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).

We've asked her if her stomach hurts during and after eating and she said no. She says she just doesn't want to eat

Kids cannot always dxpress
Get referral to community dietician and feeding eating therapist usually a SLT

keep food diary gor a full week quantity and portion size

Maybd invokve referral to CAMHS for play therapy

When bodybuilders are trying to bulk up they usually say drinking calories is the easiest way to boost their overall intake - it's a lot easier to drink an extra 2-300 calories with a meal than have basically a small sandwich or whatever on the side. If she doesn't like the sort of build-up drink you've been offering so far, there are lots of others out there. Fortisip, even things like Huel, any sort of meal replacement/nutrition boost drink. There are lots with different textures, flavours, she may find some more palatable than others. Some are more juice based rather than creamy. And you can even get fortified soups and dessert mixes.

But just made at home milkshakes or smoothies with ice cream added would be good as well. If she will eat a little bit of a pudding/cake, add ice cream or custard or cream with it.

@Embracelife

terms of the "dreaming" and taking half an hour for 3 bites of toast - this is behavioural. I

Correct
But if child has say coeliac undiagnosed it may be responsive to eating causes stomach pain
So not just being "naughty"
Behaviour is communication
Dd was same she had undiagnosed coeliac
No obvious bloating or poos but her body was saying something

By "behavioural" I didn't mean "naughty". Just that it's a normal thing for children this age and often you have to remind/encourage them to behave differently.

I have to say thank you so much everyone for your help and for trying to figure this out with us. Lots of great suggestions and it's always nice to know you aren't alone!!

@Embracelife

We've asked her if her stomach hurts during and after eating and she said no. She says she just doesn't want to eat

Kids cannot always dxpress
Get referral to community dietician and feeding eating therapist usually a SLT

keep food diary gor a full week quantity and portion size

Maybd invokve referral to CAMHS for play therapy

How do I get these referrals? Are they through the GP?

@Embracelife

You don't go by birth weight.and birth centiles vs now. You need to look at height and weight in past year. How many y centiles have dropped? Is she following a line since 6 months ago? Height growth lag or falling down height centiles since last year maybe an issue eg coeliac

Huh? Not sure I understand.

So I had a thorough look at her red book yesterday. She was born on the 75th centile. lost a lot of weight and only made it back to the 50th. Her length was on the 50th centile as well. She then within a few months slipped to the 25th and spent the next two years between the 9th and 25th centile. Length followed a similar curve. Then after joining preschool (aged 3) she actually lost weight and dropped another centile to be just above the 2nd. Now she's on or just below the 2nd and her height is on the 9th.

To me it seems quite an extreme drop (especially considering that neither dh nor me have ever been skinny or short and that in my last pregnancy scan they said she's got a long femur though I know that's not accurate necessarily) but the health visitors, GP and pediatricians were never worried because:

1. she presents clinically healthy (normal development and no known illnesses)
2. Her dropping down the centiles has been relatively gradually
3. Her weight and height are similar. However, I'm thinking that maybe a lack of nourishment is maybe stunting her growth (height) as well. Or whatever is the problem is both causing her poor weight gain and poor growth. So it's not natural or healthy. Is that possible? The clinicians seem to think that she's just naturally small (because weight is similar to height).

She spent a long time hovering between the 9th and 25th centile so if she'd remained there I could have thought that maybe her previous 75th or 50th were just inflated by some reason and she's naturally on the 9th but now she's dropped from there as well.

Haha so I can finally make this thread relevant to the aibu board. Am I bu to bother so much about centiles?

However, even apart from that it's her lack of strength and stamina that worries us. Her gross motor skills aren't grossly lagging but she's probably on the lower range of what's considered normal. She also gets pushed around a lot and everyone keeps calling her tiny. That and I not being physically as capable as other kids is really knocking her confidence now.

Like PP I would not worry about empty calories/ healthy food. If she's dropping down the centiles the priority is getting any calories in eg Nutella and Peanut butter are your friends: fat, calories and protein

Birth centile won't necessarily be taken into account.
It's height rate of growth that is looked at.
So
If in past 12 months she has not grown 6 cm
Then it s an issue
You need to look at rate of growth on height.
If she was on 15th centile
Now on 2nd for height
Then yes
That s a drop across centiles
But they won't be comparing with birth centile
Only past months
However measuring by hv etc might not be accurate
So to get referral you need consistent measure in recent months
Dd hovered along 2nd then dropped below the charts from age three
Referred to growth clinic
Diagnosed coeliac finally age 4

I would be pushing for referral to paediatric dietician too.

spent the next two years between the 9th and 25th centile. Length followed a similar curve. Then after joining preschool (aged 3) she actually lost weight and dropped another centile to be just above the 2nd. Now she's on or just below the 2nd and her height is on the 9th.

So she was between 9 and 25th (easy to measure slightly out)
And she still on 9th for height
Does not sound too bad
But do careful measure now
And again in three months

See if gp will refer to community paed now for review
And test for coeliac already

Rate of growth should be 6cm per year
3cm in 6 months
Dd grew 1 cm in three months
So that showed an issue

Less than 1 cm in 3 months that should say

@Embracelife

spent the next two years between the 9th and 25th centile. Length followed a similar curve. Then after joining preschool (aged 3) she actually lost weight and dropped another centile to be just above the 2nd. Now she's on or just below the 2nd and her height is on the 9th.

So she was between 9 and 25th (easy to measure slightly out)
And she still on 9th for height
Does not sound too bad
But do careful measure now
And again in three months

See if gp will refer to community paed now for review
And test for coeliac already

Ok. thanks tons for the input.

Just to give an update:

Gp the reluctantly agreed to test her for coeliac disease and also threw in a test for vitamin b12 deficiency. All normal.

So I think we have exhausted all possible physical reasons. It has to be psychological. The only thing I can think of is that she just has developed negative good associations. Maybe we have made meal times too unpleasant by nagging her to eat. We decided to try a zero nagging approach. We put the food in front of her. She has to stay at the dining table but it's up to her if she eats or not. I'm also putting more salt in her food in case that makes it tastier

So far it's not working great either. She still doesn't want to eat (though I guess it might take much, much longer to get rid of any negative emotions around food). We find it very hard to not to at least remind her to eat and her clothes are falling off her body. I feel like she's disappearing in front of our eyes but I'm stumped about what else to do.

I guess the next thing will be to show her videos while eating. We have tried it in the past and it doesn't work very well either. And we have to feed her because otherwise she forgets to eat while watching.

Oh that sounds so tough. Just a quick, clutching at straws thought - have you checked for threadworms? Might be worth a check as sometimes they can lead to loss of appetite

@Goldbar

Is there anything she loves, like pancakes? It's easy to slip all sorts into pancakes.

Pancakes are fantastic. When you make the mixture, treble the eggs and whisk in melted butter.

You could use gluten free flour too.

Plenty of nice chopped fruit and chocolate spread, almond butter, chopped banana and honey/maple syrup are what I do here and they are demolished.

You should definitely rule out all options but one of my sisters was like this

Dropped to

@angrydinogrrrr

Oh that sounds so tough. Just a quick, clutching at straws thought - have you checked for threadworms? Might be worth a check as sometimes they can lead to loss of appetite

Other symptoms can include: extreme itching around the anus or vagina, particularly at night irritability and waking up during the night Less common signs of worms include: weight loss wetting the bed irritated skin around the anus

So she complains sometimes of mild itching, maybe once every few weeks. And she wakes up tons of times in the night..she says she is scared and has nightmares but maybe the thing that Wakes her are the thread worms. She has a patch of what looks like eczema between her buttocks, not very close to the anus though.

I've never seen anything like threadworms in her poo but I guess I've never checked very closely..

Also, is it possible to have threadworms for years?

I think I'll speak to the pharmacist to ask if we can take meds just on a hunch.

Thanks so much for the suggestion!!

She isn't a huge fan of pancakes but we haven't made them in a while. Worth trying again. You are right. We can hide a lot of eggs and all kinds of butters in pancakes.

[quote georgarina]You should definitely rule out all options but one of my sisters was like this

Dropped to

So mine has has it three times over the years (it circulates regularly in nursery, uff!!). The first time was definitely loads of waking in the night - we couldn't work out what was going on, but she never articulated itching as an issue. The waking was accompanied by a terrible appetite over a period of months. We eventually clocked worms and checked and saw the little buggers with a torch at night ( had to check a few nights in a row). We have never seen any worms in the toilet. The second and third time it was just a loss of appetite, again over a period of months, and just a generalized irritability that gave it away. We decided to check despite the complete lack of itching and waking and low and behold after a few checks we spotted them. Her appetite restores significantly just a day or two after treatment. Definitely worth a shot to think about it. It's a long shot though, as I think the way out child is affected isn't super common and certainly our other child hasn't been affected this way.. I guess if the worm cycle is repeated again and again there is a chance this goes on for a very long period of time... But it's definitely an outside chance..
Btw if you do suspect she has them though best to try and spot them and if you see to treat the whole family and there are a few other hygeine measures to make sure they don't come back (at least from home)!

Test for b12 deficiency/pernicious anaemia & get a copy of her blood results, join a B12/PA forum & ask for help checking her results. Doctors too often don't properly understand this deficiency, it's not a standard blood test & it's frequently missed.

My DD ended up like yours after starting off at the high end of the charts. Low B12 stunted her development & she barely grew at all for several years. B12 injections had her grew several inches & develop big boobs in less than a couple of months & massively improved her appetite

PS, celiac can be a cause of PA, so both can be relevant, though in my DDs case it was PA only

@RockinHorseShit

Test for b12 deficiency/pernicious anaemia & get a copy of her blood results, join a B12/PA forum & ask for help checking her results. Doctors too often don't properly understand this deficiency, it's not a standard blood test & it's frequently missed.

My DD ended up like yours after starting off at the high end of the charts. Low B12 stunted her development & she barely grew at all for several years. B12 injections had her grew several inches & develop big boobs in less than a couple of months & massively improved her appetite

Thank you will do that.