Help! Underweight toddler won't eat...

[Vinomum]

DS1 will be 3 next month. He was small for dates at birth and weighed just under 5lb. Perfectly healthy and everything formed, but just very tiny. He's carried on being tiny and currently weighs 11kg (just under 2 stone) and is also quite short. Size aside, he's completely healthy and doing everything he should be doing at his age.

When I started weaning him at 6 months, he was a good eater, but never had a massive appetite. When he's hungry, he can eat tons, but when he's not hungry he won't touch anything, no matter what it is. At nursery he eats really well (or so they tell me) but at home over the last couple of months he's started getting worse at eating. I don't give him huge portions but it's getting to the stage where I know as soon as I put something down in front of him, it's going to be a struggle to get him to eat even half of it and I'm starting to dread mealtimes.

Last night we reached breaking point. He absolutely refused to swallow the food in his mouth. It took him 2 hours to eat half a plate of food. DH and I were at our wits' end, we didn't know what to do, we ended up making him stay at the table until he'd finished his food, telling him no toys/telly etc if he didn't finish - it was absolutely horrible, we were up till 9pm with him, he was crying, I was crying, and the whole episode was just awful. The last thing in the world I want is for mealtimes to become a battleground but that's exactly what happened.

I've read all kinds of advice about dealing with feeding fussy toddlers and everyone says not to force them to eat, not to make a big fuss, and that they won't starve because they'll eat when they're hungry. I really agree with this logic and want to follow this kind of advice, but because DS1 is so small he just can't afford to skip a meal. You can see his ribs and when you pick him up he's just skin and bones and I am really worried that he's going to become seriously undernourished and end up in hospital on a drip or something awful. I know it sounds dramatic but ever since the day he was born I've been worrying about his weight and this is just making it worse as I feel completely powerless.

I just really don't know how to handle this - has anyone got any advice?

Thanks Eddas, like you say it is good to know you're not the only one going through this. People have spent the last 3 years saying to me 'don't worry, he'll have a growth spurt soon'...umm, when exactly?!

my dd used to never eat, then i decided she wouldn't starve herself, so pretended not to be bothered any more (obviously i'd rather she ate more, but it's not really a battle i can win). but, once i stopped bothering she started eating more.

i know she's a girl and they're supposed to weigh less, but she's 3.9 and weighs 30lbs, is she off the centiles? surely not, she looks normal, just skinny.

and she really tanks up at lunchtime, she eats a good breakfast about 50% of the time, less often dinner in the evening, but is nearly always starving when she comes in from nursery at 11.30.

and i agree with everyone who's said that it doesn't matter when they eat, as long as they eat (although i personally would not fill them up on cakes and biscuits just to get the calories in, although very fatty, but otherwise 'healthy' food i think is key eg buttery mashed potato). and given the chance (ie at parties) she will have crisps for lunch. so she is not given the chance, i don't care what centile it would put her on...

(as an aside, over christmas my mil was astonished at how dd1 'lived on air' because she ate no lunch, completely forgetting the chocolate biscuits she had given her an hour earlier. some children just don't need as many calories as others - the smaller you are, the fewer calories you need to 'power' your body, so filling up with junk just leaves less room for the good stuff (read 'butter' )

long. sorry.

vino, my ds reminds me very much of my brother when he was little, I was 7 when he was born so remember alot about him growing up. He was always small, very short for his age, very skinny. and as you say, doing everything else he should be doing. He satyed short until he was about 16, he was always shorter than me(5ft4) and suddenly out of know-where he grew into a 6ft(ish) tall lanky beanpole He then kept on eating all the things he'd always eaten, high in fat things as he was so little, and he actually grew a bit of a tummy He's now 23 and has slimmed a bit, that's what the 'uni diet' does and he is pefectly fit and healthy.

Having written all that down I have no idea why I worry about my ds

I have a dd too and she was always taller and heavier than she 'should' have been according to the charts. I knew ds would be classed as underweught so I deliberately haven't taken him to be weighed I know really that he is ok, just small, but it doesn't stop me worrying. I guess what i'm trying to say is that I think my ds' eating habits aren't his problem they're mine. My HV did once say that a child won't starve themselves, they'll eat if and when hungry. She also said that children aren't like adults who can eat for the sake of it or because it's time for dinner.

I can empathise as well. Neither DD (4) or DS (2) are great eaters but what is semi working for us is:

1. giving them their food as snacks instead of larger meals (most of their snacks are sat at the table though)
2. giving them their food in basic form. neither of them will touch lasagne, stew etc but if I give them cooked chicken cut into strips or chunks with a "dip" then large chunks of semi mashed potatoes and some strips of carrots or brocolli etc they seem to eat better like that.

My niece in comparison rarely gets down from the table and would eat all day if she could, its very stressful trying to plan a meal with my sister's family as mine eat little and often.
I am hoping their habits will change

I have a 3 year old titch too. He's off the chart for height and had been wobbling on and off the weight chart for a while although he has been consistently climbing up on the weight for several months now. What works for us is to just relax. Grazing works best for him, where he has about 5 small meals a day and he eats with us when we eat. He doesn't seem to have an issue with food as such and will try new things but like your ds he eats to live not vice versa. He does go through stages where he doesn't eat as much in a day as I like but I just relax about it and trust that his appetite knows what it's doing. He LOVES fruit and veg and I often offer his carbs first otherwise he would just eat a plate of sprouts, I am not joking!

hi there, ds2 was the same. You could cook up something lovely, then he just wouldn't eat it. He's 4 now and somewhat but not totally better. I got a lot of help from a v good health visitor. One tip she gave which really worked is that your dc might be low in iron - kids that age get depleted really easily. DS had minadex at her recommendation every day for 6 months and perked up a lot. If low in iron, they lose their appetites, is then a vicious circle.
She also said, if he is eating almost nothing (for us it was living on milk and yoghurt) then just let them eat whatever they want, whenever. Then once appetite returns, you can start gently, gently steering them towards better, healthier food.
If they just eat sweets, try proposing a cake or biscuit, flapjack or similar, so it is a bit more nutritious and not just pure sugar.
Was wierd at first to stop fighting with him over meals. And to let him have a hotdog at the cinema when he said he wanted one. But it did work - up to a point. he is still fussy, mind you! But not skeletal any more. Good luck.

Hi Vinomum

You've already had loads of good advice on stepping back and letting him find his own way with food, but I wanted to respond.

I really appreciate how difficult your situation is. I don't agree with experts who say that all children will eat when they're hungry and will never starve - it's true of most but not all. One of my sons was the way you describe. He had bad reflux so food was painful to him, but even after it was treated he hated meals and we had a few two-hour long tearful meals. It was so hard. He ate nothing, was off the centiles (off the page at one point!) and fragile. Like your son he loved playing.

I hated mealtimes so much I gave up on them. I'd chop tiny squares of really healthy food up - like cubes of cheese or wholemeal bread and peanut butter, cream cheese and jam sandwiches, and cubes of fruit, then we'd go out for the day and I'd post them into his mouth when he wasn't looking. Then we reintroduced meals, kept them short and simple, and let him eat whatever he liked at them, so he associated sitting at table with pleasure not torture.

It worked for us in that he's now a chunky 7 year old who adores his food, but it had drawbacks. Table manners aren't great yet as it took so long to even establish regular eating patterns, and he also loves snacking so I have to keep a very discreet eye in case he over eats these days! I still remember a picnic in the park when he was about three and a half, I was helping my other son on the swing and saw him for the first time out of the corner of my eye, reach past my friend and voluntarily put food in his mouth. It was such a turning point.

The main things are to get him eating enough, to feel less stressed yourself and for him to associate food with pleasure. However you do this, even if it goes against all HV advice, is fine. One thing I do remember is that I had started to hate eating too and didn't do much of it pleasurably around him. I started making a show of enjoying stuff like ice cream or roast chicken and eventually he cottoned on. Also, as Meg says, so long as he likes something from each food group, it doesn't really matter what he eats. My son, when he eventually started to eat, lived for about three years on cheese and marmite sandwiches, poached salmon, carrots and pears. Not very varied but at least it covered all bases.

Good luck and I hope things calm down soon.

profpoopypants, you reminded me...another vote here for the minadex....i had to mix it in my ds juice as he wouldn't take it from a spoon.

it really did work to a certain extent, especially in the beginning. my ds is now 3.5 and is really skinny and you can see every bone in his body, but he's tall. he's on the lower weight scales, but still healthy.

he goes from eating loads one day to eating very little the next few....i figure it averages itself out.

Thanks all for your advice. I do worry about his iron levels as I know that even most adults don't get as much iron as they should from food, and as I was anaemic during my pregnancy I know how awful being low on iron makes you feel. I will ask our HV about Minadex, thanks for that tip.

The problem I'm having with DS is not so much that he's a fussy eater (though of late he does seem to be getting a bit more picky and pointing with horror at courgettes and announcing that he doesn't like them) - it's more that he'll either eat whatever I put in front of him, or nothing at all. I made a sausage stew the other day which he loved, then I gave it to him again a few days later and he wouldn't touch it. I also gave him pitta bread with dips which one day went down a storm, then a couple of days later he told me he didn't like. It's frustrating because one day I think I've cracked it, then we're back to square one again.

One other thing I should mention is that we also have a 9 mo DS. He's a total gannet and could eat as much as DH and I put together if we let him, but one thing I've noticed with DS1 is that he's seen me spoon feeding DS2 and now he wants me to spoon feed him too. This is another dilemma - I don't want to get into the habit of spoon feeding him, esp as he's moving up to a new class in nursery where they really try to encourage independence, but if I tell him that he's a big boy and can feed himself, he gets upset and then won't eat. I've tried compromising, telling him that I'll feed him one spoonful then he has to do the rest himself, but sometimes it just seems easier to spoon feed him as that way I know he'll eat. I don't know what the right answer is though, I'm hoping that as DS2 gets bigger and starts eating more finger food by himself that this will pass.

I think for the time being I'd just spoon feed him, if that's what he wants - I wonder if he's trying to use food as a way of getting babied again by you - which, for a short period, is no bad thing IMO. It won't last forever, esp not as DS2 moves onto finger feeding and then feeding himself with a spoon eventually. Maybe he just needs a bit of comforting and reminding that he's still Mummy's baby too?

I think just try and let go of all your notions of what "should" be happening at mealtimes, and change your focus onto making food relaxed and fun again. DEF no more 2 hour mealtimes, there's just no point and it takes you further away from your goal...