To think this isn’t behavioural : child’s eating.

[2024BigWhoop]

I have a 6 year old son and getting him to eat a varied diet is a nightmare.

He had a dairy, fish and egg allergy until he was about 2.5 years old and so weaning him was very difficult and fraught with anxiety. We were very limited in what we could give him and I was so nervous when we started introducing foods.

As a result we missed the window of getting him excited about tastes and solids and getting him to eat and enjoy food has been an ongoing battle.

He gets very upset if he is asked to try new foods and he will sit and cry rather than have one forkful. He almost looks scared at the prospect of eating food.

He seems to have a massive issue with certain textures to the point where he will gag if there is an unexpected texture in his mouth and he will then vomit.

He can handle having a piece of chicken on his own and some potatoes on its own but if you put chicken and potato on the same spoon and he eats it, he will vomit.

It’s got to the point where I hate going out for meals because there’s usually nothing he will eat.

Christmas was very hard as our big family was eating a lovely dinner whilst my son sat there with some sandwiches and a packet of crisps. I know our family sit in judgement of us ☹️

Me and DH have tried everything to get him to try more meals…..bribes, threats, pleading…..but nothing works.

We decided to trial him having hot school dinners instead of a packed lunch in the hope he’d see his friends eating a variety of meals and want to join them but it didn’t work, and after about two weeks of him refusing to eat his hot meal at school we went back to giving him a packed lunch.

My parents say it is completely behavioural and we need to take a firmer hand but my gut instinct is that it’s something more than that. It’s not normal for a 6 year old to start gagging and vomiting if he senses a certain texture or taste is it? Or is it? I don’t know.

Our first child eats really well so this ongoing battle with our second child is difficult and we feel lost. I don’t want meal times to be stressful but I feel exasperated. There are probably only about 5 foods he will reliably eat. And he looks so pale ☹️

I don’t know if his early challenges with his allergies and negative weaning experience has had some kind of long-term effect but I don’t know how to fix it.

I think it’s time to get a professional opinion of some sort but my DH thinks that’s OTT and we should just wait for him to improve. But we’ve been waiting for 4 years and if anything it’s getting worse ☹️

It is normal for then to become fussiest at that age but no vomiting is not normal. Speak to your health visitor

I would pay for a consult with an OT/SLT (or both). It could be issues with sensory processing and/or anxiety but hard to say without a full assessment.

Help with your child’s eating – Sensory Children

And you don't need your husbands permission to take him to the gp

Have you heard of ARFID? Would be worth looking into.

I have a very fussy eater child but this is a whole new level with the gagging and vomiting. You need to see the GP for a referral as I don’t think this is a situation you can handle yourselves.

If he physically gags to the point where it makes him sick, then no, I don't think it's behavioural. It must be horrible for him.

It sounds like he's got a genuine psychological problem around food - a phobia, basically - that needs some treatment.

Obviously he's only six, so it's probably hard for him to explain what he's experiencing, but has he tried to articulate to you why he finds eating so difficult?

The waiting list for a professional opinion on things like this on the NHS is really long so I'd get him on it now. If and when you get an appointment in 2-4 years time, if it's no longer a problem then great, discharge him and cancel the appointment so someone else can get it. If it's still a problem then you can use the appointment and have 2-4 years of further evidence of the issue.

The behaviour you describe sounds a lot like AFRID, which isn’t unusual in children who have food allergies and intolerances (they associate eating with illness/discomfort so they avoid any foods that aren’t ‘safe’).
It can cause a lot of fear and anxiety around eating, including gagging/vomiting or getting very distressed about eating foods that are unfamiliar or disliked.

If he’s only eating 5 foods, he’s not improving, and it’s affecting his health then I’d seek professional assessment and advice from a paediatrician, psychologist and/or dietician who specializes in managing restrictive eating and anxiety related to food.
If it is AFRID then trying to force him to eat new foods or being stricter is likely to be counterproductive because it will just escalate his anxiety around food and eating. You need a more holistic approach with input/advice from professionals who specialize in this.

Whilst it’s normal for children to go through fussy phases they’re normally fairly short term and not as restrictive/distressing as the situation you describe.

He probably remembers food making him sick. So its unlikely he's doing it deliberately just remembering the reaction even if he doesn't actually remember. And it's obviously become a big thing.

What will he eat?

He sounds like me.
I have ARFID and certain textures/food will make me gag.
I have a small list of safe foods that I can eat, it's limiting and frustrating for both me and others.
Don't push him to eat things you know he'll have issues with, but have the option there for him to try in his own time. He may start to broaden his food intake or he may not, there is no one size fits all.

I do suggest getting some childrens vitamins and trying to see a doctor for their advice, but keep in mind, you and he might be in for a long and difficult time.

Visit your GP.

Firstly, focus on the positives. He has 5 reliable foods. Can you list what they are? What food groups do they cover?

My DD is autistic and has a range of accepted foods. She sticks to those but luckily they do include all food groups and some fruit and veg. She ate pizza for Christmas lunch.

It's not normal. But there might not be too much you can do about it. I have an extremely fussy eater and they are at the bottom end of the weight scale and everyone that says 'they will eat if they're hungry' doesn't know what they are talking about, my 6 year old will happily eat nothing if there is not a safe food. And the whole 'try things 20 times and they will like it' doesn't work either. So I just give safe foods and offer other foods. Its hard as we love food and cooking and I'm stuck doing the same 4 meals on rotation. Eating out and parties are a nightmare.

They might be able to help (some kind of therapy since this does seem a psychological issue) but I think the advice either way will be not to force it. Do not push this or it will make your child associate meal times with stress and cause more issues. I now claim it as a victory if they will tolerate something on their plate. Have a variety of foods for them to try and don't stress if they dont.

I know someone who ate nothing but white bread with butter, plain pasta with butter, and bananas til they were 16. They eat normally now and are perfectly healthy.

My child is autistic and vomits and gags with certain foods, are there any other issues or is it just food?
We kept track of favourite and safe foods and allowed them to have them on the plate every meal and they serve themselves food.
It has improved and they now try lots of food they see us eating but we absolutely never bribe or get angry or force them. That will never work in a healthy way.

Seriously, choose your battles OP. I really don't understand the whole hatred of fussy eaters on MN. Having a child who eats veg does not make you a morally superior person.

Let your child eat what they want to eat. Remove all of the emotions, anxiety and judgement around food.

My kids dad was a fussy eater. Through our relationship he became more adventurous through seeing me eating different foods. My kids are also fussy eaters. They go through fussy phases (talking years here!) and go through phases where they are more adventurous. I follow my children's lead and let them eat what they want. Meal teams aren't a battle.

His early experiences will have had a big impact.

The standard strategies are unlikely to work as a result as they rely on the child having had positive experiences of food which he mostly hasn't had.

I think you probably need specialist help on this one - OT or similar?

Hi. Your child sounds exactly like me. I have ARFID and react to food the exact same way as you describe.

Terror at the thought of new foods, gaging and vomiting at new or unexpected textures etc.

It takes me a long time to introduce new foods - but it is something I am able to do and I now eat a fairly large range after slowly building it up over years.

Stop thinking about food in terms of taste and start thinking as textures. There are foods I like the taste of that make me vomit and foods I don't really like the taste of that I can eat fine. When introducing new things you want to find something very very similar in texture to something that is already a safe food and explain before what to expect (i.e this thing will taste like X and feel like y) as it's the not knowing part that makes it hard to try.

I find it easier to try new things when there is a plate full of safe food to fill up on and just one or two bites of the new thing on a separate plate or in a small bowl on my plate. If I get on ok with it then next time I'll have slightly more.

One thing that can be confusing for outsiders is how I can be ok with some foods up to a limit. There are meals that I like for the first 10 bites and then I start to gag. I still eat them but stop before it causes an issue - try not to force plate clearing even with safe foods as trigging gagging on safe foods can make me reject them for a year or so afterwards.

I find it helpful to imagine foods as a mindmap - a bubble in the middle with the word safe in it and different safe foods coming off branches around the outside. New food has to be able to directly connect to an old safe food. Think plain boiled chicken on the list, something like plain boiled turkey would be the new - not turkey cooked any other way. If the boiled turkey made it into the safe list after several exposures then maybe I'd try roasted turkey next etc.

While there was a lot of struggles when I was younger I can find something to eat from almost any menu now - even if it's just a pic'n'mix platter made from several sides or starters. Oh and find a chewable vitamin as I do have some vitamin deficiencies as veg features heavily in the unsafe list but even that is getting better over time now.

No amount of discipline could have ever trained me out of this - I've starved myself for days due to lack of safe food. There is no level of "hungry enough" to make me eat unsafe food and I'd vomit it up anyway. The gagging/vomiting is entirely involuntary - I don't want to be like this but I have no choice

If you have any questions I'm happy to answer them!

My autistic nephew is the same, he often leaves the dinner table to vomit as he can't stand the texture. He too had a lot of allergies and frequently says his mouth is itchy. I would definitely seek an option of a doctor or a specialist.

My son was and is exactly the same. From the day he was born literally. Having two older children that wanted to feed almost constantly from the day they were born I was shocked. He slept as soon as he was born and I had to wake him for feeds. He was breast fed and would feed for a couple of minutes and then stop. I had to wake him in the night even. He didn’t start solids until he was about 8 months old. To start with he was brilliant, didn’t eat much but liked a variety. Gradually he started refusing certain dinners I cooked. First pasta, then eggs, then refused anything with vegetables or sauce. I was of the mindset that he’d eat if he was hungry but that back fired as he just wouldn’t. He’d rather starve! It’s been so stressful, he wouldn’t try new things, used to gag. I went from being calm and encouraging to completely losing the plot in frustration at times. He’s 16 now. Still very fussy. His diet is pretty dire. Still won’t eat vegetables or any fruit. At Christmas this year he ate cauliflower cheese for the first time. We still encourage new foods and he’s definitely more open to trying things now.

He's obviously got a lot of anxiety around food and that's not at all surprising given his allergies and early experiences. I wouldn't physically take him to the GP right now as that might just further confirm how stressful food and eating are in his mind. I'd ask for a call and discuss it with the GP without him being there. With him, I think I would focus on letting him eat the food he feels safe with in the way that he wants to, for the moment (subject to advice from the GP).

FWIW, when I was a kid for quite a long time I would only eat jam sandwiches and ice cream. I wouldn't try new foods. I was quite happy to sit and stare at a cold plate of food for hours if necessary. My mum was very worried but she took me to the GP and he said I seemed to be thriving and she should just weather it, so she did. By the time I was in my early teens I was eating pretty much all food groups.

It's funny; I just remembered this - my dad always put a little bit of everything on his plate on his fork and ate it together. I'm not a fussy eater but I really hate eating that way - I wouldn't gag if you gave it to me but I really like my foods to be separate (except for things like sauces and gravy, but not everyone likes sauce either).

Get him booked in at the GP.

In the meantime, quit with any of the drama and stress at mealtimes. Get a sectioned food plate for him. Stick most the sections with a food he will eat then 1 section with something new. Don't mention it, don't acknowledge it. Just all eat together, chat together and do not acknowledge if he tries it at all or encourage him to try it. Get him a good gummy vitamin and if he will drink squash, Capri sun do a vitamin squash.

You may have a wait to see someone so just keep doing that until you do (or pay private to make it a bit quicker).

You've got chicken, potato, crisps and a sandwich listed on your post. That's actually not bad at all for a child with food issues. It absolutely matters not one jot that the chicken and potato must be kept separate.

There's some great advice above OP where adults with very similar sounding issues have articulated what your son cannot.

1. remove all conflict at mealtimes
2. always have a safe food on one plate
3. serve a small amount of directly linked (ie same in texture / type) non safe food in a separate bowl
4. clear table when you have finished with no drama or comment on what has or hasn't been eaten
5. find safe multivitamin
6. private assessment

My (likely) autistic son was and still is somewhat similar.

He was very picky about all textures, didn't want foods touching etc...

We took a relaxed approach and went with distraction techniques. I cook ONE family meal, but will always leave the carb separate (rice, potatoes, bread etc...). I put the food on the table and people feed themselves. There is always ONE thing he will eat. I just let him know what the other stuff is and it's up to him if he tries it.

We don't make a fuss. We just TALK and ask questions so he is completely distracted. We found if we focused too much on the food, the more likely he was to dig his heals in.

If he does try something new, then he gets a nice pudding. If he doesn't he has fruit.

Last night I did peanut, spinach and lentil curry. He tried a spoonful but didn't want any more. It's small steps, but he now eats a much better diet than crackers and toast. He's 8.

It certainly sounds like ARFID. I suspect my son is on the autism spectrum as his eating habits fit in with this. He is desperate to eat a more varied diet and is worried about not putting on enough weight (he's 16) but no matter how hard he tries he cannot cope with certain foods and sticks to his safe list. I've recently started making a high calorie cake for him to eat, it's full of eggs which he wouldn't be able to touch otherwise, so I'm happy for him to have this for now. It's very difficult and you have my total sympathy OP. We do get judged when our kids don't seem to eat well, and it's usually not justified at all. We need help, not criticism.

When my daughter was little she was a fussy eater and I remember weening etc being very stressful. I had hoped that once she started school things would get easier but it didn’t.

The final straw was receiving a letter home from school to say she was underweight. No advice or guidance, just stating that she was below the norms.

I researched and took her to a child nutritionist just off Harley Street for a full assessment. It cost me £160 and was the best money I’ve ever spent (although this is around 10 years ago so would probably be more now). The nutritionist did some tests, talked about eating habits etc and concluded that my daughter was healthy and I had nothing to worry about. It was so great to have a calm professional opinion after years and years of stressing about whether we were doing the right or wrong thing.

After that appt we felt confident about how we fed our child. Other people’s opinions didn’t matter to us. There was no more stress in our house around mealtimes. And eventually, as she got older her eating improved. She still doesn’t like meat textures but other than that she has a wide and varied diet.