous]

Sorry, will be long! DS is 9. For the last year or two we have struggled to get him to eat his packed lunches. It started with most of his sandwiches being left, then his yoghurt, sometimes crisps too. Sometimes he'd eat nothing. I've tried everything - no "snack items", wraps, salads, crackers and cheese, pasta/rice salads, quiche, pizzas made from rolled up pasty, school dinners. We've planned meals of his choosing at the weekend and he's helped make them. Still the same, he doesn't eat enough to keep a mouse going

I think the problem is that he wants to get out as quickly as possible. He can be the same at home if there's something he'd rather be doing, usually playing football! The problem is that he's borderline underweight for his age and I'm concerned. We have seen some improvements at home; I've tried smaller portions so that clearing his plate becomes manageable, I involve him with planning and cooking where I can. We make meal times family time to distract him from whatever else he's itching to get back to. He's not at all a fussy eater and he does enjoy food when he concentrates on eating it!

Due to his weight concerns I've asked whether school (tiny village school, less than 100 pupils) could keep an eye on him at lunch times and encourage him to eat/not let him out until he's at least eaten something. They said it's not their job to force him to eat, if he was hungry he'd eat and that's that. Due to wrap around childcare he sometimes goes almost 10 hours without food so I'm at my wits end and desperate for advice! Should I expect more help from school?

Today 18:41 existentialmoment

YABU. It's not the schools job. Who exactly do you think should be sitting with your son throughout lunch?

not sitting with him, but school meal staff are there to support the kids - we did when I worked in a large primary school when mine were small. Yanbu OP - but don't worry too much, sure he'll be fine in the end

Dd doesn't eat at school due to sensory issues but we manage it by her having a cooked breakfast, a meal when she gets in and then dinner with us later. It works for her could you give it a try for ds?

If it's something that's been flagged by his doctor, I don't think it is really asking too much that the school see if they can prompt him to eat before he goes out to play. It's not something I'd expect them to be able to manage every single day, and there may be too many other priorities, but schools are supposed to be about the whole child and this isn't something you can step in to do while he's at school, so asking if it's possible does not seem unreasonable. Also, from an educational perspective, he can't be learning as well as he might in the afternoons if he isn't getting enough to eat, it's a relatively inexpensive intervention to improve academic performance. But I would have thought the childminder would be where there would be better resources and environment for prompting him to eat. If he isn't having lunch and he's only picking at the childminders tea, is prompting going to do any good? Do you really need to be thinking more about sanctions as another poster suggested?

Parenting is all about the 3 B's - bribery, bargaining and blackmail. Could you try one of those?

Does he get a lot of attention for this? Are you showing anxiety? It sounds like an eating disorder.

Yanbu asking the school to help but there's not much they can do

Think the protein shake idea upthread is a v good idea too - also protein bars

Good luck

Is he actually losing weight or is it that he has a naturally low weight/skinny build?

If he has the energy to play extra football at lunchtime it sounds as though he is getting energy from somewhere otherwise he would be tired and listless.

Hmm, how about reducing the demands? Would he agree to eat something by negotiation if you reduce the volume - half sandwich, same filling every day, and a yoghurt? I don't think some sort of sanction or bribe is necessarily a bad idea, if sure he isn't squeamish about his food.

An idea from How to Talk so Kids will Listen... is to sit down with him, explain the problem and why it needs fixing, and together write down a list of possible solutions. Blue sky thinking. Include every suggestion he makes and some daft ones of your own (chocolate bars only, petition school to install an ice cream machine). Then go through the list together, discounting the silly ones and hopefuly working towards a solution that works for you both.

Give him hot chocolate with cream after he gets home, custard pots as puddings.

I agree with BoomBoom, this might be better addressed with the childminder. But include DS in formatting the plan if you can.

My son was and is exactly the same. He's lively, has ADHD, not interested in eating and would rather play football.
I give him a big breakfast, scrambled eggs on toast usually and also extra toast, waffles, whatever I can get down him. He also has almost a pint of full fat milk with chocolate Nesquik. He eats next to nothing at school so as soon as he gets home it's more milk, chocolate Nesquik, peanut butter on toast... this before his dinner. I just go for the calories.
I've done this for years and he is skinny but stable.

Could you enquire about ensure milk drinks at your GP's? I'm sure you can buy them online as well?

I would offer him food (snacks) throughout the time he's at home, plus his regular meals - only put a sandwich and drink in his packed lunch.

If his eating habits have been like this for a while? His stomach would have shrunken - so little an often would be my plan of action.

I'd also rule out dental and bowel issues - there's nowt worse than toothache or constipation!

I wonder if you could talk to the school nurse, they may be able to work with you and the school to help. As a pp said, if the GP is concerned about his weight, it is a medical matter, and one that will impact on his school life.

Has the GP referred to a dietician? They may be able to suggest some things to help, and if the weight loss is severe, prescribe fortified food/drink.

I don't think you are being unreasonable. If it were medication they would supervise him taking it surely. Given the health concerns, I don't see how this is any different. Any chance that you could pop in at lunch in an attempt to shame him into eating until the issue resolves itself?

To be honest I've tried not to make too big a thing of it in front of him, we ignored it mostly when he was younger and tried to encourage good eating habits/make sure he was getting food at other times. As he got older I've tried to stress the importance of food as fuel for his sport, discussed different options for his lunches etc. He's never liked sandwiches so we've agreed alternatives but over the last year or so he's eaten less and less at school. I didn't want to make a drama out of it for fear of creating a bigger problem down the line.

We took him to the GP as he began exhibiting symptoms of diabetes, which was when the doctor noted his weight. He's extremely thin, to the point where other people notice/comment (to me, not him).

I'm less concerned about what he eats with the childminder of an evening as we usually give him a second tea at home if he hasn't eaten much. It's the long stretch during the day that concerns me, both in terms of his health and the impact it may have on his concentration and learning in the afternoon.

Is he eating something else? Sharing someone else's lunch which he prefers the look of?

What has his Gp actually suggested? Has he referred on? Taken bloods? What centile is he on?

I agree with you the school should be doing more as you can't be here to control him in the middle of the day and it's a health issue of the Doctor is concerned about his weight. Would he be allowed a high calorie milkshake? I think a rule such as "at least one sandwich and drink must be had before any play is allowed". It's protecting him.

Percentile wise he's off the chart, BMI of less than 13 (a crude measure I know but 14 would put him on 5th percentile, for comparison).

So what does the GP say.
Have all medical conditions been ruled out?
Do they suspect an eating disorder?
At 9 he's old enough to express clearly why he's not eating.
If you are having such issues at home you can't really expect the school to be able to sort it for you. If two parents can't convince one child to eat properly at breakfast and dinner how can the few staff who have to cover the whole school make him eat?

He suggested the things we have started doing at home; calorie dense foods, little and often, healthy family meals. We have a follow up appointment in six months to see if there's any improvement. If not, other options will be explored. We have only asked for help from school as he's eating so little overall that every little helps, and because that is his longest stretch without food.

I understand why you're less concerned about what he eats with the childminder, but if he's had nothing all day and she's unable to coax him to do any more than pick at his tea, I think you're probably wasting your time thinking the school prompting him at lunch will be at all useful.

I think in your position i would start to enforce regular, small high calory snacks. So he has to eat something at the childminders for instance (you can agree with him what, and provide it).

We had to enforce greater drinking w ds2 after a hideous bout of constipation. As in "sit down at this table until you've drunk this glassful, your body needs it".

But if he won't eat properly at home what can school realistically do?
I still don't understand why he isn't explaining why he won't eat. Is he saying he's full or he doesn't like it or he isn't hungry?

Does he eat breakfast and supper at jhome fairly normally - if perhaps in smallish portions - but not eat packed lunches at all?

Or does he eat very little at any time?

I had thought that your worry was mainly the long stretch at school? Given the medical concerns, I would say the school should be able top put a plan in place for him - for example supervising a substantial snack at breaktime before being allowed out, specific arrangements for lunchtime, including supervised finishing of any left over food during afternoon registration, and perhaps additional calories in the form of a snack or milkshake-type drink during morning registration or just as he arrives at school if he has been at the childminders and not eaten for a while.

A formal medical plan, drawn up between you, school, possibly including childminder and after school club, could be a good way forward, just as it would be the way forward for a child with diabetes or PKU or severe food-related allergy, or eating disorders, all of which schools cope with. I would suggest that an 'active' playtime, and also football club, could become a 'reward' for eating well.

How has he reacted to his other sports being cut out? Does he seem to want to exercise excessively? You said that you've had some success with getting him to eat at home - is he resisting eating in general though?

I agree that if he's only.picking at childminders tea then school prompting would likely have little effect. I would suggest going back to the gp sooner than six months - did they rule out diabetes then? What were his symptoms?

He just says he didn't want anything. He's a pretty compliant child and will eat a small amount when prompted at home/with grandparents/childminder. Like i say, he eats so little that even if he ate his yogurt it would be better than nothing, which is what mostly happens. It really upsets me to think of him feeling hungry during the day, and he's often crabby and tired so it must affect his mood too.