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?

X-posted, sorry. i see that his overall intake is small, but that you are more successful at home in persuading him to eat something, at least? A simple 'meal tick sheet', passed between you, school, childminder etc could be a first means of communication / enforcement - he has to collect a certain number of ticks each week to be allowed to do something he would like to do as a reward once a week?

He is old enough to understand he needs food. He's old enough to know that if he doesn't eat he wil die.
If there is no physical issue you need to get back to the GP and consider psychological ones. This can't wait 6 months.

That sounds really stressful. Sorry if this has been suggested earlier but bribery for lunches eaten ie a treat at the weekend sort of thing. Or a consequence for not eating at least some of the lunch. You'll know what would work best for your child.

Diabetes was ruled out. Symptoms were tiredness, thirst and needing the toilet a lot. My dad has type 1 so we were obviously concerned, but blood tests ruled it out and apart from the tiredness his other symptoms resolved themselves. Will look into non-physical causes, I think I've been so worried about not creating psychological issues around food that I could have overlooked one already existing 😢

Gosh I’d be extremely worried and I’m sorry that you’ve received so many dismissive responses.

Food refusal can be life threatening and I’d be pushing for specialist help.

Just because he’s “old enough to understand” or “it’s not the school’s job” doesn’t mean he should be left to starve.

I think you and he need more support. GP? Psychologist? Sorry I don’t know... an eating disorders expert surely?

It doesn't matter if he doesn't want to eat because, unlike most children, his body doesn't send him enough "hungry" signals. So he has to eat at set times, including at lunchtime and at the child minder's and not doing so is not acceptable.

I really don't think there is anything abusive about making a child sit down for 10 minutes at lunchtime. I'm astonished they are allowed to skip lunch to play. We had to sit at the table for half our lunch hour and play outside for the other half.

Don't beat yourself up, you are right that it is very easy to create an issue around eating. But he does sound like He's increasingly food refusing and I'd be pushing for a referral to paeds if I were you.

Does he eat junk food willingly?

And does he seem to want to exercise a lot?

He would happily eat sweets at any time, although we have on occasions put a small chocolate bar in his lunch and it hasn't been eaten. He loves football and would happily be out in the garden playing/practicing all day, but I wouldn't say it was a compulsive behaviour if that makes sense, he just loves football!

To answer an earlier question, he didn't mind giving up swimming as he didn't really enjoy it anyway. The running was a family activity (like parkrun) which we do occasionally still do on weeks when he doesn't have football training as they are on at the same time.

I remember having to hold my spoon in the air so the dinner ladies would come and check we had eaten enough lunch to be allowed our pudding. Then putting our hands up to be allowed out to play.

I'm 33 so it wasn't that long ago although it feels like it and there were 35 in my class, so not the golden age of tiny classes and lots of teachers...

I'm amazed that schools aren't checking what kids are eating, especially as schools seem to have time and staff to be checking what they are bringing in complies with 'healthy' rules.

Hmm. What does the childminder say about his eating? Are other children playing when he opts to not eat? I do think a conversation with school would be justified, to ask them to keep an eye on his intake if nothing else. Have you involved the pastoral team?

The childminder didn't think much of it, they have tea before 4.30 so I assume she thought he wasn't hungry or was a fussy eater; she wasn't aware he doesn't eat at school. We've agreed some meals that are his favourites to concentrate on when he's there (although he's not actually fussy in his tastes) and although she will serve smallish portions so as not to look daunting on the plate, she'll encourage him to eat a reasonable amount before going back to playing, serve him first so he's not alone at the table if others finish quickly and obviously it's easier for her to let us know how much or how little he's eaten.

They don't have snacks at break times at school (other than fruit for the younger ones) so i doubt they'd agree to him taking one in.

The plan with child minder sounds good. It's definitely worth talking to school. I worked with a child who had minimal appetite due to medication and he was in a supported lunch group to ensure he ate and also had calorific snacks at break time. As a pp said, it's on a par with a diabetic child who needs insulin etc- school should be set up to deal with this without a child feeling singled out.

I notice you've said he is thirsty and going to the toilet a lot. Does he drink a lot of water which is filling him up and making him feel full? Unless he's drinking things like full fat milk which you would obviously want to encourage.

Hopefully, if he was my pupil I would fight within the school for him to be an exception to the school snack policy (which we already organise for e.g. diabetics, as well as for children to whom we provide nutritious snacks because we are aware that they are not given breakfast..) and would have an arrangement whereby he ate it in the classroom, or under the supervision of myself or a TA, either before, during, or after break. His welfare would be my concern, and a child who is inadequately nourished is as much my concern as a child who is at risk of obesity for whom we might manage e.g. additional exercise and enforce the school snack policy rigorously..

Ooh, special 'lunch clubs' / supported lunch groups are a good idea, too. Quiet room, maybe some 'special' things to do. Does the school already run lunchtime clubs - languages, board games, art, paired reading, library duty, anything really that involves some quiet sitting with some other children who are also quietly sitting and eating - and if so, could one be 'tweaked' a little for him to be included in it?

My son was exactly the same at that age. Drove me mad - making lunch, throwing it away over and over. He looked like skeletor but was healthy and well otherwise. No suggestions - mine just gradually grew out of it and by age 14/15 started eating much more. He's 16 now, 6 foot, still slender but eats normally.

My daughter was just like this. I had the same full lunch box with maybe a corner of a sandwich eaten. Spoke to head who said daughter had excellent attendance and was bright and active. She was of the opinion that we should not make food an issue with her as that was how eating disorders started. We thought she was slightly bonkers at the time. Dd was a tiny scrap of a kid. However she's now 16 fit active and has a healthy appetite. Still not overly worried about eating but maybe that's just the way she is

I think you need to push for a referral to a dietician and ask the GP if there are other physical possibilities that can be ruled out with blood tests. IMO 6 months is too long to wait.

School nurse and senco, to talk about a plan to support him at lunch times and work out a way to get him eating something, and that will enable him to have something other than fruit at snack time.

My do is 7 and is under a dietician, his growth has slowed down a lot over the last year and he is just under the bottom line of the centile scales. He has recently been put on fortified drinks and puddings (300 calories a piece!) he is allowed to have one at lunchtime and a cereal bar at snack time, as it was agreed In a care plan with the school nurse and senco.

Is he actually losing weight?

I think this is a bit odd in a small school - dd school approx 100 - she is also a food dodger in favour of play. School wouldn't police packed lunches (rightly as some are ridiculous) so we moved to school lunches - on those she isn't allowed to go out to play unless she has made a decent attempt (small school so they get when she had tried). If yours is 90 approx and like any primary they should have a system to deal with those that would rather play Than eat .

I'd contact your school nurse. If it's become a medical issue then they can advise and lease with school to come up with a plan.

I'd go with more of a motivational approach though.

So he has to eat certain things and gets tickets for this. X amount of tickets = X amount of time playing football.

Give him some control?

Agree with DS he packs his own lunchbox for a week. He must ONLY put in what he thinks he'll eat. (To be clear, this is not you packing what you've agreed with him - he gets the food out of the fridge, makes his own sandwich, packs his box etc - you only check it's done).

If after a week he's not eating what he's packed, tell him he'll be having school lunches (experience says these are more rigorously monitored)

If he's such a grazer, eating very small
amounts, he has normalised hunger. His stomach is also a bit shrunk, in all likelihood. So eating a full lunchbox will be probably too much.

But equally his choices don't affect him at the moment - he gets to go out & play, he's happy. Make the whole process of choosing and preparing the food his issue - if he has to spend time making all his lunchbox, perhaps he'll value it more?