At what point should you ask for help with eating issues?

[meerschweinchen]

DS, aged 4, is a ridiculously fussy eater. And it's not really a 'stage' he's going through, he's been like it since day 1 of weaning. In fact he was 9 months old before he'd eat anything at all.

People say he'll grow out of it. I'm really hoping he does, but do we just keep hoping he'll start trying new foods? Or should we be doing something now? I'm not even sure who'd I'd ask for help - doctor, health visitor, dietician?

If anyone else has been through this and has any advice, I'd be really grateful.

If it's as bad as you think then I would go to the GP and ask for a referral now. I wouldn't wait any longer. Just because it can take time to sort out help and obviously you want to ensure he is eating the best diet possible.

What is his growth like? If he's growing ok then don't fret too much - he might be getting enough to support his growth. If he's not growing and dropping centiles on the growth charts then the medical profession will likely take an interest.
I'm speaking from the perspective of a mum of a DD who eats little, is fussy, wouldn't wean onto solids and is barely the size of a 2yo at nearly 4yo. A paediatrician is monitoring her and testing for causes of short stature.

I would suggest a multivitamin if his diet is limited. Our paediatrician recommends one for all under 5s.

Can you do a food diary and decide how his diet balances over the course of a week?

We were told that even if a child eats the same things every day and those things cover the required food groups then they wouldn't be too concerned.

Thanks for your replies.

He's on the short side. When he was a baby he did go through a stage of being really skinny, which worried me even more. He's not now - think he weighs just under 15kg, which I believe is roughly 25th centile for his age. With regards to height, no HV has ever measured him, so although we do at home from time to time, and I can see he is growing, I've no idea where he is on the charts. I can see he's one of the shorter ones amongst his peers and age 2 trousers still fit him.

He's generally healthy and happy and full of beans. He bounds out of bed in a morning and doesn't stop all day. I don't know where he gets his energy from!

I do give him a multivitamin. Didn't realise they were recommended, but just do it because I'm worried about his diet. Glad I'm doing the right thing.

I think what worries me is that he'll eat plenty of the foods he likes, but anything not on 'the list' won't even be contemplated. I can't see how he'll ever start eating new foods when he won't even try anything new.

He does seem to have a really strong sense of smell and will often sniff things first. I can't really work out why that would mean he won't eat though!

I think what worries me is that he'll eat plenty of the foods he likes

So he's not 'not eating' - just picking what he likes.

Put it in front of him, say nothing, take it away. He gets nothing else. Do not give in.

Portofino - how many days do you refuse food to a child, if they don't give in?

As previous threads on this subject have shown, the cliche 'no child ever starves themselves' isn't actually true.

Saying nothing about what a child does or doesn't eat is great as far as it goes, but some children aren't just 'fussy', but terrified of new or different food.

Come on OP, tell us what he actually does eat.
I bet it's about 3x more variety than my fussy eater: who annoys me, but it's not a big deal, truly.
Does yours eat pasta?

As a pp said, can you give us an idea of what he eats in a day? I'm willing to bet he gets sufficient calories and an ok range of food groups if not in a day then over the course of a week.

I do sympathise with you on the fussiness. It's so hard as a parent to watch them restrict themselves but short of chilling out and continuing to offer new foods with no strings attached I don't think there's much to be done from the perspective of the medical profession. 25th centile seems fine unless he's dropping centiles. Can you measure his height/weight every few months and see where he sits against the chart in his red book?

2 books worth a read:

• My Child Won't Eat.
• How to Get the Blighters to Eat.

The first is a lesson in chilling out and trusting your DC to eat what they need, the second gives 10 rules of how to manage meal times without stressing everyone out.

NotCitrus - she is NOT refusing him food. He is eating - but only what he likes. Just put something new on the plate, leave, take away without comment. See?

I read somewhere that a new food needs to be offered 17-20 times as per Porto's suggestion.

Agree with Portovino, new foods should be offered but without comment or cajoling - see my 2nd book recommendation.

I personally find food issues really hard - we're currently mid-battle with DD who hasn't even come to sit at the table for dinner yet (we're long finished) - so my suggestions are certainly not coming from a smug 'it worked for my child' position!!

How does he react if you put a disliked food on his plate?

How does he react if you make him taste a disliked food?

What is like with food he's never had before - will he try it or reject it outright?

Porto you said put it (new food) on his plate. Give him nothing else. Do not give in.

Giving him liked foods at the same time is probably a good idea, but not what you said.

I've just seen all the replies. Thank you everyone for your suggestions.

To answer some questions

I don't think I ever said he 'doesn't eat' at all, but sorry if I gave that impression. I just meant he is extremely selective.

So, the foods he DOES eat:

Breakfast is the best meal of the day as he eats porridge or cheerios, shreddies, shredded wheat etc. Or toasted crumpet and jam. More often than not he'll eat the cereal dry, but at the moment he's in a porridge phase, so at least is getting milk.

Fruit - he loves and will eat pretty much any fruit.
Yoghurt
Cucumber sticks, raw pepper and carrot (recently only cucumber though)
French bread - as long as completely plain
Bread sticks
Rice cakes
Yorkshire puddings -dry, no gravy
Pancakes (with nutella)
Pasta, you guessed it, completely plain, no sauce.
When I make homemade pizzas, he'll eat plain pizza base (no topping), the same for pies made with puff pastry, so basically plain pastry
And that's about it, apart from, unsurprisingly, sweet things.

So no meat, fish or cooked vegetables AT ALL. No sandwiches. Not even the more 'junk' food things like fish fingers, sausages, burgers, chips. Just won't try any of it.
I wondered if it was a textures thing, as he loves to eat most things dry. Yet if it's pudding, he'll eat it. So he loves fruit crumble and custard, rice pudding etc.

Thanks for the book suggestions. I've read both of those - having read about them on mumsnet. I do try to follow their suggestions. We do try to be relaxed about mealtimes. We all eat together. We put food in front of him. If he complains, we always say he has two choices. He can eat it or leave it. He leaves it. We don't offer one food as a reward for another, we don't offer bribes. We don't withhold pudding if he hasn't eaten his main. Pudding is normally fruit or yoghurt, sometimes something I've cooked, like crumble or rice pudding.

We try to follow the rule of always having something on the table he does like. This is very hard though, and results in the following. We eat cottage pie and salad. He eats just cucumber. In 4 years he's had these foods offered 100's of times but just won't touch them.

So, yes, as Porto says, he IS just picking what he likes. But this seems to be where this approach of not stressing about it has led us. We keep offering food, he picks the bits he likes, and never tries new things.

I see other parents with completely different approaches. The 'just eat x more bites' or 'no pudding if you don't eat that sandwich' From what I've read, it's not really advised, but it seems to work for some people. I just wonder if we're being too relaxed and should be stricter? In my head, I'm not relaxed, I'm worry that I have such a fussy eater, and embarrassed when with other families whose children eat well.

I tried so hard to get weaning right. I read all the books, stuck religiously to the low salt and sugar rule, and yet he just wasn't interested. He was fussy from day 1. He did used to eat macaroni cheese, veg stir fry and baked beans, but hasn't touched any of those foods for 2 years now. Other than that, he's remained pretty constant to his plain pasta, plain bread etc

Sorry for the essay. I've read before on here of people saying they've had fussy eaters who eventually outgrew this phase and started eating more. I just can't see that ever happening, and wondered what else we should be doing?

sorry that really was an essay.
Lucky I can't make him taste a new food. He just won't. At most he may sniff it, but that's it. He'll just say he doesn't like it. When we point out the obvious, that he can't possibly know, as he hasn't tried it, he just repeats that he doesn't like it!

Wow, you have a 4yo who eats Pasta? Wow. Just wow. And pizza too?!

Oh, and fruit?! And CUCUMBER?!! Man, I have serious now.

With great effort mine eventually ate ham sandwiches & chips. Hang in there.

I went thru a phase of getting mine to lick things, even if he wouldn't eat them or nibble. Sort of helped.

He's a carb junkie (like DD)! DD's list of foods isn't too far off your DS's. I'd add cheese and sausage but take off a lot of the fruits.

It sounds like you've done a lot to help him already and you're being consistent in your approach which is important (and hard). It'll depend on his personality whether another bite or bribing with pudding will work. My DD is waaaay to stubborn for that.

I can't help but think that growing out of it (or not) is all that can be done. Maybe as our DCs get older they'll learn more about nutrition and choose to include some more foods as their palate matures. In both our cases DCs didn't even get those early tastes/textures of different foods so they're somewhat behind in that respect.

I totally empathise with the embarassment around other people - particularly my Dad! Unfortunately meals have so many social niceties associated with them that it's not really just about whether he fuels himself suffuciently. Is he at preschool/nursery? Does he eat the food there? What about the free meals at school? How will he do with those?

I'm 39 weeks pregnant with DD2 and dreading weaning already!

Lljkk You're the first person who has ever said 'wow' about his food list!

I think licking foods might be a good option. There's a chance he might do that. How did you manage to get yours to eat ham sandwiches? I'd be over the moon if he would eat a sandwich! And he's definitely stubborn too.

cant you're spot on. He's a total carb (and sugar) junkie. I worry about his lack of protein.

He's at preschool. The children all take packed lunches, so he does at least eat something, but it's really hard packing a lunch which doesn't include sandwiches. Before that he was at nursery, and just refused to eat most of their food. He'd eat a bit of malt loaf or crackers and cucumber at tea, but that was it. Absolutely none if the cooked lunch. He'd come home ravenous, but nothing would persuasion him to eat the food there.

I'm already worried about the food at school. I'd love him to eat it, but knowing what he's like, I think I'd better send him with a packed lunch. He's quite a worrier, and gets worked up about situations where he thinks someone is going to try to 'make' him eat something.

Congratulations on the impending arrival of dd2! I have a second child too, but thankfully he's completely different. He loves food, and my only worry with him is he's going to choke because he can't cram it in his mouth fast enough! DS1 treats him a bit like a dog sometimes, and I catch him feeding things he doesn't want! Am sure yours will be a better eater too.

You can get away with the 'one more mouthful' thing if your child doesn't have issues around food but it still isn't a great idea. If it starts to become any sort of battle that strategy is usually counterproductive.

Your DS sounds healthy and His diet sounds like it probably covers what he needs. If you're concerned about him missing out on some nutrients, you can do a food diary and have it checked by a dietician.

Healthy children don't starve themselves if the food is made available to them and they are left to it. There are some children with neurodevelopmental difficulties who don't fit in that category but that is very unusual.

His diet will improve as he gets older if you don't allow eating to become a battleground.

There's protein in milk and yoghurt, but also egg in Yorkshire puddings. Peanut butter and marmite? Whole grain bread also contains a goodly amount of amino acids and fibre - with fruit and cucumber you've got fibre and vitamins as well as protein covered.

So I guess it comes down to your child's personality and a year or two of really relaxing round food - potato printing, fruit and pasta painting, helping prep stuff, socialising with friends eating, etc. Though don't take my advice as my Ds is 6 and still eats much less than yours except does eat fish fingers and bland sausages. Still, as his response to new food and any perceived pressure is to curl up in a ball and rock and panic for an hour, I figure he's doing well to have school dinners and eat more than his slice of bread on most days. The professionals have basically said to try to reduce anxiety and wait for him to grow up, given he's otherwise growing well, not even to worry about multivitamins. We can even manage the odd meal out and have him behave ok at Pizza Express (eats garlic dough balls and dessert, dd eats the rest of a child menu), or local pub (eats bread and a few chips), which makes a big difference as DP and I love eating out.
His reception teacher tried teaching him about nutrition and importance of vitamins etc. It backfired as he pointed out how healthy he was and quoted packaging of foods he does eat...

Dd is nearly 3, eats anything if cut up small, though if asked to eat a mouthful of something before getting down says "ok" and does. Great relief - especially as Ds ate everything until around 18 months before shifting to bread-only.

I understand your worry about the protein. Although he's probably getting enough (for him) from his dairy. Just be sure your multivit has decent levels of iron - we give DD Wellkid vitamins which are good for iron and vit D.

Tricky with school meals. DD manages something from the nursery hot meals usually - maybe her repertoire is better than I think! - so think we'll sign her up for them. Could you check the menu cycle and sign him up on pasta days or ask if he can just have pudding/fruit so he gets used to the concept?

Thanks re DD2, it's good to hear they don't always follow suit. Another fussy eater would probably kill me!

Good luck!! :-)

I am terrified of new food. I like my food bland, I will never understand the point of mayo, vinegar, salad cream etc. I also don't like food swimming in sauce, or strong smells.

I have got better, especially in my early twenties it got awkward being the fussy one. I once gagged at a boyfriend's parents house, his mum was really offended, but it was out of my control!

My cousin used to hold her breath to try new food, I don't know if that is worth a try? I wouldn't have done it though, too afraid of tasting it when I breathed out.

It has taken me years to realise it is okay to eat a food I don't necessarily like but don't hate either. As a child, I think I didn't have that ambivalent setting.

Sorry, not much help, other than to say it did slowly get better. How bland is your cooking? My ideal bolognaise barely tastes of anything, DH can't eat it!

Your little boy just sounds like a picky eater my boys went through phases of this (only wanting plain foods separated) but as they got older will now pretty much eat most things you place in front of them, meat, fish and things covered in sauces! If they are hungry enough and it's a decent meal. We still have days that they state they don't like stuff but will eat up if they are hungry, they are aware that that's the only option.

Talking to other parents at school over the years and having visiting children over for tea. I would say that most kids are picky to an extent and enjoy 'dry' foods but most do grow out of it!

From the list you've made It sounds like you could make enough variations of foods he'll like. I often gave/give my kids different foods at meal times. As they were hungrier earlier than me and I'm a vegetarian and they aren't. So I made things that I knew they'd like and not family foods that they probably wouldn't eat. I know pandering to his food choices won't help him want to try new things but does ensure that he eats.

Oddly a lot of kids do just decide one day to try new things. Or even to take you up on your offer to try something you're eating.

I now have the opposite problem my kids now think that anything i'm eating is in fact fair game...and like to help themselves

I once took a food refusing 7 year old on Brownie pack holiday for the weekend. She was paeds referral and had anorexic tendencies. We (the Brownie leaders) had to have "training" to know how to deal with meal times and food issues with her.

She would only eat chocolate things and we were under orders to give her a choice of chocolate foods (provided by Mum) at every meal, never force 'proper' food. Encourage her to sit with others at meal times but do not force this. Other things like this.

Mum had provided chocolate pop tars for breakfasts (ewww). It got to breakfast and this girl sat at the table with 15 other Brownies. Toast and cereal were help-yourself on the tables. As we were preparing poptarts for this girl, we found she was helping herself to rice crispies and without a word or backwards glance, followed this with toast and butter.

The same followed for lunch and dinner times too. We just let her decide if she wanted to join the que for food with the other girls, and she always did. She not only ate, but she ate A LOT, her appetite was massive.

OP - Maybe when your 4 year old is at school, you might notice him eating better with his peers if he stays for dinner at school. It is amazing what eating with peers can achieve.

Great advice from Fatedestiny.

My very fussy DS was very similar and would only eat specific things that he liked. I refused to do him a packed lunch and he had school dinners. I was dreading him refusing to eat them, but he did. I was amazed. He sometimes has a moan about some of the choices, but he does always find something he likes.

His best friend was the fussiest child I had ever met with food. His Mum decided to put him on school dinners and has never looked back. Peer pressure and making his own choices has made a huge difference.