18 month old hardly eats and mum has stopped giving milk

[Lucy025]

Im a CM and look after a 18 month old child, who has been ill constantly reccently the parents say they dont like taking him to the doctors and but he has now started to hardly eat at least one whole meal in a day, but parents dont agree on him having anything else during the day aprt from his meal times.

Now they have stopped giving him his milk, because he wont drink cows milk and they dont want him having a bottle any more, so have stopped it completely.

Its making life hard when i look after him because he is miserable and always tired. Is this the right thing to do or should i say something to the parents? What do you think I should do about the situation?

I'm not a CM but i think that i would have to say a diplomatic word or two if i thought that the child was suffering.

Stopping the milk is probably the best thing to try to get the child to eat more food and stopping bottles is fairly normal by 12 months. I would concentrate on giving a healthy snack in the morning and see how you go.
As the weather improves and he gets more active during the day, lots of outside play may lead to a better appetite and sleep pattern and it may all improve.

If a child is 'constantly ill' always tired and miserable he needs to b seen by a doctor, have the parents taken him? As a nurse now cm I would be strongly advising them to do so, these symptoms are worrying and could indicate an underlying illness.

how long has this been going on?

ime it's fairly normal for a child to go off food following illness, but obviously if this is a more ongoing issue then you may need to diplomatically say something.

I agree that dropping the bottles may be one way to increase his appetite for solids. If he's been ill then that may explain a loss of appetite. What was he ill with? Colds? Seemed like everyone had horrible colds last month! Can you describe what he eats in a day - how long is he with you for - are you providing all his meals during the day?

Lucy025, I too would be very worried about this. I had this exact situation with my second ever mindee. When I first changed his nappy I was scared that he was so thin. He wasn't eating properly, his parents didn't want him to have cows milk but hadn't made any substitution. As a result he was very thin. I spoke to my network coordinator who said it was unintentional neglect, she told me to advise the parents and if they didn't take action I was to report them. It all turned out ok and he is a great, healthy kid now.

While it is best to reduce the amount of milk taken from a bottle to encourage solid food intake, an 18mo still needs calcium and nutrients and if he is not eating much and is noticeably eating less after an illness, I would be inclined to let him have milk at, 18mths most babies are having at least one bottle a day. I look after 3, 2 year olds and they all get a bottle of milk after lunch before their nap and a bottle at night before bed, their parents and I know it is advised that they should be weaned off bottles onto cups by now and we are in the process of doing this but we would never deny them milk just because they refuse a cup. To deny a baby milk, and therefore nutrients, if he is barely eating can be considered neglectful. I presume he isn't taking milk from a cup and you have said he isn't snacking at all, which isn't right, babies and toddlers need to eat small healthy snacks between meals. Growing is hungry work.

This situation is a welfare issue so if I were you I would monitor the baby's weight and health. Tell the parents that you are very concerned that the baby's illness is ongoing and that he is not eating or sleeping. Tell them that he won't be able to sleep if he is hungry (it amazes me that some people don't make that link) and that you strongly advise them to allow him milk, at least until he has seen a doctor and ask them to make an appointment as soon as possible to see a doctor or hv. Record your concerns, any conversations you have with the parents and their responses. Speak to your coordinator for advice. If they haven't taken him to see anyone or taken any action in the next couple of weeks (at the latest) or if you notice any decline in the baby's health, inform them of your legal obligation towards the baby and his welfare and report them if necessary. They probably haven't realised how serious this is and will more than likely take action when you are firm with them.

It may sound heavy handed but you must always err on the side of caution when it comes to a child's welfare. Remember, your obligation is always to the child.

My 18m mindee doesn't have bottles and neither of my own children had bottles past 9 months. You don't need to worry about the calcium if he's eating cheese, yogurt (a piece of cheese the size of two fingers has about the same amount of calcium as a full glass of milk) and other dairy products. What's his weight, what centile is he on, has he dropped?

What's the problem with having milk? DS2 still has a drink of milk morning and night...same as I have tea (or hot milk at night)

18 mth might be a bit late for this... But maybe he didn't like the sudden swap from formula to cows milk? We transitioned both boys from formula gradually by mixing with cows and reducing the formula over time.

Now there is follow on formula for even 2 yr olds might it be worth investigating with the parents?

It's quite ok and normal for toddlers to drink milk! It's also ok for toddlers to not b really fussed about food, some find the sitting down process a pain so giving healthy snasks and food on the go is great.

But this child is miserable, tired and always ill, that's not normal and i would advise parents take to see doc, if it continues and they don't it becomes
a safe guarding issue, cms have statutory responsibilities that go with the job.

As a CM I certainly expect to know the weight and normal centile of my mindees.

Though perhaps I should add that as I have one full-timer at a time I'm seeing considerably more of them than their mothers do, so perhaps a bit different.