What can I do about my sons refusal to eat........now below the 0.4th%ile.

[Peacheye]

My 19month old has always been small. He has never managed to get above the 9th percentile. He has also always been a fussy eater. He was diagnosed with reflux at 10 months which was a huge relief as the mediation given final meant we could get over 40minutes sleep in a row. He is now finally off the mediation however he is an extremely fussy eater and whenever he gets the slightest cold (every other week) he refuses to eat. I might be able to force in 1 fruit pot (64calories) in 24 hours and 100ml of milk (75calories). I dread every meal time and end up crying frequently as he eats so little even on a good day when he actually eats a little better. His weight is below the 0.4th percentile and has consistently dropped over the last 4 months. His height is off the bottom of the chart. I try so hard not to show any sign of disappointment in front of him and to make meal times fun, but day after day it is so difficult. I try giving high fat high calorie food, but if he refuses everything this makes no difference.

He will not eat pasta, potato, rice, couscous............the list is endless

This is the first time I have posted. Please can someone give me recipes ideas or advice on how to get him to eat

Have you been offered any advice though your reflux clinic?

Have you spoken to your GP/health visitor? I would keep a food diary and ask for a refferal to get help.

What do you give him to drink?
He's not filling up on squash or water?

Has he been referred for failure to thrive?

Poor dietary intake can persist beyond when reflux resolves. My DS was below 0.4th centile & had severe reflux until age 3.5.

It was a few months after it resolved that he began to eat more.

I asked for a dietitian referral & we were given a high calorie prescription milk to support weight gain. He is still on it now. It was a real life-saver when he didn't eat. We also give high-calorie foods eg Jersey milk, milky bar puddings etc.

Good luck. It's hard with when they don't eat.

Ps his reflux was always worse with teething & colds.

Winter was so bad & he only ate smooth soups, yoghurt, ice-cream & rolo/milky bar puddings. For 6 months.

Poor you. My dd2 is fussy - shell only eat chicken nuggets and chips in terms of what you'd regard as proper food but she is following her centile. We saw a paediatrician but he wasnt worried as she was developing normally and putting weight on albiet slowly. Afriend of mine had issues with her daughter and she got prescribed that milk shake that another poster is talking about. She is now doing a lot better and is about 2.75 yrs. you shd seek help from hv and dr tho do sympathise re fussiness. My dd eats a lot of Ella's kitchen 4 month smoothies still. She'll eat yoghurts, custard, crackers, pancakes, bread and cereal. Nothing else apart from rubbish. My son was also fussy. He improved dramatically after he was 3. All kids have had reflux. Your son sounds on lower end so does need some attention - but my niece dropped off her centile completely but she was developing and although still thin, is doing a lot better. There is light and kids can live on next to nothing (my dd sometimes doesn't eat any dinner!). But do get help as it can be incredibly depressing. My dd went from 50th to 12.5 th centile but is back up. Hope all works out but don't do it alone

I'd ask for a referral too, if his weight has dropped from the 9th to below the 0.4th, and his height off the bottom. Be persistent as well. Even paediatricians can dismiss poor growth as not important. I have so many anecdotes about this, it still makes me cross thinking about it! Don't let them say, oh he is growing a bit, or, my favourite 'he's following his own centile'. If his weight and growth remain poor, ask to be referred on to a gastro-enterologist and maybe even an endocrinologist. I'd also ask about his blood sugar, if he is that small and not eating for long periods when he is ill.

Also, you may find the Child Growth Foundation helpful here They have really helpful people on their helpline and they will provide support and help you negotiate the referral process.

Holding your hand; it's just awful and so worrying when they won't eat and are tiny.

It's so hard when they refuse to eat. I'd agree with the other posters that you should ask for a referral to a paediarician if you aren't seeing one already, and a dietician. They'll be able to check his general wellbeing and may also be able to help you access the feeding clinic at a children's hospital, where they'll be able to offer advice (and you'll be around other parents with similar issues, which can be helpful in itself). They'll probably want you to keep a food diary too. Our DS had reflux as a baby and younger toddler; when he started solids it really became a problem - I remember him having peas coming out of his nose one evening; very distressing for him. Meals were really, really difficult - quite often he just refused to eat anything. When he was ill he simply wouldn't eat at all for days, just drank milk. We asked for a referral as he was sliding down in the centiles, and his paediatrician checked his general health and did blood tests, which showed he was anaemic, so he took iron drops for quite a long time. He was referred to the hospital feeding clinic but the waiting list was so long we never actually got an appointment as over the next six months he gradually started to eat a bit better, to the point where he eats fairly normally now at 2.8 (if not quite as much as some toddlers). I'm not sure what changed. I'd definitely ask for a referral to get support and advice. In the meantime I'd make everything as high calorie as possible - our paediatrician still has us adding extra fat (oil/butter) to everything hot that DS eats to boost the calories he gets from the food he does choose to eat.

If there's anything he does like, I'd give him that every meal while you wait for a referral.

Peacheye, are you me? Although my DS is 25 months so maybe not. Your story sounds similar to mine though so know you are not alone.

Yes try and get referrals or go private if you can afford it. We started getting help once I bypassed my GP and went private. We saw a gastroenterologist pediatrician, speech and language therapist, child psychologist and dietitian. The SALT was the most helpful, you should be able to find one with feeding problems experience.

My DS got prescribed a high calorie milk called SMA High energy. This really helped him gain a bit of weight. The private pead prescribed it then I asked the GP to prescribe it on the NHS as DS clearly needed it. The GP was a bit annoyed at my approach as the milk is very expensive but he kind of had to prescribe it once the specialist said it was needed. So this could be a good first step to get LO's weight up.

Although I did find that the high calorie milk affected his appetite for real food and I also found, when we came off it suddenly when DS had a stomach upset, that DS's general behavior improved when off the milk. Probably the fact that it is processed high sugar made him a bit hyper.

I have currently got myself into a slight pickle in that I have started letting DS watch favourite programs on my iPad during meals. This is the only way he will allow me to feed him (self feeding isn't great at the moment given he doesn't want to actually eat) and so this has allowed me to fatten him up a bit. I pause the program and then play it once he takes a bite.

We still have SALT and our therapist is not that happy about my iPad method as it is clear that DS is not really progressing much in learning about food. But I am putting physical growth above this at the mo.

I could talk for ages about all this as it has taken over my life. My top tip though is not to be scared to throw the parenting books out the window. There is a resistant eaters thread on here and I've had some comfort from that too.

Have you considered doing more snacky things than sitting down for proper meals? It must be horrid for both of you if you are so upset by the whole thing that you end up in tears. We used to give my daughter, who was stroppy about food, a pot of raisins and little cheese cubes, or jam sandwiches cut into tiny squares, when she was in her pushchair and she seemed to eat without noticing. Or you could put a little plate near where he is playing and just see what happens. It might take a little stress out for both of you to not have formal mealtimes for the moment.
I agree about further investigations with the doctors too and I hope things improve for you soon.

And meal times sound quite understandably fraught. Try and get round that by changing the venue. Offer him pain au chocolat in the buggy, cheese on toast in front of the tv, etc. Go for high fat options at every opportunity- so rather than that fruit pot you mentioned, offer créme caramel, add chocolate powder to his milk.
Good luck- its frightening and upsetting. DS, now a lanky but tall 13 yo wouldn't eat for a while- I let him have McD whenever he asked! (he was 7)

x with scooter.

I feel for you, my DD 17 months does not eat when not well and takes a week after to start eating again. She just eats pots of frut pure, yogurt, milk. The only other things she eats is rice cakes and various baby snaks wich she can feed herself. So maybe you could try snaks, pieces of banana, mango, grapes. I know it is not very filling, but at least is something. An her favorite that she always eats is a cheese scone from M&S, the freshly made ones.

I really feel for you. Children are very clever at working out what gets a reaction from their parents and I wonder if maybe he's worked that out all ready. So the little and often high calorie snacks meals on the go could work and hopefully you won't be too stressed out.

Don 't feel bad about the iPad either a friend of mine has to do it, at your dc's age they are IMO too young to rationalise with. Once he's a bit older you can say eat dinner, then watch the iPad and he'll understand.

There are also lots of parents who make you feel guilty about giving your child anything other than homemade organic vegetable bake - ignore them give him what he'll eat just avoid loads of salt obviously.

have you tried McCain over chips? if you grill them they're not actually that bad and probably better than mash with loads of butter anyway. Also for you own sanity they only take 15 minutes and they're not too messy either. If he doesn't eat them then at least you haven't spent ages making it which when you are stressed and can just about be the final straw

Hello,

I'm not much use but just to say both of my older ones survived on little actual food, and mainly milk at that age. I don't know if he will take milk but if so then don't worry if that's all he wants iyswim x

DS (Teeny Taffy!) sounds very similar .... he is now 3 and just under the 0.4th (despite having been born off the top of the scale at 6lb 13oz at 8 weeks prem!) We have just had a referral to a dietician who has given us powder supplements to add to food - which is great if I can get him to eat anything in the first place!

It's very, very frustrating - but he is very active and I have no real concerns about his development otherwise (late potty training and a bit delayed with his speech)

He loves cakes at the moment and so I am now baking things like carrot/courgette/banana muffins. My HV has been very supportive and offers great advice and is good at just talking things through on a monthly basis when I get him weighed. She has been quite relaxed about what he eats (lots more sugar/junk than is really good for him!)

Little and often and eating more informally has worked well for us.

Does your DS have a multivitamin?

Try not to stress too much about it - kids are resilient, but its worth seeing your GP and/or HV to get him checked if you haven't already done that.

If he's picking up on the stress, maybe not have meals at all for a while? Just put a whole bunch of different snacks/finger foods etc out on a place he can reach and just let him pick whenever he wants.

My DS was the same, specially when he had colds - we found that feeding him in the bath worked! I think the steam made him feel a bit better/cleared his nose and he was happier to eat. I still do it now sometimes and he's 5!

My DS also has food issues. I'll join the chorus saying talk to your HV/gp and get a referral. Also check out the book my child won't eat by dr g-something. It helped me relax about DS's not eating.
What I do now is ensure that he's getting his necessary vitamins and minerals so I don't worry if he doesn't eat much or just eats chips. I give him things that I know he likes and keep trying other healthy foods. At dinner he gets a small amount of whatever we're eating. Sometimes he eats it sometimes he doesn't. It's taken a lot to get me there, but I just relax and let him eat or not eat. I'm sure I get totally judged for giving him biscuits and chips and things, but I know he may eat them. And the SALT told me him eating is more important than what he's eating.

Wow

I wasn't expecting so many responses. Thank you everyone

We are seeing a dietitian, and a paed consultant. We also have regular contact with the HV which is hit and miss (they keep telling me not to worry, even when he lost 750g in 2 weeks, as he was still on the graph, albeit below the 0.4th%ile). He is on calcium supplements and multi vits as along with not eating he doesn't drink. We are lucky if we get half a sippy cup (50-100ml) milk in a day. I have started putting skimmed milk powder into his milk and making lots of milk shakes as they seem to go down slightly better and we have just been given a prescription of high fat fortified milk (after 3 weeks of begging). I have given up worrying about how much sugar he has, if he is eating or drinking anything I am grateful.

I am convinced his reflux has cleared. He is no longer sick (I used to change his sheets and clothes 3 times a day) or coughing which happened when he burned his throat. We came off the medication over a period of 3 months and there was no variation in what he would or wouldn't eat over that time

He is so fussy about food, it is very limiting. He has never eaten a piece of fruit (other than mashed wizzed or hidden) and refuses vegetables unless in a stew.

He eats better when we are out the house, especially in the car or pushchair. Roll on the summer when we can spend more time outside. I have got to the stage where I take him out for a drive just so we can sit somewhere and I can spoon food in.

We have another review with the paeds in 5 weeks. I just hope he has put on some weight and height. I know at the moment he is only getting enough calories to survive and not enough to grow. At 19 going on 20 months I really want to be able to put the 6-9 month trousers away, but they are the only ones that fit!

Them not eating is so difficult. Keep trying different foods and anything the he likes let him eat. DS loves golden Grahams cereal. So on days when everything else is refused I let him eat as much of that as he will. Plus their tastes change. A couple of months ago DS refused cows milk and now he's a milk monster. Keep trying things and do whatever helps him eat. And this is the hardest part, don't let him see you stress about it. I used to give DS lunch/dinner and he'd refuse it all and id so sit in the bathroom and cry for a bit.

Hang in there, it does get better, I promise. I too had an 18 month old in 6/9 month clothes.

As I mentioned up thread, it has taken us years for his diet to improve. The sheer desperation I have felt about this cannot be put into words.

Hard as it is, please try not to show ANY reaction at all to food refusal. I would simply remove the plate without a words (and swear when my back was turned!). I remember he'd gone 4 days without eating a single thing - I gave him a Rolo pudding in sheer desperation - the little bugger ate it all!

One thing that helped us was "roleplaying" with toys at a meal time eg favourite toy really "enjoying" the pudding, all the toys having a "taste" etc.

Mine wouldn't eat in public so if you've got that, or eating outdoors/in buggy, go for it. Is there anyone else who could feed him to give you a break eg at weekends? I wonder if letting him have a meal with good eaters would help?

The high calorie milk will give him all the vitamins & minerals, so just concentrate on getting him to eat anything. Full stop. Doesn't matter if it's healthy or not.

OP one thing I have realised over the last few months is that my DS's problems seem to be about trusting the food and trusting me (being the one who feeds him) rather than a taste or texture thing. So the foods he will tuck in to (comparatively!) are things that always look the same, so he trusts them. So, white rice (although I sneak grated cheese into it), strips of cheese, peas, chocolate, strips of beef (sometimes). I don't live in the uk now and don't cheaply get things like baked beans or fish fingers but they might be good to try for always having a uniform appearance.

Little one has lost more weight and we are now being admitted to hospital for gastric feeding............

Poor thing. Hope the ng feeding helps. Has milk allergy been ruled out? Coeliac?