To be at a loss with my fussy eater?!

[onetwonetoo]

Posting here for traffic but please God will someone help me

Our six year old DS eats next to nothing. He pale and always tired.

I've tried all types of things - his (once) favourite meals, hidden veg meals, paediatric milkshakes, bribery, being strict, being soft.

None of it works long term.

His response to an offer of food is I'm not hungry at the moment and he'll then complain of belly ache which we know is hunger.

When he does eat he will look at the plate and say I can only eat half of that even if the meal is tiny.

He always leaves something and it's a massive effort to get him to eat even a small amount.

I'm at a loss and I'm worried about him.

Every week his diet becomes more beige and more stuff drops out. So now he will no longer eat eggs, and is very reluctant to eat cheese which was once his favourite.

Any advice would be appreciated

A few questions -

1. Where is he on the growth centiles and has there been dramatic drops from his birth height and weight centiles ?
2. Can you enlist a standard day of food and amounts for him?

Has he been assessed for ARFID? Is he under a supportive dietician?

What does he eat?

Today he has had

1/2 a small pain au chocolat
1/2 a scotch pancake
Three grapes

Child's bag of cinema popcorn

Homemade hamburger - small like a McDonald's burger.

Three slices of cucumber

Two rich tea w dairylea
A slice of bread

All beige.

We've offered lots of healthy tasty food. He wants none of it

Presuming dinner hasn’t been had yet? I’m not sure what you’ve described is “eating nothing”. He’s certainly had a share of carbohydrates and some protein via the burger. It’s not ideal but perhaps this doesn’t include dinner yet?

does he drink milk? Homemade Milkshakes? Yoghurt with fruits?

Does he go shopping with you to farmers markets or supermarkets to help choose things to buy that he’d like and can feel he can control?

also what about the centiles as asked above? Does he take a multivitamin like wellkid etc

The biscuits and bread were dinner.

That's it. That's all he's had in a day. We've had dinner. He's refused it.

He's now overtired and over hungry ai there's absolutely no reasoning with him

He was on the 3rd centile when born, I'm taking him to be weighed this week. I'll be surprised if he's still on that

He takes a multivitamin and vitamin D.

He drinks full fat milk and yoghurt - but I live in fear he'll start refusing those too.

The selection of what he will eat is so limited I'm scared of foods dropping off

Do you plate up for him? I appreciate its effortful but I remember a study replicated on tv where they found fussy children will sample a wider range of foods if they can select them themselves from shared plates at the table with no commentary / encouragement from the parents, except for afterwards a “great job for trying that xxx” or similar. You could try it with non-perishable things so there’s no wastage – carrot and cucumber sticks, tomato halves, cheese slices, wholewheat crackers, pasta that can be had for lunch the next day etc. And always try to have at least one “acceptable” food for him to choose.

Lots of children have developed parosmia after Covid. Food tastes foul to them, but they struggle to communicate how and why. It is commonly dismissed as fussy eating, but changes in their taste perception makes food horrible to them. Have you asked about how food tastes? Some parents have reported success with nutrition shakes, which are bland and provide a balanced intake.

We put food in the middle of the table for the kids to take what they wanted onto their plates. So for example making fajitas - some would eat tomato but not cucumber, others would eat lettuce and sweetcorn. Some would have cheese, some wouldn’t. Some would put sour cream on, others would prefer it dry. Some would have rice,
some wouldn’t. But everyone ate bits of something they would eat and weren’t pressured to eat things they didn’t like.

I would say you need professional support but qualifying for that can be tricky. One thing you could ask the doctor to do is a blood test on his iron stores/ferritin. Low iron causes low appetite and tiredness. Beige diets aren’t high in iron. It’s easy to become very deficient over time. Iron bisglycinate taken with a high strength vitamin C drink can really improve iron level. I went from ferritin of 4 to ferritin of 150.

does he try new foods ever? Does he only like certain textures? Can you focus on fortifying the foods he does eat with oil, cream, coconut cream, butter, melted cheese? High fat add ons to things he might eat?

was there a particular age it got worse or did he never take to food as a baby?

This. Usually needs a specialist in eating disorders to diagnose.

That comment about food tasting funny resonates - that is his answer to everything. I can't have that it tastes funny. That or I can't have it it gives me bellyache.

Re serving food we've tried a mixture of approaches - family style, plating up, having him help with the cooking, having him help with the shop.

Family style is why he had a slice of bread and two biscuits and cheese spread for dinner tonight. He completely bypassed everything else.

And tbh at this point even if he ate that in a big volume I'd take it, the minuscule portions worry me

I had a fussy eater.

Multivitamin tablets with iron every morning. You can get ones that are like sweets.

Then you don't need to worry about low iron etc.

I assume he is at school during the day. Mine didn't eat lunch for a number of years because he didn't like the school food.

We had some success with choosing meals -ie basically putting out a picnic with lots of raw veg and letting him choose and try some.

I also made a bargain that he could come to Tesco and choose one new food he wanted per week but he had to try a mouthful of it.

It did get him trying a lot more food, most of which was unhealthy but hey.

My fussy eater has been slightly better since we did like... buffet style dinners. So put all the elements on plates in the middle of the table and everyone dishes their own. It took a lot of time as originally he would just take the bowl with his favourite thing in and not try anything else but slowly he has gotten better and even tried two new things this week!

Also we focused on "well done for having this on your plate. You don't have to eat it, but just have it there" to over time him touching it or smelling it before even worrying about him tasting it.

Not always possible but we tried a veg patch, we hoped his excitement over planting/growing the food would translate into eating it. Looking in recipe books/online and letting him choose dinner for 2 or 3 nights a week could help, at first mine just chose his safe foods but after a few weeks/a month or two he started choosing slight variations (carbonara pasta rather than plain for example) so he feels he has a choice over what he eats.

We also did a star chart focusing on him self regulating around the food rather than on eating it and keeping the meal time as relaxed as possible. Of course that might not be relevant to you of yours isn't upset being around the food.

If he is complaining of belly ache I'd be concerned about intolerances.

Lactose intolerance can develop after the baby stage.

Are the belly ache comments after every meal or is it more specific meals/foods?

Thanks all lots of help advice here.

We're seeing the GP this week so I'm going to ask about intolerances and anaemia. Also check his height and weight.

I'm hoping by preserving with offering food he'll try some new stuff big at the moment everything outside of his safe goods are a flat no.

He will only eat what he likes and won't tolerate other foods on his plate or anywhere near him. It also extends to us eating food with a smell - like eggs for example - near him

Do you know if he eats at school? Will he eat sweets, chocolate and crisps, etc? My DN went through a stage where he would only eat tinned sausage and beans. He gagged on anything else that was put on his plate. This went on for months. He hardly ate anything until he started school and ate lunch with all of his friends. My sister asked his teacher what he was eating at school and then made exactly the same dinners and slowly he started eating more at home......there was a lot of chocolate based bribing to begin with but he now eats a more varied diet, with a small treat afterwards as a reward instead of a desperate bribe. I'm sorry that you are struggling so much with your little boy. It must be a worry for you, but keep trying to introduce new foods, and hopefully, he will start eating more soon. Also, my DN is autistic and struggles with textures. Could this be a reason why he won't eat? (I am in no way suggesting that you, little one is autistic) x

I hardly ate a thing until I was about 12.
Mum gave me vitamin tablets every day to suck on and I just picked at a few foods. I rarely ate snacks or chocolate either, I genuinely had no appetite. My appetite grew naturally as a I got older.
I personally wouldn’t make a big deal of it. Give him a varied diet but just small amounts and don’t make eating food an issue. Lots of chatting at meal times and leave him to his own devices. Have fruit in for snacking, even if it’s things like strawberries.

Could he be coeliac or lactose intolerant?I'd investigate the sore stomach comments as a first step.

Has he been tested for coeliac? Before I was diagnosed I felt nauseous all the time.

He does sound a bit like a child I knew before their coeliac diagnosis. They were very tired and downcast and didn't want to eat, because they felt grotty and food made it worse.

If he's in pain and feeling sick then he probably will be hypersensitive to food smells and textures.

Get the GP to rule out a physical cause and don't settle for them chalking it up as psychological / personality without investigating. Coeliac, inflammatory bowel disease (colitis, Crohn's etc), intolerances, etc.