Help with 4 yr old dd's eating needed please!!

[Foxy800]

Hi there, my lo is 4 and teatime is a nightmare and getting worse!!!
Breakfast and lunch are very limited as to what she will eat but at least she is eating. Teatimes are a nightmare.
As a baby she would eat anything then she choked a couple of times and that is when the trouble began.
We have always had a rule that if she trys tea she can have pudding( depends how much she eats as to what she has) and she can have a snack at bedtime. If she refused to touch it then no puddign but she could have snack at bedtime.
Normally she nibbles on it so gets pudding but am trying to encourage a better diet as it not great with what she will eat. Over the last 3 nights we have had 2 nights of screaming and refusing to touch it so no pudding and no snack at bedtime apart from glass of milk.

We often get tears before we have even made tea and the other day after refusing tea she woke up the next day and complained about being tired and refused her milk and brekkie, an hour later she was slightly sick then was fine and suddenly had her appetite back and ate loads. Im sure it was a coincidence and not related to not eating tea the night before.

Im a bit of a worrier though and am concerned she has some sort of food phobia and dont know how to help her.

I have spoken to hvs before and been told to just keep trying!!! We are currently writing food diaries ( on week 2 tomorrow) and am doing a meal planner just for tea times. Am thinking about trying to get hv or doctor to refer us to a dietitican but dont know if that is the right move or not.

Thank you for reading if you got this far and any advice greatfully recieved.

I meant to add as well as the screaming ( dread to think what neighbours think) we ahve ahd a lot of hitting me, which I am sure is anger as it is something she does in a temper. She is given timeout for this which is the same if it occurs during teatime.

What actually happens when the food is put down in front of her? What do you do/ say?

She sees us preparing it then she helps get her table out and sits down, I sit next to her and eat some even though we eat later on. Then she just starting crying and screaming and getting into a state, she is just reminded that there is nothing else to eat and if she trys a little bit she can have pudding.

Try not to make too big a thing about it but it is hard as I worry she isnt eating enough etc!!!

She used to help us choose but it really made no difference.

Im just feeling such a failure on this and want the best for her.

we have even tried leaving it till it goes cold for her to eat in case it is the heat that is bothering her.

Get her to help cook/prepare the meal - getting messy and involved with touching and feeling all the textures and smells. Let her lick her fingers.

Don't get into a discussion about the food if she starts to get upset. Ignore it and talk about something else.

Eat as a family as much as possible, talk about other things, don't focus on getting her to eat, talk about the food or negotiate.

i.e. keep the pressure off.

Remove the plate at the end of the meal without comment.

Give her her pudding if she wants it.

Just think how much she must dread mealtimes and try to make them as lighthearted as possible.

My DS1 (just 5) had a minor choking incident at Easter and that turned into a food phobia/issues on and off for the next good few months (it still plays on his mind but he hasn't spat out or refused - except for normal refusal - for a while). You have my sympathies as it really is very, very stressful. I did a bit of reading around and apparently after choking incidents or reflux as a baby (which my DS1 had) they can be more prone to having food phobia/aversions as small children. But almost all of them get back to normal eventually - so it won't be like this for ever! But also lots and lots of pre-schoolers have food aversions - not phobias - which is just par for the course and is just something they'll grow out of.

I know mine may be a slightly different scenario as mine was short-lived and came on suddenly but anyway...in case its useful...

I went from trying not to bother, to impressing on him the importance, to bribing, not giving in and trying to. I was very worried as my DS1 has always been underweight (altho' I guess normal for him). Anyway....the Dr offered to refer us to an children's anxiety clinic or a ped dietitian. But before any of those she suggested that we just go with whatever he wanted to eat for a couple of weeks, just take the pressure off completely. So we did....and I went from trying not to bother to really not minding - as I knew we had a plan to act on in 2 weeks - and I think me not stressing and letting him be in control a little just turned it all around.

I know they say they won't starve...but my DS is a stubborn little man and he was rolling around starving and you could see he was actually scared. So maybe that's why it worked with us. I was worried about doing this in case it just left us feeding him custard and tomato soup for the next ten years. But at his own pace he came round.

There's a food clinic in London (Harley St, I think - pricey!) - Children's Feeding Clinic. I rang and booked an appt, but the nurse specialist was very, very helpful and gave me advice over the phone for free. Might be worth giving them a ring...even if you're a way away. Sometimes just nice to have an expert view. Anyway we didn't need the appt in the end thankfully.

Hope you manage to find something that'll work.

Thank you for the reply.

She refuses to help with cooking, apart from cakes.

We ignore the screaming as much as possible and try to talk about other things but she wont let you.

We cant eat as a family due to work patterns but I always sit and eat a little with her. When we are able to eat as a family it is just the same as normal.

Plate is just taken away and put on side in kitchen in case she changes her mind and we go onto do something else.

Should I give in and let her have pudding and snack then even if she refuses to try it?
(Am worried she will never start eating the food as she knows she will get something else).

DO you think we should get recommendation for a dietitician or do you think we are wasting our time?

Many thanks to you both for the replies.

Sorry Zam72, didnt see your post. Glad you son has improved and we wont be able to afford harley street but maybe an nhs dietitician would be able to help then.

If she had her way she would have sausage and chips 7 nughts a week!!!

I would give her something that you know she will eat and also a small amount of something else.

I would give her pudding.

You need to try to move away from the association of mealtimes=stress and a battle of wills. So just as zam did, give her what she likes for a while and let her have pudding.

Don't worry too much about what she is eating at first but more in reducing the anxious behaviour. Once she relaxes more, you can worry about broadening her range of foods.

A dietitian would be fine as long as they have experience in behavioural feeding issues. In my experience, many of them do not however. I would ask for a referral to a psychologist. Some hospitals do have feeding clinics where they work on these issues.

Dr Gill Harris is amazing if you are anywhere near Birmingham used to be at the Children's Hospital). Have heard her speak at a course I was on many years ago.

Does she do messy play at all? Lots of children with limited food ranges also find getting their hands messy very stressful.

Would she help you 'cook' for someone else? e.g. make food for a friend, you, granny?

Thank you so much for your reply.

Will get in touch with doctor or hv tomorrow to see if we can be referred to a psychologist.

I dont think her nursery did messy play much and I have tried at home but she wont play with it (I know its not food but she has to be in the mood for play dough play too).

She loves making cakes for other people and making things with her toy food for other people but not with real food.

Sorry I know it is another question but if she wants sausage and chips, smiles etc 7 nights a week would you give it to her every night. When she has this she has veg with it that she will nibble on, if asked, would you put tha tin or leave it off for now?

Sorry for all the questions.

Sorry did you say a small amount of something else so for example pasta, fish or something. Would you still give the pudding if she refuses ti try it ( she would normally expect us to take it off the plate before she eats anything else).

Sorry one more question, would you stop the food diary and meal planner until had further advice then?

Really sorry bout all the questions.

If you usually add the veg, then maybe just put a little on.

Maybe invite some friends over who are good eaters but remember not to comment on anything food or eating related.

How does she eat at nursery?

Will she play with sand or paint with her fingers?

Do you know if there is anyway to get hold of Dr Gill Harris if you are not near Birmingham, we are in Surrey.

Again really sorry about all the questions but feel I am getting somewhere will you (so very much appreciated), dont seem to be getting anywhere with hv and dp just seems to leave it ot me ot make the decisions on this and goes along with what I suggest (moans if not working though)!!!

You could try putting any disliked food in a separate bowl next to her. But, having said that, I would concentrate on doing whatever it takes for her to have calm meal. It has probably been a while since she has done this.

I wouldn't comment on whether she is eating or not. If she says I don't want x, just say 'ok, just have the rest then'. After a suitable time (20mins) or when finished, ask if she has had enough and remove her plate. Then give pudding, again without any comment about what she eats.

Perhaps do the diary for a while because you may be asked to do this at any appointment you get but if you feel this makes you more anxious by focusing on dd's eating all the time, then just stop.

Unfortunatley her nursery was a morning only one so they didnt have meals there. They did have snack there and she ate that well but it was fruit and she is good with a selection of them.

If we go to family members for a meal they tend to give her something that she will eat even if it is different to us.

She has hada hot tea at a friends before and I forgot to tel lthe mum how bad she is and we ended up havign meltdown!!I felt awful for both her and the mum!!!

She loves her sand table and likes finger painting.

I really appreciate the replies so thank you so much.

No it has only been really really bad this week, the rest of the time it is reasonably calm but not great ( she has mainly had food on the plate that she would eat though) with a little of something else.

Will keep going with food diary as only do it when she has finished any way.
Think I will discontinue the meal planner and just go with the sausages, pototo wedges, smiles, chips etc for now ( sounds like I just give her rubbish doesnt it!!) and ring doctors in the morning to see if we can get appointment for psychologist.

Again thanks so much for the help.

If she is happy playing with sand and paint then that suggests that she does not have a general sensitivity to textures, which is good.

I'll ask around and see whether I can find a clinic in your area. It's a while since I worked but still have a few contacts and worked with some therapists in Surrey for a while.

Many thanks for your help, would gp not refer us to someone?

And as I said in my last post will discintinue meal plan for mow and go with the food she will definately eat.

Again many many thanks for the replies. Will have a look on here now to see what I can find in Surrey.

Yes, ask gp who they he/she thinks should see her. It may be a community feeding team that is best in your area.

Have had a quick google and can't see any contacts yet.

Think GP is best starting point. Bet refers to Dietitian though. If he does, go for it but ask them if they have experience with behavioural issues.

Shame you are not nearer me (London). An old colleague of mine does a 'fun with food' feeding group whih would be perfect.

I'll ask for more specific details and maybe you could start some of the things as a 'distance learning course', lol

I'll see her tomorrow and come back with anything useful.

The other thing I read about what food combining (I think it was called) to widen their horizons but in a way that they feel they have some say in/can understand. So if she loves sausages and chips - then make a list of things that are like sausages, and things that are like chips. So for sausages I guess it could be sausage roll, sausage casserole, sausages in gravy, then if she accepts say the sausage roll, then you can do the same with flaky pastry and x,y,z if you see what I mean. Or foods with similar colours, textures, etc. So you build up lists that she can see are similar and she might like to try. There was a book on amazon about it.

Yes...no the harley st place was expensive but you might be able to ring them just to get some advice. First off I just said I didn't know whether I needed an appt and explained the situation. They didn't push at all for me to have an appt.

Thank you so much for both of your replies.

Unfortunately unless it is a normal sausage she will not touch it, we do have a selection of potato products she will eat like potato wedges, smilies, potato letters etc.

Any advice your friend could give would be fantastic DaftApeth. (I too went on google but couldnt find anything).

Well gps open in 5 minutes so will give them a call.

I sympathise, Foxy800. My dd was a very picky eater and for a while every meal time was a battle. I completely agree with everything DaftApeth says - it all started to improve when we took a step back and stopped trying to persuade her to eat. I think it was the battles / pressure which was making her not want to eat, rather than the actual food. It took a while, but she's much better now.
She didn't really help with cooking, but one thing which helped was letting her serve herself. That was a suggestion I found on MN actually. If she could choose how much went on her plate, she was much more inclined to eat it. I explained that she could take as little as she liked, but could always have more afterwards. To my amazement, the first time I tried it she asked for seconds!

Thank you so much everyone.

WE have a doctors appointment for this morning to see what they say.

Great. Hope the GP is supportive.

I'll grill my friend later

Thank you, just thought Id pop on quickly and say have seen gp and she is going to refer us, not sure who to yet though so going to talk to her colleagues and call us back later today. She also said to speak to hv again so called them this morning and they are coming out on friday am. have given us some new pointers to go on for now EG still go with food diary, do meal planner and still offer new food but maybe to give pudding first and if she refuses the main then she doesnt have snack but at least she not going to bed with nothign at all to eat.

So will go with meal planner and do one day of something she will eat and one day of something else.

Fingers crossed gp will call back today.