How to get 5 year old to eat more

[AliveAndSleeping]

Apologies but posting here for traffic.

DD is on the 2nd centile for weight and the 15th or so for height though she was born on the 75th. She's been seen several times by a pediatrician but they can't find anything wrong. I worry because she doesn't have as much stamina as other kids and it's starting to knock her confidence. Both the lack of stamina (and not being able to keep up with other kids physically) and always being the smallest. She keeps getting told that she's tiny by her classmates (and some adults) and it's starting to get to her. Doesn't help that she's the youngest in her class as well.

She just doesn't like to eat. She never seems hungry. She isn't super fussy but her portions are tiny. She's also a very slow eater. She just wants to talk or dream away. There are a few things that she seems to like but she doesn't have much of them either. Even chocolate she refuses most of the time (unlike her mumhmm) though she does like it.

We've tried everything. No pressure approach, bribery, getting her involved in food prep, playing games over dinner and setting a timer. At school she eats even less.

I'm getting desperate but I don't know what to do. All her clothes are too loose (and short) for her. Any ideas?

(She likes healthy food like vegetables and fruits but it's difficult to get enough calories into her. I add fat (olive oil or butter) to her food and am trying to increase her protein intake. She has a bottle of pediasure every day as well).

I'd try having her eat in front of the TV and also in the car.

@parietal

and if she loves ham & salami, let her eat as much as she wants. At this point, the notion of what is healthy for an adult doesn't matter. you just want to let her get the calories.

I probably should. Just worried about the preservatives, which are apparently highly carcinogenic. I try to get the ones, without sodium nitrites but they only last a day or so, which means I'll have to throw most of it (I'm a vegetarian and dh doesn't like cold cuts).

I guess once or twice a week should be fine from a health point of view and I can try to alternate them which turkey / chicken slices and cheese. And just ignore the waste factor.

@HalfShrunkMoreToGo

Oh if she like salami, Tesco do mini salami sausages in little snack packs, in my local they're near the hot deli in with all the special cheeses and breadsticks. They're brilliant, DD loves them, not highly flavoured just chewy little sausages.

DD is 7 and really tall, she cannot eat a proper dinner in the evening, we've figured out that she eats best in the morning, by dinner time she has a tiny plate of food. Today it was 2 spoons of cheesy mash and half a sausage.

mini salami sausages in little snack packs sounds great. I'll try to find them.

@immersivereader

I know this is a last resort but have you tried junk food?

Also, how big are you and her dad? If you're tiny, it's to be expected that she'll be small also

Dh is quite talk and I am average or slightly above average height and both of us tend to be overweight. So quite big in all directions.

She was born on the 75th centile and I remember the radiologist saying at the last pregnancy scan that she would be a tall girl as her femur measured quite long. She very quickly went down the centiles after she was born. Now she's so skinny I can see her ribs and all her clothes are falling off her.

She was exclusively breastfed and my worry is that I possibly had a very low milk supply and she just got used to never feeling full.

@immersivereader

I know this is a last resort but have you tried junk food?

Also, how big are you and her dad? If you're tiny, it's to be expected that she'll be small also

Yes. Till recently I didn't really offer junk but didn't restrict it either if she asked or had it outside or at a friend's place abd I've always been happy for her to have biscuits and cakes ( which she doesn't like though).

She likes sweets like Haribo and sometimes chocolates but will have very little of even that.

My mum keeps saying I should proactively give her s junk like crisps every day so that she learns that food can be enjoyable. I don't mind offering once in a while but I'm a bit reluctant to fill her up with empty calories on a daily basis.

Now she is says she doesn't want pediasure anymore either.

I was about to suggest adding more peadiasure but doesn’t sound like that’s going to work either.

Does she get involved in cooking/baking at all? That may help her want to try what she has made.

For now focus on getting calories in, don’t worry where from or about keeping things in the normal meals just let her eat what she will!

@Sirzy

I was about to suggest adding more peadiasure but doesn’t sound like that’s going to work either.

Does she get involved in cooking/baking at all? That may help her want to try what she has made.

For now focus on getting calories in, don’t worry where from or about keeping things in the normal meals just let her eat what she will!

Yes she loves baking and we make a lot of cakes, cup cakes and bread. She rarely eats anything we make though. She might have the top with icing or sprinkles but that's it. DH and me end up eating everything we bake for her..

I haven't read all your replies so sorry if this overlaps..but did want to just say this sounds exactly like my now 5 year old when she was 18 months. She dropped from 75th and 50th centile in height and weight to about 2nd. She had no appetite as such .. Just wasn't fussed about food and getting her to eat was impossible.. and she really only seemed to go for low calorie stuff like cucumbers and veg. Her energy levels were also starting to drop and she was sleeping a lot. It sounds all really clear and obvious something was up now but at the time it wasn't as she wasn't sick, vomitting etc. Her bowl movements were more or less normal etc..

We were just watching with doc and he initially assigned the drops in centiles to a couple of bouts of illness etc. He thought maybe she was just going to be small! But then randomly
he decided to throw in a Celiac disease test (total ttg, ttg iga, ttg igg, ema iga and dgp igg are the tests he ordered). She was positive and also anaemic.

Now after 3 years following a Celiac diet she is still not the best eater ever if I'm honest and has a delicate frame..but it's so so much better and she is around 50th plus centile on height and around 40th on weight! She eats a full and balanced diet and has energy.

Good luck, whatever it is that's going on, I totally understand how worrying and frustrating it is!

In the meanwhile it is only games that worked for us in terms of keeping the dinner times positive and helping her eat. We always mention the actual food she is eating In the game so that she associates fun with those foods and is eating them with awareness. And we pushed cheese avocados, banana , olive oil, milk (and regretfully looking back.. porridge, Weetabix, pasta and some bread!)

Oh and nuts!!

We went through this when my DS2 was 3 - he dropped from 25th centile to under 7th and looked skeletal. It was so worrying. I was concerned about coeliac and diabetes, but all bloods etc came back normal. I will say for him there was a big anxiety element - he couldn't cope with a fuss being made at mealtimes or attention being brought to him eating. He's 8 now, and he still can't eat if there's any kind of emotional upset.

Paediatrician told us at the time to do what you are doing - add fat to everything, cream to porridge, butter to potatoes/pasta, snacks like cubes of cheese and salami, full fat yogurt. Lots of snacks rather than focusing on 3 main meals. Also (appearing to!) relax about food and meals - if he didn't eat dinner I would offer him a snack later and for a while I had to stop worrying about salt levels and things being unhealthy and just give him what he would eat to get the calories in (plain McDonalds cheeseburger anyone?)

If she will eat a salami, cheese or ham sandwich after school every day I would give it to her, on her favourite bread with butter! I think as they get used to the feeling of being more full that can stimulate the appetite and then you can alternate to other things.

Some children are just naturally thin and slight build, ds2 is 8 and he is still really skinny (I can lift him easily) . I think it took a few years of gradual weight gain to get back on his centile, so it's a long haul.

2nd centile not 7th (typo)

She was exclusively breastfed and my worry is that I possibly had a very low milk supply and she just got used to never feeling full.

If it helps, my son is very similar, and I produced an excess of milk. I definitely agree with PPs that she needs to be checked out for celiacs, but I find with my son that he just can't stomach a lot of food at one time, so we offer lots of small meals and snacks. He's just not interested in food and is very easily distracted. He's also a very slow eater, and we let him take his time. Plus, when he shows interest in something, we buy lots of it (although that pretty much guarantees that he will instantly lose interest in it again!).

@angrydinogrrrr

I haven't read all your replies so sorry if this overlaps..but did want to just say this sounds exactly like my now 5 year old when she was 18 months. She dropped from 75th and 50th centile in height and weight to about 2nd. She had no appetite as such .. Just wasn't fussed about food and getting her to eat was impossible.. and she really only seemed to go for low calorie stuff like cucumbers and veg. Her energy levels were also starting to drop and she was sleeping a lot. It sounds all really clear and obvious something was up now but at the time it wasn't as she wasn't sick, vomitting etc. Her bowl movements were more or less normal etc..

We were just watching with doc and he initially assigned the drops in centiles to a couple of bouts of illness etc. He thought maybe she was just going to be small! But then randomly
he decided to throw in a Celiac disease test (total ttg, ttg iga, ttg igg, ema iga and dgp igg are the tests he ordered). She was positive and also anaemic.

Now after 3 years following a Celiac diet she is still not the best eater ever if I'm honest and has a delicate frame..but it's so so much better and she is around 50th plus centile on height and around 40th on weight! She eats a full and balanced diet and has energy.

Good luck, whatever it is that's going on, I totally understand how worrying and frustrating it is!

In the meanwhile it is only games that worked for us in terms of keeping the dinner times positive and helping her eat. We always mention the actual food she is eating In the game so that she associates fun with those foods and is eating them with awareness. And we pushed cheese avocados, banana , olive oil, milk (and regretfully looking back.. porridge, Weetabix, pasta and some bread!)

Looks like we really should investigate coeliac. Just not sure the GP will agree because he's just ordered full bloods (and they were all fine) and the pediatrician said if she drops more they'll check for coeliac in six months..I don't want to wait for 6 months though.

I think I'll call the GP surgery again to ask if the blood test included celiac.

Did you say that your DD did vomit or didn't? Our DD has only vomitted about three times in her entire life so definitely not something common.

I'm wondering if we could do a trial run of cutting out gluten just for a week or so. Would a week be enough? Ok.very reluctant to cut out any food for her also because she does eat a lot of wheat based food like pasta, bread, etc though maybe that's the problem.

One of mine is the same OP, we use Fortini multi fibre formula as it’s higher in calories than the pediasure and about double the calories of full fat milk, it is prescribed by the GP.

I know you don't want to but could you give her Lollys or something as she watches tv, that if she keeps in her mouth give her calories?
Maybe a bottle of coke on the way home, or other nice things to train her mind that food taste nice.

Coeliacs test for sure but also I think you need a referral to a feeding therapist/OT to observe her eating and maybe look into ARFID. It could be so many things that have triggered this. The comment about being told of by school if she doesn’t finish her plate is significant to me. I know the small portions predate school but it’s funny what kids latch onto an internalise. Definitely get your Gp to take this more seriously.

Not quite the same situation but my DD was very small, and very fussy.

We realised that her stomach was also tiny (seems obvious but didn't make the connection for a while). After her brother's massive portions, she ate like a bird. We took to giving her 6ish almost-meals a day, rather than 3 meals and snacks. Whilst they were quite small on their own, overall DD ended up eating more over the whole day. It is harder when they are at school, but definitely something like a sandwich on the way home, and then leaving a longer gap until dinner might help. Have you tried letting her help herself to things rather than serving her a full plate?

Even now, at 17, she has just reached 5'3", and has a small appetite. If I put too much on her plate it's like her stomach shuts down and she can't eat anything.

I wouldn't cut out foods without drs advice, especially as I think you said no gastric type symptoms (bloating, diarrhoea, abdo pain)?

I too noted what you said about school dinners and needing to finish their plate - I'll bet that is part of the jigsaw.

This is the one I mean.

They come in all different flavours, have a good dose of calories and they taste good too.

So out little one didn't vomit at all. No tummy type illness so I never would have thought Celiac, especially as no one in our families is diagnosed... the main symptom I would say for her was this complete lack of appetite , drop in centiles (we are all 95th centile in height so her height falling was even more of an alert for us in fairness!) And eventually an increase of sleeping and tiredness (although this was just beginning the week of the blood test).

It's definitely worth checking the Celiac stuff if you can, even if it is just to rule it out (for now) ..Celiac disease is quite common in the end.. they say 1 in a 100. By 5 the main ttg iga blood tests should be quite accurate so that's plus total iga is the one you could push for..and there is no massive advantage to waiting I don't think! I wouldn't cut out gluten in the meanwhile... Mostly because you need to be eating it for bloods to be accurate. And also because for Celiac disease you really have to cut out gluten completely including the risk of trace contamination so it's quite involved. The difference we saw from the diet change was over the course of weeks and then even months /years for height to pick up.

The anaemia was an important indicator for us. If your daughter had good blood iron values that's probably why the doctor isn't jumping on the Celiac test. It's worth a try anyway as Celiac disease presents in so many different ways.

Good luck!!

With DS we where given a “we will see him in 6 months and if he has lost more we will intervene” by a consultant, but ds had lost after 3 months so I phoned his secretary and we where seen and his needed intervention within a month. If your worried worth getting back in rouvh

Check out kids eat in colour. She has a website and is on social media pages. Lots if good advice around kids nutrition and avoidinglanguageon good and bad foods. She advocates treating over and under eaters the same way. Ultimately it is up to you to provide the food and her to eat or not. As pp said, make sure you don't cut out gluten before the blood test too, as the test is checking for a reaction.

Op if she has slipped continuously down both height and weight centiles please push for endocrinology referral. For some reason paediatrician are really slow to do this, I can only assume there is high demand.

If her endocrine system is not working (she could be lacking growth hormone for example) she will have no appetite. Doctors who are not specialists will try and tell you how much a child eats drives growth, but really it's the other way around, growth hormone stimulates appetite, which is why when a child has a growth spurt they tend to eat you out of house and home!!

Please please please don't cut out gluten until she's been tested. You run the risk of a false negative otherwise. Your first point of call should always be medical testing. If coeliac is suspected then it's extremely counter productive to cut out gluten before it's confirmed.

Good luck!