Extremely fussy toddler getting too thin

[MogwaiTheGremlin]

Hello

Sorry for long post but I need for some help please.

When my ds was weaned he ate pretty much anything and had a big appetite. About 6 months ago he got a really nasty tummy bug and was quite poorly and lost a lot of weight. When he started to get better I gave him plain foods like toast, banana etc but when I tried to reintroduce a wider range of foods he refused to eat them.
He's now 20 months and has an extremely limited diet and won't eat many things he used to love. All he eats is:

Bread
Cereal (eg rice crispies, cheerios, frosties )
Plain pasta with a tiny bit of butter
Yoghurt
Banana, grapes, raisins, nectarine
Scrambled egg / plain omelet (occasionally)
Ham (occasionally)

He will eat plain snacks (eg bread sticks, rice cakes, plain oat bars) and as an occasional treat he will have a plain croissant or a plain cookie.

Everyone said it was just a phase and he would grow out of it but it's not getting any better and he's starting to look a bit thin. I always eat with him and serve him a small portion of whatever I'm having but he refuses to try it. I then give in and let him have plain pasta or something. He won't eat restaurant food or anyone else's cooking so it's not just me. I've tried having play dates at meal times but he refuses to eat what the other children are having and just goes hungry.

Does anyone know how I can get him to eat better? Does he need to see a doctor and, if so, what should they be checking for? Given his limited diet should he be taking some kind of multivitamin?

Thank you

I also should have said he has approx 14oz / 400ml of full fat milk a day.

Thanks

Please don't take this the wrong way, because it is crystal clear you have responded in the only way you could following his bug, but do you / have you pandered to his fussiness? Has he got used to dictating what he eats?

Have you tried the eat this or eat nothing approach? Obviously start with something familiar with an additional new thing, like cheese on toast instead of just toast or ham omelette in instead of just an omelette? This is a brutal and at times horrid approach but it sends a message that this is what you need to eat. He will probably protest very loudly (make sure the windows are closed!) but if you stick with it you should be able to break the pattern. Tough love his hard but the outcome is worth it.

Also be aware the his body may not be able to cope with a lot of protein or fat to begin with so start gradually.

Thanks Odyssey and yes I do think I'm partly to blame. But I really hate the thought of leaving him hungry - especially before bed - and I wasn't sure it was fair to suddenly get strict. He's used to being given something he likes and 20 months seems v young to understand the 'eat what you're given' mantra. Eeeeek tough love sounds tough!

I think the issue is the giving in and giving him what he will eat when he won't eat what you've served, though it is understandable why you do this. What happens if you serve a meal that incorporates something he will eat along with things he won't, but where the things he will eat aren't quite enough to stop him being hungry? While I do believe you should cater to children's tastes, that's not to the point of letting them entirely dictate exactly what they should eat all the time.

If you are worried about his weight it would probably be reassuring to see a GP. However toddlers do thin out at some point - ours is (currently) eating well but she is still thinning out.

Ive been through various phases like this with my toddler. I would also do the tough love approach as described above as it does seem to work. If he misses a couple of meals then it doesn't really matter.
My additional tips would be:
For now, only give him milk at bedtime so he doesn't fill up on it throughout the day
Don't give him a drink with meals until he's at least half way through (otherwise they fill up on fluid and wont eat!)
For now, don't give him snacks throughout the day
Don't make any fuss or drama if he doesn't eat (even if it makes you really anxious).

DS is similar with refusing to eat. He gets a bottle of formula at night so I know he's getting vitamins and minerals.
I just try not to make a big deal about it. I feed him what he likes but offers other things as well. Get him weighed by a HV or GP and see what they advise.

Thanks all. To answer your questions...
If we're out/at someone's house and he doesn't like what's served he simply goes without. If we're at home I give in and let him have something else - so that's obviously what I need to work on.
If I incorporate other things into his meal (eg ham, mushroom, tomato omelette) he just picks them out. But if it can't be picked out (eg any kind of sauce on pasta) he won't even try it.
I doubt he would be classed as 'underweight' but I should get him weighed anyway. My family are all long and thin so I think he's naturally built that way. I'm more worried that he doesn't get enough vitamins / minerals so maybe I should switch to formula at bedtime rather than cows milk.

A vitamin supplement would probably work out cheaper than formula - all children are supposed to have them up to age 5 anyway, if they aren't on formula.

Thinking he looks a bit thin isn't the same as his weight being a problem, but if it's worrying you, definitely get the HV to weigh him and see where he is on the charts.

He was ill for 2 weeks and ate/drank nothing so I had to syringe rehydration solution into him every 20 mins. But that was 6 months ago so he's definitely better!

Ok thanks. Does anyone have recommendations for vitamins? Is it just multivitamin drops I can get from Boots? Clueless sorry.

Supermarkets sell a wide selection and they all seem slightly different, which isn't much help! You can get ones which are like gummi bears if you think they'd be more likely to be accepted. My DS has Abidec which I think smells vile, lemony, but he seems to like and he's very fussy!

Mmmm sounds great thank you

My DD was extremely fussy with food but this coincided with chronic constipation. She takes movicol regularly now and her appetite dramatically improved.

We use the Wellkid Baby and Infant liquid. Both Boots and Superdrug sell it. It has iron in it which, considering his diet, is probably a good idea. Not all drops / multi vitamins have iron so watch or if you go for something else.

Don't think of this as about blame. You did what you needed to do. Don't beat yourself up over it. Move on and in the right direction.

It sounds like you know what to do just be strong. We have a very willful 3 year old who went on hunger strike for 26 hours one day but he caved in the end and has been 100 times better since.

Explain what is going on but him understanding isn't as important as you being consistent. That way he will learn what to expect.

once you establish that his health is fine and this is just toddler fussiness, could you try regularly letting him "help" you while you are cooking?(Apologies if you already do).
My ds always tries 90% of the ingredients when we are cooking, even if they are something he used to like but wasn't eating anymore or things he said he didn't like without having tried them.

He loves cooking so I let him 'help' prepare meals but he doesn't bloody eat them!
Off to buy vitamins today and then will start my tough love approach. Am going to do as someone suggested and gradually add one thing at a time - so tonight he'll have pasta with cheese sauce or nothing at all. Eeeeeek!
Presumably if he won't eat the pasta he doesn't get pudding (usually fruit or yoghurt)?

I'm trying that if DD doesn't make any effort at all with the main, she doesn't get any dessert. So in your case, if she at least tried some of the pasta, even if she then spent the next ten minute digging around to find the pieces that have the least cheese sauce on them, she would probably get some pudding. If she refused the pasta outright but ate the vegetables, without screaming about the pasta, I'd probably give dessert. Any throwing of the plate means she's not hungry and doesn't get anything - but part of that is leaning manners to, that it's ok to not want to eat a particular thing on your plate but you just leave it, you don't lob the whole lot on the floor.

It feels very difficult to know where to stand on the pudding issue and sometimes it feels like withholding pudding for good or bad behaviour, which I don't really like to do. But I'd take your cue from his behaviour and response to the main. Is he able to say something like "I don't like it"? That can help, as we've encouraged DD to say that it makes it clearer why certain things are being rejected.

Try and give him food which is separate. So little bowls with nice chopped fruit and veg in one bowl, pasta in another, blocks of cheese in another etc. If he doesn't like it mixed maybe it is because he wants to know what is what.

My ds in particular was like this - he preferred meals which were not mixed up.

Now he's fine (4 years old)

Lots of good advice above. I just wanted to add one thing.... get him weighed. You might be worried about nothing (regarding his weight, not his eating habits). They do start to look skinner as they get older as they stop being babies and head towards being adults. if he is tracking his percentiles then I really wouldn't worry. The food becomes a control thing, subconsciously on their part. They know it matters to you, and that they can control this aspect of their lives (they don't really have any control over anything else). So they make a night mare out of eating. I had one like that who at 4 is much better. And one aged 15 months who I am determined not to follow in his footsteps.

Urrrgh epic fail

DS totally refused pasta with cheese sauce. He just sat there screaming and getting more and more frustrated/upset because he was v hungry (did the no snacks thing - so he'd had nothing to eat since lunchtime.) I gave in again and he ate a good portion of plain pasta. He then ate some ham but wouldn't eat it mixed in with the pasta - it had to be separate.

I gave him nectarine for pudding and some vitamin drops so by his standards that's quite a nutritious meal.

I just don't think I'm strong enough to put my foot down and watch him get so upset over mealtimes

Ps definitely going to get him weighed. He was 90th percentile as a baby so I think i just need to get used to his new leaner self! Fairly sure he wouldn't be classed as underweight but would be nice to know where he sits

Our DD is 4 1/2, as tall as all her friends, but only weighs the same as my friends average weight 2 year old (despite being a chunky 8lbs newborn). Both DH and I are naturally slim so it almost stands to reason that DD would be the same. Could there be something similar going on here?
Honestly DD is a fussy eater and has been since she came off the purees, basically eating similar things to your DS. We top her up with a multi-vitamin on our doctors reccomendation and just encourage her to try new things. We don't force her to eat what we eould rather she did because IMO (and experience) that's just going to lead to negative association and food aversions. When she tries new things she is highly praised and when she doesn't we just ignore it. As she is getting older, she is trying and liking more things. Something that has really helped is when she sees her friends at preschool eating different things.
By all means, go see your doctor, but try not to stress and worry too much. My sister was a fussier eater than my daughter (my parents dealt with this in the same way we deal with DD's fussiness) and although naturally slim, she's now very tall, healthy and loves all kinds of foods.

DS is a horrible eater and won't eat much. We reward him eating by letting him watch Andy's dinosaur adventures while eating. If he stops eating Andy is turned off.
It doesn't help with the variety but now he'll actually eat something without a major battle.