To ask how to make DD eat?

[NotMakingItABattle]

DD is 7.

She had covid in January and ended up in hospital with it.

Since then she flat out refuses to eat. Anything at all apart from crisps, sweets and chocolate.

She’s lost enough weight that if she doesn’t eat soon she’ll end up with a feeding tube.

She’s had counselling and the counsellor thought it was attention seeking rather than a huge issue. She got a lot of attention in hospital when she refused to eat and so they offered her yogurt or whatever she deemed to eat that day so now she says she’s not hungry or doesn’t like it to try and get us to give her what she wants.

I’ve temporarily banned all sweets, crisps and chocolate until she eats but she still tries it on refuses to put anything in her mouth claiming she doesn’t like it or she’s not hungry. I found a stash of sweets under her bed last week that she’s clearly been sneaking in and eating at night – she’s now in my room where I can monitor her.

I’m offering to make any foods she will eat as often as she wants until she’s back to herself but she still mostly refuses. I am at the point of saying “fine have the tube then” but I know it’ll hurt her and may make her even worse with food.

Other than practically force feeding her is there anything else I can do before we reach tube feeding point?

School are also open to suggestions as she’s also refusing to drink there and they’re at the point of saying they can’t meet her needs if she doesn’t improve.

She’s very stubborn so things have to be her idea rather than mine or schools. She’s also very hypermobile and plays on that as she knows it gets her out of doing things like sport – her physio has said it’s common in children because they realise the condition gets them extra attention so they don’t want to get better because of it. She’s also suspected dyslexic and dyspraxic – has processing and memory issues alongside these.

So anything I can try? I don’t want to make food into a battle.

Before she had covid she was a good eater, bit reluctant with vegetables but could be persuaded to eat them. Always loved fruit, pasta and most meats though. She’s also very sensory, loves heavy blankets and cuddles so I suspect a little bit of sensory processing going on to.

If she was mine id give her whatever she would eat to keep her alive while you get some professional help. Even if it was 10 packets of crisps a day. You seem to be quite passive about getting her help - not many children would deliberately starve themselves for attention. Id say as a non professional its probably more likely due to the trauma of being hospitalised than she just likes the attention.

I was just wondering about pediatric meal replacement drinks too.

I also know of foster parents who when taking in new children, make dishes of easy and appetising food (pasta etc) and place it all on the table for self serving. The children can control how much they have and what they choose, no big deal made of any of the options.

I wonder if a similar approach might help?

Also, I remember watching a documentary on children and food and they need to encounter a new food 7 times before feeling comfortable eating it. This means smelling, tasting, touching/playing with the food...perhaps putting out something like sliced strawberries (or whatever) each time without the pressure to eat would help.

Could also try making milkshakes and puddings etc from scratch with her but with real fruit etc. Hopefully she'll become desensitised with a bit of time and repeated exposure.

Is she feeling nauseous post covid, I did for 4 months but weirdly still fancied chocolate/sweet stuff. I'd give her as much chocolate as she wants, at least it is high calorie and has some dairy content. Dieticians always say let children eat what they will /their safe foods and then try to introduce others a little at a time.

Gosh this sounds so tough. At seven she's old enough for you to explain what will happen with the feeding tube. Does she already know and just not care? In your shoes I think I'd just give up for the moment and adopt the any calories are good calories approach. Can you take her shopping with you, fill up the fridge and just tell her she can eat as much of whatever she likes? And then appear to totally ignore when and what she is eating. At least you will be able to see how much she feels she needs, and gauge if she definitely has just lost all appetite.

When kids are restricting food I have been advised they should always have a plentiful supply of their 'safe' foods even if it is all chocolate.
I just plate up chocolate flavoured everything, and even though I worry about my DC's teeth, there is worse things than cavities. A feeding tube is one of them. I had to make my peace with that, and stock the cupboards with crap.

Chocolate milk and jelly sweet vitamins got my ARFID child through for a while, along with white carbs covered in chocolate

I agree with the poster who said it is way above mumsnetters to advise on this serious issue. I think it has got beyond what can we do to make her eat. Seek the help again of your GP and asked to be referred to a medical professional who specialises in this area. I think I would reluctantly give her the chocolate for the time being as a short term thing as you do not want her to become seriously underweight.

What if you went to McDonalds, do you think she would refuse to eat there? Sounds silly but something exciting in an exciting environment / string smell of food might just break the chain of behaviour. Maybe crisps sandwiches, baby fruit pouches from the fridge.

I second putting the food in front of her for 30 mins and no fuss trying to get her to eat.

Would have done this with a baby or toddler but when they least expect it, from behind put a little bit of food in their mouth. So say like hummus or Tuna mix (can't choke on it) but it just gets the taste buds going. Or sensory play with foods.

Dates are sweet and full of energy. Honey on toast. Glass of milk. I think if you can get her to eat fruit instead of processed sugar (help wean off it) that might her get 1 step closer to eating proper food.

What did she love eating before covid?

I'm so interested to read this as it is exactly the same with my 14 year old since having covid. Nothing apart from McDonald's, sushi, crisps and sweets tempt her and she used to be a proper foodie.

I'm worried too as she is losing a lot of weight fast and she was slim to begin with.

When DH had covid he lost his taste. Salty came back first (after about a month), then sweet and oranges. It could be that she can taste the crisps and sweets but not much else. Maybe try orange juice (that seemed to help bring DH’s taste back) and sweet or salty foods to ease her back into eating?

@Relentlessrose

When kids are restricting food I have been advised they should always have a plentiful supply of their 'safe' foods even if it is all chocolate. I just plate up chocolate flavoured everything, and even though I worry about my DC's teeth, there is worse things than cavities. A feeding tube is one of them. I had to make my peace with that, and stock the cupboards with crap.

A feeding tube comes out

Cavities in adult teeth are for life

My dd's tastes have changed since covid last July too. She used to love sausages and tuna. Won't touch either one now. Will only eat wotsits - used to love crisps. Was mad about peanut butter immediately post covid, now not keen at all. Ate ice cream by the load immediately after covid, then went right off it.

I would buy ensure shakes online and use as a supplement temporarily. They are super creamy and nutritionally complete. Offer a range of fairly plain food alongside; chicken, mash, gravy, carrots.

Gosh this is a terrible situation that really needs proper medical advice, which clearly you are doing your best to get.

I was just wondering, at such a young age does she actually understand the connection between what she eats and the very real effect on her body and health (energy levels etc)?

I’d try and see if food isn’t tasting great. Try and work out what she can get on with by trying lots of different things.

@SomePosters

Yes but it's circular because vitamin and mineral deficiency will cause bone and teeth Issues anyway. Better to use a cavity protect toothpaste, follow proper dental care, but allow a child with ARFID to eat their safe foods even if they are full of sugar. The examples I gave were chocolate milk if they won't drink milk and jelly sweet vitamins if they won't take vitamins.

Depending what area you are in an the weight of your daughter and her weight loss there should be a referral mechanism for urgent eating disorder referrals which generally has a two week standardised turnaround. If you want to say what county you're in I'm happy to have a look and see if I can find the equivalent referral. Alternatively your local PALS team for the CCG might be able to get the information of what the referral should be under.

I have some experience (adults with learning disabilities and neurodiversity) and we'd totally take the focus off eating in that situation and let the person in question eat absolutely anything (obviously adults are "allowed" to eat whatever they want, but ensure that the foods were available even if complete junk food/ sweets, and express no opinion or even interest) they wanted without any comments either way until they put on some weight and got in the habit of eating.

Obviously eventually you have to address what she's eating, but not until she's out of danger and in the habit of eating something.

If she's 7 where is she getting the sweets she's sneaking in?

By providing the attractive food openly you'll solve the sneaking/ hiding/ secrecy which is potentially an absolutely huge issue long term.

Eventually you'd gradually forget to buy as many sweets and have lots of almost as attractive alternatives like yoghurt, toast and honey, and slowly wean her towards a semi normal diet but always without comment and without openly being bothered what she's eating...

Obviously ideally you'll be led by her medical team not MN but we don't always get the amount of input we need...

Try telling her that she is old enough now not to have to ask for snacks and you are trusting her to help herself when she wants to anything cold.

Point out yogurts, fruit, mini cheeses, chicken satay sticks etc also some biscuits and crisps, just don't have enough of those available that she can eat just those.

Worked for a friend although the underlying issues were different.

I don’t understand how anyone can say a child refusing to eat to the point they could need tube fed is ‘attention seeking and not a big issue’. Counsellor sounds like a quack to me.

Has she been left with Parosmia? My DD lost her taste and smell, then it came back but totally altered so nothing tasted like it used to. She lived off protein shakes, one brand of cereal and bagels for months and months. I thought it was an eating disorder for a while but it wasn’t. Everything tasted wrong and disgusting to her.

Who’s telling you she’ll need a feeding tube if you’re not under medical supervision at the moment?

I don’t want to make food into a battle.

It sounds like you already have, to be honest. I get it - you want the best for her - but if all she’ll eat (literally all she’ll eat) is chocolate then you start there. You say you’ve banned chocolate & sweets but also

I’m offering to make any foods she will eat as often as she wants until she’s back to herself but she still mostly refuses.

Put chocolate back on the menu.

Chocolate meal replacement drink/milkshake.
Chocolate yoghurt
Nutella on toast
Frozen banana dipped in chocolate

Etc.

Then wean off to healthier stuff very gradually alongside the sweet stuff.

No child feeding expert who deals in disordered eating will tell you to restrict when you face a severe issue like this. Keep all the options open.

@ThatsNotItAtAll

I have some experience (adults with learning disabilities and neurodiversity) and we'd totally take the focus off eating in that situation and let the person in question eat absolutely anything (obviously adults are "allowed" to eat whatever they want, but ensure that the foods were available even if complete junk food/ sweets, and express no opinion or even interest) they wanted without any comments either way until they put on some weight and got in the habit of eating.

Obviously eventually you have to address what she's eating, but not until she's out of danger and in the habit of eating something.

If she's 7 where is she getting the sweets she's sneaking in?

By providing the attractive food openly you'll solve the sneaking/ hiding/ secrecy which is potentially an absolutely huge issue long term.

Eventually you'd gradually forget to buy as many sweets and have lots of almost as attractive alternatives like yoghurt, toast and honey, and slowly wean her towards a semi normal diet but always without comment and without openly being bothered what she's eating...

Obviously ideally you'll be led by her medical team not MN but we don't always get the amount of input we need...

This is good advice.

You need to take the pressure off. The more you make everything about food the more of a “thing” food will become. Priorities are important right now and yours is getting calories into your daughter. You can have a surprisingly balanced diet on a limited number of foods. It’s not the same thing but when I work with children with ASD and eating we start with suggesting the following:
-remove the need to sit and eat at meal times, they become an argument if she is not eating what you want her to eat
-get her involved in food preparation - no pressure to eat any of it though
-allow her to graze. Put out bowls of things you know she will eat so you know she is at least getting calories in.
-work up to trying new foods: a sniff, a lick, a small bite.
-don’t make a huge fuss when they eat something new
-messy play with food items
-do not ban or hide the foods she will eat; this is only more likely to make her restrictive about those food items also
-introduce one new food a week, slowly

Another poster here saying to not underestimate the Covid impact. I lost my sense of taste and smell when I had Covid at the start of the pandemic. It's not been right since. Previously favourite fragrances no longer smell the same. My appetite and enjoyment of food has completely changed - and I've always been a bit of a foodie.

I can cook things that technically I like - but then just have no desire to eat them. Some days it's fine - other days I literally have no idea what I want and nothing tastes enjoyable - other days I just want to eat crap. Before Covid it was an extremely rare event for me to eat McDonalds - was never a fan - but since Covid, there have been days when it's all I've wanted. Thing is when you recover from Covid you CAN taste and smell things - but it's definitely not the same and there have been some days when it goes again completely. It's confusing to me as a grown woman so I feel for your DD because I rather suspect she simply doesn't know what she wants.