Wits end with 8yo - low appetite, fussy eater, getting worse

[MerryMarigold]

My ds1 was recently 8. He's always been a bit fussy, but I realised recently that it has got really bad now, gradually over the years. I have 2 other children who are 'normal' when it comes to food, they eat most of it, try things, don't like certain things. He is different. He does have certain issues, recently diagnosed developmental delay by paediatrician, but it is not major in any area ie. he is possibly midly ASD but nothing major, mild ADHD, some sensory issues.

I am at my wits end really. We have a repertoire of about 12 meals which he will eat. Recently this has got worse and he is now refusing several of them. I don't know what to do. He has school dinners but mostly has a sandwich, which they offer. He generally has a low appetite, has stopped asking for a snack after school. His 5yo brother eats more than him, sometimes double. He is very slim, but he is just about ok, basically because I have managed to keep him eating by cooking things he'll eat or 'encouraging' him to eat his food.

• If I say, "take it or leave it", he will happily leave it. His behaviour will degenerate, he will not sleep well.
• If I start cooking him something separate, will this make it worse? Is it 'not fair' on his siblings. I don't really want to be offering choices every night, but is this necessary?

Every night apart from macaroni cheese night, we have had issues. He no longer likes spaghetti bolognaise which he has eaten his whole life, I bought fish fingers in batter which are not acceptable because it is not breadcrumb, home-made burgers in buns - not acceptable. I have tried some things he should like so...he likes bacon, I try a baked ham. Nope. Chilli con carne on a jacket potato instead of rice. Nope.

At the moment mealtimes are a bit of a battle, very prolonged. He is not hungry and asking for food like his siblings are from 5pm. We all sit down. He says, "I don't want it." He has to eat 'enough' that I judge he won't wake up hungry. (This is pretty minimal - last night it was half a burger and a few carrot sticks/ tomatoes). So, he sits there whilst I cajole, encourage, moan and I feel frustrated and he feels frustrated.

Any advice, please, please, would be much appreciated.

Hmm, very difficult! I have a toddler who is not too fussy but has spates of not wanting to eat one thing or another from time to time.

I've got the Rose Elliott veggie food for kids cookery book and she has lots of ways of making food more interesting by involving them in the preparation/decoration of things - mini pizzas, savoury muffins, etc. All the foods are nutritionally balanced.

One thing that sprang to mind was if he likes macaroni cheese, you can hide cauliflower in it by adapting RE's cauliflower cheese recipe. I'm happy to PM it to you.

Thanks, that would be great. Not sure I can hide unless I puree it. I have to puree onion, he's that bad, and used to spend half a meal picking it out.

I would suggest a visit to the doctors with a referral to a paed if the GP can't help. My children are both younger so I'm not talking from experience, but do you think there's any chance he may have an eating disorder? Or could it be linked to his sensory issues?

I only have experience of toddler fussiness which is far more common, I would say, than an 8 year old. But hopefully someone with direct experience will come along and help!

Thanks. I did speak about this at my appointment with the paed but she let it slide. I actually mentioned it several times as it is the most frustrating thing about him! If it continues, I think we will need the GP. I don't want him to turn into one of those people that can only eat toast. My ds2 was a fussy toddler, if anything worse than ds1 at the same age, and I thought, "Oh no! Here we go again." Now he eats pretty much anything so goes to show that the toddler thing is usually a phase.

Bump?

My 6yo is a fussy eater so I feel your pain, his is related to his food allergies (he's mega cautious with trying new stuff), he doesn't like food that's mixed up or has 'bits' in, I think he likes to feel safe when he's eating.

Anyway he probably eats about 12 meals too... so, I give him the 12 meals he likes. That's enough for a different meal every night for a fortnight - probably more variety than I eat myself! Every now and then I try new stuff but I don't sweat it if he doesn't like it. I don't make a fuss or cajole him to eat, I let him eat what he wants really. It's been much MUCH better since I stopped fighting him about food, and took all the emotion out of it. I would rather he doesn't stress about food and eating, even if it means having fish fingers every week, than grow up thinking mealtimes are something to be anxious about.

That's just me though, I know a lot of other people are much more hardline and have success with the 'eat it or starve' approach...

This must be so hard and i do totally sympathy. My 6yo is very, very fussy too but I think with everything else you have going on you need professional help. Do speak to your GP and I think that a referral to a Paed dietician might help too.

Have you tried posting in the SN board too? Some of the posters may have experience of fussiness and sensory issues

I have a 9 yr old DS, he eats OK but I tend to give him things I know he likes and as he's got older he has got much better at trying things. I think I would be more concerned that he doesn't seem hungry. When he doesn't each much of his main meal does he ask for other food? With my DCs as long as they eat a fair amount of their meal I will always give them fruit and yoghurt afterwards and bread and butter if they are still hungry. If mealtimes become a battle ground it just gets stressful for everyone. Does he show any interest in food? Could you ask him what h would like and get him involved with making it?

Meg, I don't make a fuss or cajole him to eat, I let him eat what he wants really.

I think I worry that if I do that he won't eat anything. And this will affect him, not just long term weight loss but very early waking due to hunger, difficulty concentrating, out of control emotions. We have been there before.

Yes, basically I cook within his repertoire of acceptable meals, but even these are becoming unacceptable.

I think I will wait and see if Christmas hols help. He is possibly tired. My theory is that he has a sensory overload and doesn't actually know he is hungry, just like he doesn't know he needs the toilet until he is wriggling around everywhere and I have to tell him to go. I will post in the SN as well.

theynevershutup, no he is not asking for other food. My other 2 can try it on a bit, not finish their food and then all of a sudden be 'hungry' for 'something else'. But ds1 is not interested in dessert (we have stopped having it anyway as they have it at school). He's really lost his appetite but he doesn't seem stressed in other ways.

I think I would go to GP after Christmas if things don't improve just to ask their advice, because my DS is very slim and active, but is always very hungry when he gets in from school and at dinner time. He gets very over emotional when he's hungry too. Has your DS got plenty of energy? Sorry not much advice, must be very frustrating or you.

It’s probably best just to give him the things he likes, plus one other thing to “try” (but no worries if he doesn’t try it). I wouldn’t worry about fairness on his siblings, he has different issues from theirs. If he is on the autism-spectrum then familiarity will be very important to him, and things which are similar to things he likes but are not quite the same will seem just as bad (if not worse!) as things that are totally different.

Children on the autism spectrum often have sensory issues which make eating difficult. My DS (who has Asperger's) actually ate quite a good range of foods but he was very conservative so I always had to serve the same foods in the same way. His diet gradually got narrower while he was at primary school, then broadened out again when he became a teenager.

There are some books on managing picky eating for kids on the autism spectrum. Can’t Eat Wont Eat is written by the mother of a child with more severe eating problems but you might find some of her ideas useful.

I usually give really clear advice to leave the food in front of children and allow them to decide what to eat but I don't think that's appropriate for you.

Most children won't allow themselves to become undernourished and missing one meal will trigger the hunger that helps them to enjoy the next one.

It's different for children with ASD. They may not recognise feeling of hunger. They may feel unreasonably anxious about food, thereby supressing their appetite. They may have serious sensory issues which mean they are unable to tolerate smells, tastes and textures of food.

You need to go back to the paed or see your GP and ask for an urgent Occupational Therapy appointment. The OT can assess your DS's sensory profile and help you find ways to make eating a wider variety of foods easier for him.

In the meantime try not to jump through too many hoops, don't put him under pressure to eat more than the bare minimum and try really hard to keep mealtimes as relaxed as possible.

As he has undiagnosed difficulties linked to ASD, if the problem becomes more severe, you may be able to get him seen at the GOSH clinic which helps out with more complex cases from all over the country.

Thanks for your advice. The asd stuff really does match up with him in terms of eating. I feel calmer and have had some advice over on sn chat. It helps just to know there are other people who deal with this. I am buying the book pronto, thanks for that. I will try and take pressure off him a bit.