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?

I have an 11 year DS who is very fussy and has gone through periods of not eating. He's suspected Aspergers and that often comes with eating issues.

He is better with everything separate and plain things. He will eat sausage (plain), sausage rolls, bread, fruit, mash, burgers if plain, biscuits, crisps, crackers, breadsticks, pancakes, plain rice, plain spaghetti, roast dinner, peas, brocolli that's about it. He will drink water or lemonade usually diet. He will starve himself if he can't get these and his weight went down to 4th percentile at one point. Yours is probably too young but buffet restaurants work well where he can pick and choose but he seems to always have all food the same colour. If he is like this being strict doesnt work. The doctor said to feed him anything to get weight up. Over the years he has added a few things but its rare. School dinners help though have left him in tears at time when they change the menu without warning him.

He responds to praise not to nagging. He used to say things like I only need one pair of trousers. 😂 Could well be completely different though. He responds to things like pea eating competitions counting the peas. I do tell him that people need to have vitamin C / fruit and veg everyday. He will help himself to fruit if bowl put in front of him, between him and TV! He tends to eat loads of the same.

Have you heard of AFRID? Avoidant/Restrictive Food Intake Disorder? It can often be triggered by an illness that causes eating/drinking to be painful. Sometimes there is an underlying physical cause and often there is an emotional, unknown cause.

My DS has benefited from Direction of Responsibility, loads of info online and here is a very helpful FB group but the summary is:

• you are responsible for providing food, your DC is responsible for eating.
• present food as deconstructed as possible, buffet style and always include 2-3 safe foods (I found it best to forget about healthy/unhealthy foods. When a child is not eating all food is good food)
• do not threaten, bargain with, cajole, praise or in any way engage with the child’s food choices from the buffet (other than maybe dealing with portion control so other people can eat)
• encourage cooking, messy food play, food books/videos, etc , anything really that promotes contact with food.

By the way because this always comes up on these threads and has come up already, children will starve themselves. On the FB group there are families whose children have ended up in hospital being tube fed without an underlying, physical issue.

Thank you all so much for your supportive comments and suggestions.

I tried baby babyccino (sp?) but he won't even try it.

I think he might enjoy a picky tea, will try that. I just want him to eat normally 🙁. I worry that I'm doing the wrong thing by 'pandering to him'. The judgement from others is hard to deal with. The drs and hv I've spoken to have clearly felt I am just not tough enough and if I stopped indulging him he'd be fine...

My gut feeling is that we need to leave him the hell alone and not comment at all on what he does/doesn't eat but people, even childminder, parents etc can't seem to help themselves . I do definitely think there is something going on though. Even on the rare occasions he does try something new, 99%of the time he'll spit it out.

merryoldgoat my ds sounds similar. Well done you in persevering!

OP, do you take him food shopping? Could he choose some food? She what he picks? 'What would you like to buy?', rather than, 'What would you like to eat?"

Agree with Booboostwo read up on the division of responsibility.

Also agree with WishIwas19again about serving meals at the table with everything in the middle and you help yourself. Always make sure you offer something you know he does like as well as stuff you know he doesn't. He can eat as much or as little as anything and no pressure at all.

Also remember there is fluid in food, so don't get too hung up on the mls he drinks as he will be getting some from food too, especially stuff like jelly.

I've got 2 children with autism who are both restrictive eaters, and one of them a fluid restricter too.

If he’s not loosing weight then that’s great. I would offer chocolate milkshake at all meals made with only a bit of powder and put in vitamin drops.
At each meal I would offer a few things that you know he will eat and then a combination of other things that are healthy, so fruit veg and protein. I would try to make meal times as fun as possible, talk or sing together. Always eat something with him and let him. Don’t put any pressure on him to eat and don’t comment on what he is eating unless he tries something new and hen offer praise. Offer praise even if he touches new food and talk about what it feels like and what it smells like.

He hasn't lost weight, no, but he's only on the 9th centile.

How does serving from the middle work with such a limited range of foods? Would I just put our normal tea in the middle alongside a bowl of dry cereal?? As he'd definitely only go for that? So I'm not sure how that works!

He probably will only eat that for the first few weeks but hopefully in time he would start having small tastes of new foods and then the range of foods he will eat will expand.

I'm sorry to hear about your ds and how difficult this is for you both.

There are almost certainly a few things which have contributed to this so it will take time to change.

There has been some great advice on here so I hope you're able to process it and take up some suggestions.

My DH is a fussy eater (gags on new/unfamiliar foods unless there's been much mental prep). He was keen none of his children would suffer like him so our aim was always to give a wide range of foods. But also in a supportive manner as he was often force fed which increased the trauma!

Mine are good eaters except for dd2. At the same age as your ds I was despairing of her diet as it was so restricted. (We didnt get to your stage though.)

However, I found a few things which worked and 6 years later her repertoire is much better and she is far more likely to try new things.

1. Don't talk about the food except in a positive way. (Well done for eating that, good try, thanks for helping me make tea, etc)
2. Make sure that something you know will be eaten is available e.g. I knew she'd eat plain pasta so I'd put that on the plate but then a teaspoonful of sauce near it (so she could try it).
3. Deconstructed meals worked better (without any elements touching). This meant she knew exactly what she was getting and felt more in control.
4. Encourage viewing/helping during food preparation. (This wasn't as much about if she made it she'd eat it (as that wasn't massively successful) but about normalising different foods, taking the weirdness out of them for example. )
5. Ignore judgements and try to minimise conflicting advice. (I had to speak very firmly to my mum as she would praise dd1 and say it was a shame dd2 wouldn't be as good as her!)
6. Breathe. It's hard but you're doing the best you can.
7. Keep pestering doc as you should be able to access dietician support or testing depending on what the root cause is.

DD2 is a bit like this. Will only have a limited kinds of food and a limited amount as well. She's tiny too, I suspect she may be on the lowest centile, or maybe even off the scale. BUT - she is perfectly proportioned, poos every day and has energy like you wouldn't believe. I also knew she wasn't losing weight, she was just putting on tiny amounts of weight slowly. I cannot tell you the number of people who've expressed concern at her non-eating. I used to obsessively worry, until my mum pointed out that I was an extremely fussy eater and yet turned out OK.

It is VERY hard not to get emotional over their eating, I still struggle, even though I don't worry about her weight and even though I know her saying no is a way of control.

During the bad days I let her eat what she wants, that way I know she's eating (even if all she's eating are chips and cake). Being tough doesn't work in our case, all it does it make the situation worse and she ends up not eating anyway.

We do get glimpses of hope though, she has decided that she does like "pancakes" (that's what we call omelettes!) and had some chicken for the first time yesterday.

So no real advice to give but just wanted to let you know you're not alone!

OP this website has loads of excellent advice. Here is the bit about division of responsibility:

Division of responsibility

About meal times:

Meal times

If he is having frequent sore throats etc, food will probably taste horrible. Try cleaning his teeth about 30mins before food? Maybe that will get rid of the bad taste? My fussy eater DD would eat brocolli, raw baby spinach leaves and sweet chilli crisps. All strong tastes eg she would eat curry but not sausages or baked beans or bread.

I found an old food diary of when she was two and her daily food was a Farley rusk in milk for breakfast, a piece of broccoli and two grapes for lunch, a sweet chilli Pringle for snack and a tea spoon of cottage pie for dinner. She eats much better now, I think she didn't trust the food / it scared or worried her and also tasted rotten.
Also try putting a small portion of food on a large plain white plate - so it won't overface him.

My DD started refusing food around 3.5 years. After a few weeks of her refusing to eat (she'd drink milk), despite GP and HV telling me she'd crack eventually, she'd lost so much weight that I sat her down and appropriately explaine to her that she needed food to grow. And that if she didn't eat she'd get smaller and smaller until she disappeared.
She agreed to try some custard. Then some spaghetti hoops cut up very small, and we slowly built things up from there.

Years later I asked her if she remembered not eating (she has a fantastic memory) and she told me she'd hurt her throat on something sharp at pre-school.

For a long time after she started eating she would pick the ends off sharp chips, crusty bread etc.

No expert knowledge but this book by Bee Wilson has a very good section on children who refuse to eat and the evidence based methods to get them to eat more foods. It’s also a very good easy read.

www.theguardian.com/books/2016/jan/10/first-bite-bee-wilson-review

You can also get some flavoured fizzy drinks

That should say flavoured fizzy water. Of course you can get fizzy drinks!!

We've had no food issues here (rather the other way, a child who doesn't feel when they're full) but I do know a child who ended up in hospital through not eating. She eats banana, plain pasta and carrots. They were also advised to offer food, make sure at least one of her foods is on the table. Not comment and let her get on with it.

Good luck.

Just pop your normal tea in the middle of the table, try to include bits he may like, our Dd loves beans so we often put them out alongside our meal. Then don't comment on the food at all, don't say a word, don't get into discussions about it, don't offer alternatives, don't respond if he says 'yuck', it doesn't matter if he doesn't eat anything at that meal, just chat normally about your day. My Dd often enjoyed putting food on her plate but then didn't eat it but that's fine. Also getting her to help prepare the family meal even if she wasn't going to eat it was good. If she had a tantrum we used the 'time out step' but never mentioned it was due to food, just stressed her behaviour was the issue.

The worst bit was getting nursery and family on board, it really annoyed me they kept commenting on food no matter how many times we stressed they weren't supposed to. I had to speak to the nursery manager and write a letter but the judgement was hard. Consistency is what worked for us over time but it's taken months

Each child is different but this is how we do it:

I prepare the family meal and present it deconstructed in different plates, so it would be plain pasta, sauce, each veggie in a different plate, plus two things that I know he is currently likely to eat. The safe foods can be anything, wheetabix for lunch, bread for dinner, grapes and chocolate for breakfast, I don’t care if the food fits in with what we think as appropriate for that meal. My DS goes through periods of really liking one thing, so one day he may have 12 nectarines over the day, the next he may eat just salami, then only harbor sweets (yes, shopping is very difficult and yes it isn’t very frustrating but I try not to show any emption because any reaction and not stops eating altogether).

He then gets offered everything on the table one by one. He can say “No thank you” but not “Yuk, that is disgusting” which is a useful thing to learn as it helps in social situations. He can serve himself which he really likes. If he doesn’t eat anything and ask for new item X I just say “Sorry X is not available at the moment, maybe you can have it as a snack later” and I try to offer X a couple of hours later. This has helped enormously as he has learnt that not every food is available at any time, so now we can eat out - if he doesn’t like anything he knows he can say no and wait for the next offering. Before I was doing a lot of catering, e.g. I’d ask him what he wanted, he would say X, I would prepare X and he would say “No, I want Y”so off i’d go to make Y, and so on. He actually eats more now.

My DS was down to 23 safe foods. They were all very specific, so spaghetti pasta only with no cheese or butter. This was very scary because he had weaned really well, eating everything and then started reducing and reducing. I didn’t know when he would stop rejecting foods! We’ve done DoR for six months and he has added about 20 foods to his list. He has also become more flexible, e.g. he now accepts that pasta at a restaurant may be just penne.

Also if your HV is being unhelpful, keep a food diary for a week or two, stating exactly what food you've offered him and exactly what he's eaten and show it to them. It may help you see a pattern you're missing, and will help them realise you're serious he'snot eating or drinking

Oh OP I feel your pain. How does he sleep? Is he a snorer? Does he seem constantly bunged up?

DD didn't eat properly for a year and lost a ton of weight. We saw specialists for allergies and intolerances, specialists who advised us on overcoming fussy eating etc. In the end it turned out that her tonsils were so big that swallowing each mouthful was a huge effort and they were blocking her throat at night. God knows how it took so long to diagnose when the GP was looking down her throat weekly but once the tonsils came out she slowly started to eat more normally again and is now a very healthy 6 year old.

Hope you find the solution whatever is wrong and he can enjoy a meal soon!

I would give him lots of jelly if he eats that. that contains a lot of liquid.

I am gritting my teeth and sending my asd child to school with a snack that i disapprove of.

No expert but my general technique when faced with refusal is to do what poster that did Henry does

Don't mention food or make big deal of it.

What about stuff like complan? We have gone through many phases of all sorts of refusals and I find distraction at meal times. So putting in good film.. Feeding them whilst film is on or playing game..

I'm sure people shocked by that but we got food in which is the goal. Using very different tactics... But starting off by backing away totally, not mentioning it definalty don't talk about him in font of other people...

Try and pack what he does eat with cream, cheese etc

Doc once said to me he knew small dc only eating two things, one was satsuma I think.. And now he's large healthy man.

I think your doing the right thing, as pp said your buying into the power game of toddlers.

Just back right off, put nice mix out also.. We eat with our eyes. Can you do stuff like food snakes? Not too fiddly some sandwich cut up, snakes face with grape for eyes, carrot slice for mouth etc.
Pinterest has excellent dc party food presentation ideas

Something like that, just put by him when he is playing or distracted with film, his fav TV show may start to help him change his mind about food.
I'd do something like that, not at table.. And just exclaim as if I didn't know where it came from!!

Oh look Peter!! Is that a snake! Or is it sandwiches made of snake. See if it gets him exited... Oh look its sandwiches... Try one, say yum then leave him and the sandwich snake and film...

Popcorn is a good one too, little pot of popcorn, crisps, melon..

He may not ever eat 'normally' and THAT IS OKAY. I promise. Yes, it can cause some social difficulties if he ends up with a restricted diet as a teenager and adult, but they are not insurmountable. My friend's son is now 18 and still has less than 10 foods he'll eat, but he manages with that. There is, in fact, more to life than food.

I would be a bit concerned about the lack of fluid intake, however. At this stage I would just be monitoring carefully, though.

Mine's older so may be too young but he likes 'cocktails' mixing lots of different drinks. Think just makes it more fun.