To ask if anyone has expert knowledge on young children refusing to eat or drink?

[CanYouHearMeAtTheBack]

By expert I mean I don't want smug posters arriving to tell me that I just need to be tough and he'll give in and eat eventually.

DS3 has been a fussy eater from about 18 months. After a succession of ear and throat infections the range of food he will eat is pitiful. What really concerns me though is that he is now barely drinking either. In the last 24 hours he has drank less than 300ml of fluid.

This has been going on for weeks. I've taken him backwards and forwards to the drs. They usually say either his throat or ears are 'a bit pink' but no obvious infection. I feel like I'm not being believed, but I really think something isn't right.

He does feel hunger, and will ask for junk like a packet of crisps or party rings but won't even eat all of them. I've stopped having junk in the house so that he can't have it but it just means that he's now eating virtually nothing.

I'm really worried but don't know what else I can do

Why would a 3 year old refuse food and drink? What can I do?

Is he losing weight? Not meeting milestones? Any other concerns apart from his eating? Presumably the Dr or HV have checked his weight/height.

What things will he eat? Will he drink milkshake or juice?

Will he take ice lollies?

Amazingly he hasn't lost weight... I really don't know how tbh. HV said as he hasn't lost weight to just be really tough and he'd crack and eat eventually. It's not working though. Childminder is now saying she feels uncomfortable about looking after him all day when he's refusing all fluids.

Nutrient deficiencies can cause loss of appetite. Could he be low on iron or zinc?

He won't have ice lollies (too cold). He'll eat:sausage, mcdonalds fries, dry cheerios, dry coco shreddies , jelly and fruit. Party rings and crisps. That is it.

He'll have milk flavoured with chocolate powder. So today he drank approximately 175ml of choc milk, plus 100ml of squash(if that). He usually has a chocolate milk before bed, but tonight he didn't drink it.

I'm not an expert and I've never had a fussy eater but i think I'd just leave things about the room which you could both help yourselves to without comment.
Maybe a bowl of grapes, a couple of cups of different drink. An open packet of crisps things like that.
If he sees you eating on your way past he may do the same

Ok well first of all you and your childminder needs to find other ways of getting liquid into him via ice, lollies, milk, squash, or whatever. He obviously isn't dehydrated or you would have said so.

Try not to panic, definitely don't make a fuss, don't cajole with rubbish. The calmer you stay (difficult I know) the easier it will be.

Keep a diary of mealtimes, what he eats/drinks over the course of a week. That will give you a better indication of what he is actually eating/drinking.

Put out food at mealtimes. Include something you know he will eat and other bits and pieces. Children of this age quite like a "graze board" type meal (ham/cheese/fruit/crackers/veg/hummus)

Don't mention food, chat and eat keeping it all lighthearted. Don't insist he eats anything but praise him if he tries something. Have a set time for the meal, say about 25 mins. After that time clear it away without comment unless it's praise "wow you did well with your lunch today, well done". Vary what you give him but always include something he doesn't normally.

It's unlikely, given the list of foods you listed, that he is a food refuser for any major reason. Calm and consistent is the only way to go with this really. It will take time and patience but, for most children, it will work. Good luck

So if he doesn't like cold does he like hot? A cup of fruit tea, or a half cooled down cup.

What is he drinking from, could it be the texture or size of cup?

My kids drink more if I put a jug on the table and small beakers because they want to pour from the jug.

Fizzy water?

I guess you've asked him, but did you give an open ended question (why don't you like it?) or closed (is it too cold? Hot? Tickly? Scratchy)? Sometimes kids don't have the vocab or deduction to tell you why something isn't right but can pick it out from a choice.

Does he see you drink water?

Have you tried telling him to drink it? (Rather than asking) "Drink that, then we can go to the park." kind of thing.

My DS has/had food sensitivities after suffering sever reflux as a baby/toddler and yes lots of people will say they're just fussy but for mine tastes are just much stronger than they are to us, certain textures would make him gag and vomit too. I never sought help as he had an ok range of healthy foods and ate certain fruits and veg and his calorie intake was ok but a friend of mines child had severe food restriction and was diagnosed with Arfid, some info below. I'm no expert though and there may well be physical causes in your child's case.

www.beateatingdisorders.org.uk/types/other-feeding-disorders/arfid

Hmm interesting questions thanks.

I've tried every cup/bottle known to man.

I've tried putting a drink near him without comment. I've tried saying, "Have a drink babe," which is usually met with a shake of the head.

We have had some interest in drinking fizzy drinks ie diet lemonade, but I don't like the idea of fizzy drinks. Fizzy water is worth trying though, thank you.

Does he see me drinking water? Actually, no, hardly ever. I drink tea all day usually. I will make an effort to drink water too.

When I ask why he doesn't want a drink he will just say he doesn't need one.

Could you offer him a cup of tea with you? Half decaf tea and half milk?

NapQueen tried that, he says no.

Itsatravesty he did have silent reflux and was on omeprazole until he was 2,so that's very interesting

Apple juice with fizzy water instead of a soft drink?
I would let him eat and drink what he will for the moment. You can gradually move him to a more varied diet but I would avoid it becoming a battleground.

Not an expert but my DD had eating problems starting when she was 2.5yr old after a series of tonsilitis and sickness bugs. Over time just seemed to stop eating less and less, having a mouthful or refusing to eat anything at meals. She was underweight so HV referred us for a behaviour and eating programme called 'Henry'. If you look it up online it looks like it's aimed at helping families with nutrition and obesity, but they adapted it for us and the ideas we got from our key worker helped so much.

Enforcing her sitting at the table with the family even if she chooses not to eat, never, ever commenting on her food or eating (not even allowed to say positive comments if they do eat as they can find it overwhelming!), self serve with food in the middle of the table, lots of really fatty food like mixing cheese into everything, loads of butter on toast etc., no carb snacks only carbs at mealtimes, adding in supper, spacing out her meals and not letting her overeat at one meal (she always ate well at breakfast so we stuffed her too full as we would be so thrilled if she was hungry that day, then she would eat nothing all rest of the day).

Our Dd problem with eating was all about control (She is a very anxious and emotional child with super tantrums!) and her stomach had also shrunk so she genuinely wasn't hungry. We got lots of support and over the last year our daughter has learned to eat again and is now healthy weight and eats a wide range of foods, but she still can slip into bad habits so we have to remain on it. Insist on support from the HV or go to GP.

Hang in there, it's so worrying when they don't eat and we found it hard being judged by friends and family

My daughter got the point of eating almost nothing and in the end she had blood tests and was diagnosed with coeliac disease. She was feeling sick all the time it turns out. She was only physically sick about once a week, but it can be symptomless. If it carries on I would consider asking for blood tests just to rule it out.

From what you describe he prefers beige dry and crunchy as opposed to soft and wet. Can you extend that if possible e.g. breadsticks, crackers to widen his choices?
If he likes chocolate milk, give him chocolate milk. You could try reduced sugar highlights stuff and top up with milk. Would he use a twirly straw to drink other things through?

Babychino? Hot frothy milk sometimes with a sprinkle of cocoa powder even better if it's in an expresso cup (so grown up).

I also wonder about telling him like a previous post said eg drink up then we can go to park

My kids love a "snack plate" for dinner as toddlers in one of those plates with sections. Hummus in one, bread sticks, sliced hard boiled egg, grated cheese, carrot sticks, chopped fruit etc

Good luck.

You can also get some flavoured fizzy drinks, or dilute some fruit juice with fizzy water. It's not ideal, but better than nothing. Be warned though, some kids water bottles will leak with fizzy water in.

DD wouldn't drink from bottles (refused dummies too) , squishy straws etc. She drank from "hard" stuff like a metal water bottle, camelbak chute.

Did you try "drink that now!"
Instead of asking "do you want a drink" give two options "do you want x or y"

Could you use Arla big milk with all the fortified vitamins or add vitamin drops to his usual milkshake whilst you figure this all out, so that you know he's getting the correct vitamin and minerals?

Hi OP - he sounds quite similar to my son - he has HFA and the start of getting him diagnosed was his food issues (although with his it was gagging).

He ate quite well until around 2 when 6 months of hellish infections led to him basically eating:

Weetabix
Fruit purée
Yoghurts
Chips
Crisps
Rice cakes
Toddler tray meals of cottage pie
Peanut butter sandwiches

He didn’t lose weight but he’s always been a good milk drinker. Less good with water.

Being tough didn’t work and it felt horribly inappropriate the few times I tried. He’d cry, vomit, panic etc and I decided that I was going to leave it until he was older and fed him mostly cereal, fruit purée yoghurts and peanut butter - sometimes he had cereal for breakfast.

Just before he started Reception I decided that he was ready and I talked to him about it. I said we’d have a game called ‘New Food’. I said he HAD to try it but if he really didn’t like it I wouldn’t force him.

I purposely chose food I knew he’d like. I allowed him to feel safe and try the diversions he needed to make it easier. He needed me to count to 20 in twos whilst he covered his mouth. Sometimes he needed me to feed him.

I waited until a new food was ‘bedded in’ until moving to something else.

He now eats (in addition to the above)

Pizza
Chicken nuggets
Burgers
Toast
Cheese
Cheese toasties
Sweet corn
Mixed veg (mashed with butter)
Baked potatoes
Spaghetti hoops
Apples
Raisins
Ham (reluctantly)
Macaroni cheese
Homemade cottage pie
Pasta bolognese

This has been life changing as we can now eat out, eat with friends, he’s not looked at like he’s weird and it’s made him more confident.

Still a long way to go but we make progress every week.

In your position OP is just give him whatever he wants even if that crisps and chocolate milk and make changes little by little.

It’s very difficult and emotive and I know how you feel.

I also used foods he liked as a reward if he tried new stuff and always give him a choice for dinner so he feels he has some control.

I don't have any experience I'm afraid, I just wanted to offer support, and to say that you sound like a great mum who is doing everything possible - so be kind to yourself too. It's incredibly stressful when kids don't eat, but it isn't your fault.

A thought - pop in to Holland and Barrett (or similar) and see what you can find that might appeal - cocoa nib and nut balls etc that look like sweets, yogurt covered raisins etc. Not a green salad I grant you, but it might help widen his choices with 'healthier' options. (like grate cacao nibs into milk to make chocolate milk etc)

They also have dried pulses and a wide variety of crisp breads etc that might be liked.

Oh and Bear cereal is like a vaguely healthier version of choc flavoured cherios etc - if he likes things to be crunchy they are brilliant.

Read "My Child Won't Eat" which may help a little:

www.pinterandmartin.com/my-child-wont-eat.html

I think the worst thing you could do is get into a battle over it.

Given the Omeprazole and reflux issues I'd look into restoring stomach acid levels and good gut bacteria, and also consider the possibility of food allergies.

I would mainly focus on getting enough fluid in.

Will he take a multivitamin?

Ds is 8 with a very restricted diet. I would let him eat what he wants, when he wants. Keep everything relaxed as possible. Maybe some playing with foods away from meal times.

I was going to ask if he was autistic?

Personally- if he is a normal weight I would stop the game completely. Three year olds are notorious for power struggles and you are playing the “please eat” and “I want to make you eat/drink” game and he has power over his own body and eating and not eating is immensely powerful.
Stop. I know it is hard. And you will feel anxious, but hide it. Don’t offer and do NOT praise. In fact, try to downplay even if he does eat or drink.
Drink and eat your own food and drink but don’t even offer him his. Set food out that he could eat if he chooses to, but then focus on your own food and maybe even read a book or look on your phone while you eat. Don’t engage in any discussion about food or drink for at least 24 hours and see what happens when you leave it entirely up to him.
A very wise GP once said to my mum a healthy child won’t ever starve themselves. And I believe he is correct. If your son has ASD this may not be so simple, but it’s worth a try and is safe as he is a healthy weight.
IF he starts to eat or drink or ask for it, be low key and don’t give away any indication that you care if he does or not. Maybe even say “in a minute” if you’re really brave.
Stop any kind of power play, stop praising/cajoling/bribing/threatening...