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?

School lunchtime (in England) is outwith the official school day - hence the lack of staff covering- they only have to have enough for safety.

But because it is outwith the school day you are entitled to take him out for lunchtime - if he eats better for family, can a family member go and take him out - even to the car - watch him eat and take him back. Thereby actually making sure he eats rather than relying on the school to come up with something (after 2 YEARS of not doing so).

Some good advice, thank you. Unfortunately there isn't really anyone who could go in at lunch times as DH and I both work, as do our parents.

Is he still drinking and urinating a lot? Did the doctor check for diabetes insipidus? (Water diabetes). It can be a temporary or permanent thing and range in severity. From what you describe, it sounds on the milder side if he has it at all. I'm not an expert btw. Just a suggestion as weight can also be an issue.

If it's a body hydration issue, it could be an electrolyte imbalance. The cells in body need salt and glucose to uptake fluids, which he may be lacking as he eats so little. You can buy electrolytes in powder form from the chemist, which are a good balance. They may have to order them in.

All I'm thinking is if he drinks less, he may eat more.

Borderline underweight can be completely normal, as can skinny kids, though we have lost sight of that a bit recently. I've been "borderline underweight" all my life. I eat loads and I'm healthy, it's just how I am.

...oops

Focus on the childminder not the school and try to get more fat in him, but less sugar. Will he snack on cheese and can you swap him to full fat milk? Rushing off to play is a sign of a healthy child, not a problem.

I have only skim read the thread but I think yabu.

You sound at risk of making food a big issue. Ds is underweight, his diet is very restrictive and doesn't eat much to the point we are now on build up drinks. One thing that everyone we have seen has agreed that food can't be made a battle zone that is more likely to lead to more issues in the long run. Let him have control over what he eats and within reason as long as he gets calories in don't worry where they are from.

I am also amazed that a doctor suggested restricting physical activity! That's not going to lead to a healthy attitude either IMO and being active is more likely to make him get hungry and need to eat

can he make his own lunch and chose what to eat, and let him take whatever he wants, and agree that it has to be at least 3 items and label each item on when to eat, playtime, lunch and after school, so like an apple of even half, but core and cut in to 4 per half so its easy and fast to eat
get him to agree that it will only take 5 mins to eat it and then he can go play,
same for lunch,
cut things into small bite sized bits,
like 4 quarter sandwiches and make him agree to spend 5 mins eating all of it and then for after school more fruit or a treat and build from there,
give him a timer if it will help,
keep the portions small and fast to eat,
add in a protein drink too, we have "up and go" which is meant to be like having a cereal breakfast, if you have something like that it can be a boost to his diet during the day,
but make him agree to to do and each day check and if hes eaten it all for a month get him a new game or toy as a reward? ( each month maybe untill it becomes a habit)
and dont get caught up on everything being healthy until you can get him eating each day.
small things,
like a boiled egg but shell and cut it and season it, so all he needs to do is shovel it in
a apple, but core and cut into 8ths, give him 4 or all 8 slices
an orange, again cut up in the 8ths
a plain sandwich, 1/4'd even crusts off for a start, if he likes peanut butter use that as a boost
small pies, the mini savory ones
a bag or popcorn
crisps etc
just keep it all small and fast to eat

I really wouldn't worry about being 'borderline underweight' as long as he's not losing consistently and he's healthy. Two of my dc are or have often been 'underweight' according to the charts (and the third is too according to age but is in proportion for height). They are healthy, have good appetites and are just on the light/skinny side.

And I would never force a 9yo to eat. Mine often virtually forget to eat during the school day. Yes to small, filling bite-size things.

You are in very real danger of giving him an eating disorder.

Step back. Stop making it an issue. Stop discussing food & planning it with him. He's 9. Let him out into the garden to play football & be a kid.
The more you carry on, the more of an issue it becomes and more of 'a thing'. More of his identity of himself.

You've ruled out Diabetes etc. His Dr doesn't want to see him for 6 months, so he's clearly not that worried about him.

Kids are supposed to be really skinny. Maybe he's a bit skinnier than that, but if all the kids around him were the correct weight then he wouldn't seem so extremely skinny.

I know it's very hard when they appear to exist in fresh air, and trust me, I've done my share of worrying about it. But things were much better when I took a step back & let them get in with eating when they were hungry & not making an issue about food. At all.

Oh, and I'd change Doctors too. Any Doctor recommending a fit & healthy child stops/reduces physical exercise needs to be avoided.

Take DS swimming for FUN. He'll eat afterwards!

The doctor does not consider him to be healthy though, that's the problem. DS was participating in sports 5-6 nights a week, this has been reduced to two or three as tiredness is an issue and he's currently not eating enough to sustain that level of activity. I don't feel like doing nothing is an option, so it's incredibly hard to read that you all think I'm actually making him ill.

tbh, I'm surprised they don't prompt him to eat more before playing, if he really isn't eating hardly anything. When I worked as DL, the kids always had to ask before they could leave table & go play (DS snuck out anyway ). With yr6 kids it was definitely just so we could lay eyeball on them, not that we would check what they ate. With kids in R-yr4 I would have a look at lunchbox, & try to make sure they had finished the most substantial thing in there (like the sandwich instead of the crisps).

Yr5 is borderline age, which I guess is what OP's son is.

Sorry if I missed it. Did OP describe her son being listless & low on energy?

mmm... sports 5-6x a week is a lot, after a full school day. 2-3x would tire most ordinary kids out I reckon.

How is his learning at school? Undernourished kids don't concentrate well, either.

How about trying to approach it from a different angle, assume the packed lunch scenario isn't going to change but maybe go for a big breakfast, substantial snack when he gets in after school then a decent evening meal. Or try and increase small and regular snacks, my daughter was never very easy trying to encourage 3 meals a day but now she's at uni she eats really well with smaller meals and plenty of healthy snacks.

Is this dr a specialist or a GP?

You could try the school nurse as suggested.

and basically what billybagpuss said:

look into a really nutritious breakfast

make childminder's his lunch place and just make sure she prompts him to eat something really nutritious (supplied by you) as soon as they get in: she can sit with him and ensure that he eats before he gets to play

After an awful period of ill health in my teens, I only weighed 6 st (not due to any eating disorder). I knew I had to do something when I saw some holiday photos of me, where I looked absolutely awful.

It was actually really hard to put the weight back on, as it was a catch 22, I was so tired all the time and had no energy, but this meant I also found eating quite exhausting.

I started having high energy drink, which come in different flavours and are similar to a yoghurt drink

www.nutridrinks.co.uk/ensure-121?gclid=CL3KyJXZuNYCFUW6Gwodd1UE4w

I used this in between regular meals and it only took a few weeks for me to gain the weight I needed.

Not the same as your DS of course, but maybe this could help

It is so hard when they don't eat, my sons asd and wouldn't eat lunch at school but his school were very good and kept an eye on him, they suggested taking a snack in for first break and someone would encourage him to eat some of his packed lunch as well, this did help matters, also doctors can prescribe yogurts and milkshakes that are high calorie and they are very good, if I remember rightly yoghurts were 320 calories each so would make a difference, hope things start to improve x