My toddler hardly eats - please help

[smuggler]

Dd has never taken to food. When she was about 13 months I saw the HV and told her dd didn't eat (besides yoghurt and breastmilk) and she said to keep a food diary. I offered dd things at every meal time and dd just didn't eat. HV was pretty useless and patronising, saying she knows you'll offer her yoghurt if she doesn't eat the first option which I'd clearly said I wasn't doing. As dd wasn't underweight at around 17 lbs, she wasn't concerned and said she'd grow out of it.

Fast forward to 19 months and in a way she's vastly improved as she's tried more things and has more variety but still eats very very little. For example, for breakfast she was offered buttered toast which she sometimes eats a slice of. Today she ate two mouthfuls and refused her banana. She had some whole milk mid-morning. For lunch she was offered crackers, ham, cucumber and grapes. She ate half a cracker. She had some fruit bread mid-afternoon. For dinner she was offered meatballs, pasta and garlic bread. She ate a slice of garlic bread. She was offered strawberries and cream for pudding but ate none.

I don't get stressed when she doesn't eat. She doesn't seem to feel that hungry or get whiney or anything. She weighs around 20lbs and looks tiny for her age. Her big sister was also slow to enjoy food but now, at 7, is a great eater.

Dp and I disagree on how to tackle this. He thinks we should let her eat whatever she'll eat and reason with her to try different things when she's older. I think we should offer her healthy things and that if she has no other options she'll be hungry enough to eat them. So the above example was her day with me. Dp looked after her on Sat and she ate crisps for breakfast, medium fries from MacDonalds for lunch and four chicken dippers for tea. On Sunday she was crying and banging at the snack cupboard for crisps and bringing me my shoes to take her to MacDonalds when she was hungry. I didn't give in but hate seeing her upset over it and think dp is being extremely unhelpful.

What do you think? Any advice?

If she is generally healthy, and energetic and growing (even if she's small) then the chances are she's fine. If those things are true I'd keep offering her a wide variety of food, not too much milk and let her get on with it.

Others may think differently but I only know one child raised the way your husband suggests and she has the worst and most limited diet of any child I've ever seen. Now 12 she eats chips, chocolate, white bread and oranges. Sometimes a little grated cheese - and that's all. So I wouldn't go down that route although I wouldn't force her to eat or even try new foods at this age - just encourage.

I agree with your approach. I'm a GP and I also have ds1 (now 5yo) with eating problems and extremely limited diet following severe reflux as a baby and feeding refusal. The background to him is that he learned that drinking milk caused him pain, so it was better to starve himself. He was in hospital 9 times before he was 1yo as he hadn't drunk for 24 hours and kept getting dehydrated. He didn't start eating until he was 15mo - after 5 months of two finger food meals a day, where he either didn't touch the food or spat everything out. Our biggest mistake, in hindsight, was to follow the advice of the SALT team who suggested trifle sponge fingers and meringue which would dissolve in his mouth and help him learn how to swallow. We went for the approach after that of giving him anything that he would eat. Subsequently we now have a 5yo who lives off chicken nuggets, sausages, chips, waffles, yoghurt, and cakes, biscuits etc. Trying to get any fruit and veg into him is a nightmare and we see the dietician every few months for ongoing advice about this. He has a fear of trying any new foods, and of textures that are not dry. Please don't feed your lo MacDonalds and crisps when she won't eat anything else, or that is all she will end up eating. I think you're doing exactly right by giving her variety and not fussing when she leaves it. If she has two bites of anything, at least that means she isn't afraid of it, and you can work with that to encourage her to have more in time. That is far easier than a child who simply won't touch anything healthy, believe me. Please show your dp this! Your dd won't starve or do herself any damage if she lives mainly off milk and small amounts of food for now (that was advice that we were given at the same age from a paediatrician who is one of the UK's leading experts on feeding difficulties in babies - and ds1 was very skinny, with weight 2 centiles below his height). All the best, stay patient (the key is patience patience patience...) and ask your GP for a dietician referral for some extra help and support.

Thank you for your replies. The food she eats (not everytime but ssometimes) are:

Crackers
Toast
Pancakes
Banana
Raisins
Yoghurt
Ham
Garlic bread
Chips
Chicken dippers
Pepper
Sausage roll

And that's it. At least she seems to eat a variety of textures I guess. I tend to offer her a couple of things I know she'll eat throughout the day but she has been known only to have milk and not eat all day at which point she gets clumsy as she must be so hungry hence dp thinks I'm cruel for 'starving' her. I think if she didn't have the prospect of junk from him every few days she'd begin to eat better.

I would probably offer some of the foods that she will eat every day, but with other foods offered as well. So if you let her have garlic bread, give her some pasta in tomato and veg sauce as well. And perhaps some grated cheese. Put it all on her tray and let her do what she wants with them. She might go months without touching the other foods but at least they'll look familiar and feel familiar. The age between 1 and 2 years is a typically fussy time and you may find that as she gets older she will start to try some of the other things offered. I would view poking at pasta or throwing it on the floor as a partial success. You haven't got a big repertoire of acceptable foods there, but at least you have a range, with a bit of fruit and protein in there too. My niece is actually a very good eater, but would never touch tomatoes. My patient SIL put them on her tray most days for months and months and one day she picked one up and bit into it. IMO the key issue is not what she eats right now, but encouraging her not to be afraid of food in the future. It is so hard at the time, as you have this constant gnawing worry that they won't eat, will never eat, and will get sick and not grow. But looking back I can see the bigger picture, and wish I'd approached it more like that with ds1, rather than giving in to chicken nuggets all the time.

She sounds just like my DS except he won't eat raisins or ham. I do exactly the same as you and continue to offer healthy- ish choices, alongside one thing I know he'll eat.

Some things I've tried recently with some success:
Yoghurt coated strawberries
Granola bars
Multi veg muffins (will post recipe link)
Whole apples
Chips made out of parsnips or carrots
Homemade chicken nuggets (chicken rolled in polenta and fried)
Sauté potatoes

It does sound very stressful and I totally agree with your approach of wide variety of healthy foods. Would you say she prefers very sweet and very salty foods generally? Does she have any problems touching the food? Do you think it's the look of it, the taste, the texture….etc that puts her off? How many times in 24 hours is she having milk and how much roughly?

and how is her sleep and digestion?

My DD was like yours and still has phases of not eating much. It used to drive me bonkers. She's a tiny little thing.

Sometimes she would have one bite, sometimes two, but she never ate much. A typical day would be one bite of toast, one spoonful of weetabix, a quarter of a banana, a spoonful of baked beans or a slice of ham and maybe a couple of pieces of pasta and a spoonful of yoghurt.

She was always worse when teething and still is.

One day something clicked, and we call her hungry Horace now. She's a few weeks off being 2 and eats nearly everything I give her and then some. She asks for food now, which I thought she'd never do.

If I gave her McDonald's fries and crisps during her non eating phase she would always find room for them, but was quite happy to function without. I must admit to giving them to her a few times when I was getting desperate for her to eat.

I found it helpful to write down what she'd eaten and look at it over the course of a week instead of a day.

My DS was like this and he barely ate. It was very stressful.

I would say DON'T go down the road of getting her to eat whatever, I tried this and as a consequence DS has a really skewed idea of what a normal portion of sweets or crisps is. He also developed the habit of eating in front of the TV which I hate :(

I tended to dish up food which is either something you know they like or something fairly similar/safe, or occasionally something new, but most of the time stick to safe foods. Leave it for a decent amount of time or until interest is lost and then nothing until the next meal or snack time. If you can stick to quite a strict routine of 4 hour meals with snacks in the intermediate 2 hours then this works well, and keep the snacks small. So if lunch is abandoned but she wants crisps, no, crisps are a snack food not a lunch food. And definitely not a breakfast food. I don't think that McDonalds and chicken dippers are bad, but obviously you can't give her mcdonalds every day. If she's associating McDonalds with Daddy then that's not fair on you, either - he needs to keep it for an occasional treat as well.

In my case I gave DS his dinner as usual one day when he was 22 months old and without any fanfare or reaction, he ate the lot. I tried very hard not to look surprised or cheer in excitement and asked if he wanted pudding. He ate three yoghurts! From then on, he never stopped - he would eat four bowls of cereal in a row for breakfast. He's still irritatingly fussy now at 5 and we are having issues again but it's nothing like it was, at all.

Are you still breastfeeding? If you are, don't stop, it will be getting a lot of goodness and actually a fair bit of protein into her, but in my experience it doesn't fill them up (and anyway, even if it did, the equivalent volume of breastmilk to pretty much any food is fantastic in terms of nutritional content.) And read the book "My Child Won't Eat" by Carlos Gonzales.

And with the meal/snack thing, I always made sure the snack was a snack, and wasn't a full meal, even if it consisted of more than he usually ate in a meal. It's supposed to keep you going rather than replacing the meal itself. I wanted him to get the idea that we eat at set times, although some people go down the grazing route - I found that when I enabled grazing he wouldn't graze on healthy things but sweets, chocolate, crisps, nothing particularly substantial.

One thing I did do if our DC eased up on the eating was to remove milk and snacks and then be flexible to move the next meal earlier if needs be. You can always add porridge just before bed if all her meals have shifted such that the gap between tea and breakfast is too big. I also left a plate of cut up veg around all day that they could pick on / look at / poke if they fancied it but removed it an hour before a meal.

That soon sorted them out.

oh and no biscuits / crisps / juice / cake etc - I find that all that just makes them want sweets/salt rather than normal food.

My gp told me that a portion of food for a toddler is the size of their fist. So my dd eats a tangerine - that's a portion and she will then be too full to eat a full dinner. If that is the case, and your dd ate the garlic bread, it is unlikely she would still be hungry for the pasta bolognaise. I would offer her the healthy options and no snacking and see how she gets on then.

Thanks for your replies. She has about two small cups of milk per day in between meals and breastfeeds at nap and bedtime. She doesn't like touching food at all, can't stand mess or the feel of it it seems. She won't poke or try anything new, sometimes she will try it if I offer to put it in her mouth for her but obviously that isn't ideal. If there's nothing she recognises that she likes on the table she'll just want to get down.

I put out some bowls of cheese, tomatoes, crackers, cucumber etc for elder dd and I to eat after school and dd licked the cheese and took a bite of a cracker but that's it. Still better than complete refusal I guess. Just need to get dp on board with not undermining everything I do! She only drinks water and milk, she's never had sweets or chocolate. Shes had the occasional bit of my cake or biscuit and likes them lots. She doesn't like anything too salty, even crisps - she won't eat salt and vinegar ones for example. She ate some dry rice krispies tonight when we were Making rice krispie cakes which is a brave texture to try I think, although obviously not the most nutritious choice! Going to try porridge again in the morning as it's been afew weeks. fingers crossed! Will get that book, thank you

sounds like DS1 2.7, lives on porridge, toast, fruit, yoghurt, mash and bloody apple juice. he's offered the same stuff as everyone else and ds2 13mo and dd 7 have no complaints! no idea what to do though.

oh and ds1 made dp feed him a pancake because he refused to touch it himself not liking the way it felt

With that info - I would take her on lots of nature walks, touch leaves, mud, sand, trees, wet grass and anything you can get her hands on. Also round supermarkets and get her to touch tins, packets, veg, packs of cheese etc etc and do lots of messy play and deal with the sensory side of things. Also as an activity you could sit her down with a blunt knife and a pile of mushrooms to have fun cutting things up :)

Other ideas are:
Make penne pasta necklaces
Hide items like farm animals in wet rice
Squidge wet pasta
Get her to help you make mash and she can lick the spoon
Get her interested in cooking actually - stirring on the stove (you hold her and her hand) etc etc

I would def remove the milk.

Generally - whatever you find difficult, do more of it!

Through our bombastic nazi approach, in a year, we have got our little one through his phobias of:

drinking anything other than breast milk
sitting on grass
touching grass
touching sand
touching food
touching snow
being on his front
only eating smoothies
loud noises
being in any position other than upright
having sticky hands
touching anything new
tasting anything new
going in swings
walking rather than being carried.

Criky - reading all that, I feel rather proud!

Telephone she really hates touching strange feeling things and just won't do it. She hates mess and asks to clean her even if they only got a crumb or miniscule dot of pen on her hands

'Just take a bite' is a book I've often seen recommended for children with oral aversion, so might be worth looking at too, OP.

I would give her a combination of what she will eat, and one new thing.

My DS had severe reflux, oral aversion, gastric dysmotility, sensory issues, little natural appetite. All part of a rare syndrome. He was tube-fed for four years, now eating a reasonable diet.

When he started eating (at four), he would eat chocolate fingers, bread and butter and chicken dippers.

He now eats mince, plain chicken, garlic bread, plain rice, pasta and pesto, pasta in tomato sauce (has to be smooth), also cheese sauce, fish fingers, kedgeree, grated cheese, egg mayonnaise, sausages, sweetcorn, bananas, green beans etc etc.

He will still gag if he sees earrings, or a messy hairstyle (!).

Where is her weight now on the centiles, OP? Could you ask for a referral from your gp, and maybe get some help from a feeding specialist?

Smuggler - I completely understand. Our little one screamed when he saw me about to ask him to touch all the things I listed below. I do think its worth doing. It's made a big difference for our little one in all sorts of ways and particularly eating.

Ahhh, see I hadn't noticed this as part of the issue with my 17 month old DS. I started a post today about him not eating and had a go at Ella pouches . I think the makers of Ella got onto my thread and took it really personally!
Anyway, yes he has a small list of things he will eat but it's his aversion to food that upsets me the most - he won't touch it or try it.

Mind you, he will wear a Spaghetti Bolognaise on his head, such is his enthusiasm for it.

He had reflux too. My other two had it also but they eat well.

So this book reflux, Just Take a Bite. Have you read it? If so what is the main thing you took from it? Any tips from it that stand out?

Well, no, I haven't .

I kept seeing it mentioned on here and looked it up on Amazon and thought how good it looked, but by then, I had sort of got over the hump with DS, so I have procrastinated. (I'm good at that.)

But the title and contents list resonated with me because when we took DS to see a world-renown expert in his condition last year, she had said this to him: Just take one bite of whatever your mum is cooking for your siblings. (Then fill up on bread and butter or whatever.)

It was different to the advice I'd been getting from the people responsible for DS's care here: When I'd expressed concern that all he would eat for tea was chicken dippers, they'd said, well keep feeding him that then.

The other book (My child won't eat) seems like it is more about reassuring parents that picky toddlers are getting enough, and taking the emotion out of mealtimes. (disclaimer: I haven't bought that one either!)

Which all sounds sensible, but not enough for my DS who had not physically eaten more than tastes of things (quite often nothing at all in a day) for four years, and who had huge revulsion issues with food, as well as an appetite that didn't/doesn't work properly.

(A young adult with DS's condition spoke at a recent convention and said that as a child, she permanently felt how unaffected children feel when they've eaten christmas dinner. But she felt like that even when she hadn't eaten for 8 hours.)

Sorry for the essay.