6 year old refusing to eat (underweight)

[Riverandrocks]

We are under a dietitian but so far things aren't working. He has a very limited diet so have been working on trying new foods. He has his foods I know he eat and a plate with some new foods on. Hes yet to touch them but now is refusing to eat anything. We are on day two off not eating. He's still drinking still.

He has adhd, behaviour problems and possibly asd).

I have similar issues with my 6 year old. She is nt but horrific with food.

What is your son's current weight?

I have no advice because meal times end up a huge fight most nights here but happy to lend an ear!

Which foods do you know he will usually eat? It's a lot harder for children with Sen particularly to cope with the change in routine and there's been so much change recently. Plus hot weather doesn't help with appetite in my experience. If possible I'd stop the new foods for now and stick to things he knows and is more likely to eat.

Last weight a few months ago he was just over 15.5kg and 108cm height. He's tiny but always has been the smallest in his class he also a August born child.

He will eat most fruits and veggies, plain pasta, chicken, Yorkshire puddings with gravy, yoghurt, custards, bread, ice lollies

Would he eat if you just gave him a plate with only things he likes on? His favourite things? I agree that with all the upheaval and change to routine at the moment that expanding his repertoire might not be the top priority. Maybe just focus on getting food into him and go back to working on the new foods once you're back on an even keel? Can he tell you what he would like to eat or make requests? Is there something he likes more than anything else, like a treat-type thing, that might get his mood for food back? Ice lolly? Some fruit and custard?

As above I would give him the things he likes right now and look at him trying new foods as a longer term thing once things are more normal. Or if you really want to do try now then maybe do it at one meal and just one new food and only the tiniest amount.

OK so he is a little lighter than my dd. She is 19kg, but she is a bit taller, around the 112 mark and also August born.

But your son eats a far wider and more balanced diet than she does so from that perspective please don't worry too much.

With regards the not eating, at 6 pretty much the only thing they have control over is what they eat. They have gone through SOOOOO much change in such a short time. Try not to stress, let him eat what he wants when he wants, it won't hurt. I have resigned myself to the mantra of "something is better than nothing" lately.

Dd will eat sausages, chicken Nuggets, pizza and red liecester cheddar. No veg, rarely fruit, no potatoes etc. So I absolutely understand your pain and frustration.

How is your son at understanding reasoning, so for dd she will eat a chicken nugget but not a plain but of chicken breast. It has taken years to get her understand that a chicken breast is just a naked nugget. But it is slowly sinking in. Would that maybe work with him?

I have asked him what he would like to eat to be screamed at "nothing" i tried a picnic in the garden for lunch time but he didn't want his bread or fruit he justing wanting juice.

Also forgot to mention food can't touch each other and he will only have a small amount off each never had a full plateful.

He can be fussy with chicken some chicken he won't eat as it feels funny.

@riverandrocks dd comes out with the same sort of stuff.

Silly suggestion cos you have probably tried it, but maybe try getting him to be involved in meal planning and cooking? Will he engage in that?

I would try not to stress over it, out a selection of what he will eat out, he either eats it or he doesn't. Don't argue with him or try to bribe him, just accept it for now and let him have the control for a little while.

So so difficult. I would stop all and any mentions or discussing of food or meal times. I would have meals and serve his but not ask him to join in, just carry on without referencing it. After you’ve finished leave his out for a period of time. Don’t mention it or even look at the food. Afterwards get rid of it quietly. Take every single bit of attention away from the food. Follow all his food rules, ie not touching, food he previously would eat and see if this eases things . You can always return to the new things at a later date.

The good news is that his selection is relatively healthy and quite varied. If he doesn't like food all at once, what about offering bits and pieces throughout the day? So some fruit at breakfast. Yoghurt an hour or so later. Some chicken around early lunch time. Maybe a bit of pasta a bit later. Yorkshire's for supper etc.

DD can be a bit irritating too but like your Ds she likes an okay variety if not idea so it's not unusual for her to get three meals through the day but in bits and pieces as she goes. She loves ham and cheese so she'll sometimes have ham and cheese with fruit for lunch but then some pasta for an early supper or whatever.

The issue of course is getting his weight up (we don't have that problem!) Does he like smoothies? Because if he likes fruit and yoghurt, a fruit and yogurt smoothie could work. DD doesn't like to eat first thing so sometimes I soak oats overnight in apple juice and then add them to a smoothie and she has that for breakfast.

It definitely sounds like a stress response. I agree with pp, give him access to the foods he will eat and take all the conflict/praise/attention out, that will hopefully neutralise the anxiety. There's a lot of 'for nows' about but severe constipation, dehydration and malnutrition are to be avoided in the current circs and they are especially likely outcomes if he is unable to choose his responses. I'd go with doing whatever he needs 'for now' even if it means doing away with all the usual rules.

Thank you all currently cooking pasta so I'd do him a dish and leave it on the table. I'm just so worried about him loosing more weight and having SS involved again.

I haven't tried smoothie but it something I can try once he's starting to eat. He likes more food that doesn't involve chewing so that might work!. He wee'd loads today but haven't had a poo so that'd also a little worrying

Could you get him a little apron and ask him to help you prepare and cook a meal? Make it more fun. Chopping, stirring, trying to work a tin opener, weighing ingredients that sort of thing.

Also put the food on serving dishes on the table and let him help himself. Sit with him when eating and do the same, serving yourself and have happy chatting about friends, what happened today - anything but talk about food! Let him take control of what he is eating and give him choice.

Take the focus off it and see if that helps. He will pick up on your anxieties.

Try serving a selection of foods in a muffin tray. One food per muffin section, and mostly things you know he will eat with maybe one other thing in one section.

Taking @lightlypoached'S idea s bit further, might he like to serve you your dinner? Good to have close proximity to food even if not eating it in order to break down the restrictions he's put upon it.

He will eat most fruits and veggies, plain pasta, chicken, Yorkshire puddings with gravy, yoghurt, custards, bread, ice lollies

I think that’s a very good diet even if he didn’t have SEN. If the problem is he eats tiny portions then you could just let him graze all day. If the problem is food touching each other then make meals Korean / Japanese style For everyone with separate bowls for each item.

DS lost his appetite after being unwell - to an extreme degree for over a week so the weight was falling off him (he was skinny to start with) and he was well into ketosis. A family member (retired nurse) said to give him whatever he will eat just to get him back into the habit of eating again, apparently they can "forget" and don't register hunger. In our case it was chocolate fingers and ice cream, he started with just a lick and it went from there, took several days eating just that and we never normally eat a lot of sweet stuff so I was a bit horrified but it worked! Might be worth a try with your DS?

I’d quit the new foods for a while. He has a varied enough diet that if the stress of new foods results in no food it’s not worth it.

Specific ice lollies? Or any ice lollies? If any you could make smoothies into ice lollies,

Will he drink milk or milk alternative? I was thinking you could make him really calorific milkshake by whizzing up ice cream in with it? Not ideal sugar wise obviously but will give him some extra calories. The Rolo dessert pots are really high calorie if he'll have those, they are similar texture to thick custard I suppose. You didn't mention eggs but eggs are good for calories, we do boiled egg mashed up in a cup with a good lump of butter, you could grate the egg to make it smoother.
I have a very fussy ds (age 7)who's currently having asd assessment so I've been through all this with him. It's so frustrating. Luckily my ds will eat certain cereal so if all else fails he will eat that on a bad day.

Also one of the things he will eat is thick slices of bread, again with real butter. He will eat cheese so I cut chunks of it.

The foods he will eat don't sound too bad. I would definitely stick with those for now, forget trying anything new. Try and get him back to eating anything at all. My DD used to sometimes push back and refuse to eat anything when I tried introducing new foods. I tried so many different ways. Until age 3 she ate mostly bread, sometimes with cheese and very occasionally an apple. Bread and milk were her main source of nutrition and I just reassured myself that both had vitamins. It was a very stressful time. She's better now aged 5 but still has a very limited diet. It is hard.

Thank you all I will be trying all the things you have suggested. He didn't eat his pasta but settled on half a banana before saying he feels sick and his tummy hurts.

Has he been referred to a child psychologist? Some hospitals have play specialists that can help with this sort of thing too

Wow! Compared with my 6 yrs old ds (suspected ASD) yours is amazing! Mine will eat cake, bread, pasta (sometimes), one type of cereal, tomato ketchup, chocolate spread, ice cream & milk. He will also eat Mac Donalds chicken nuggets but no other type. He won't stay in a room where fruit or veg is being eaten as he says he can't handle the smell. He weaned fine and ate a very wide variety of food at that point.

Back to yours - I wouldn't make food a battle. Feed him what he will eat especially as that seems to be healthy but I'd try to up calories - milkshake if he will drink it. High fat yoghurt and ice cream. Will he eat mashed potato? If so put plenty of full fat butter in it. Would he tolerate butter or fat on his pasta. Just basically look for anywhere where you can sneak calories in. I had anorexia as a teenager and this is what they recommend. Also there are meal replacement milkshakes for children which are added as a supplement. They're called ensure. The dietician can prescribe them if he's underweight and you could get them into him. Several flavours available.

My DD used to be a little like this, very fussy with textures and new foods and didn't eat large amounts. Really feel for you as it is frustrating and stressful! I think PP's advice below is spot on, but I know it's really hard to do! ...

So so difficult. I would stop all and any mentions or discussing of food or meal times. I would have meals and serve his but not ask him to join in, just carry on without referencing it. After you’ve finished leave his out for a period of time. Don’t mention it or even look at the food. Afterwards get rid of it quietly. Take every single bit of attention away from the food. Follow all his food rules, ie not touching, food he previously would eat and see if this eases things . You can always return to the new things at a later date.

I was also going to say, I think the health professionals can get a bit too hung up on weight and make you worry more. My older DD is a small build and used to barely eat any of her packed lunch aged about 5/6 - I think the school fruit and milk filled her up - but now she's 8 she does eat most of it as she's bigger. Now my younger DD (nearly 6) often doesn't eat her lunch, but catches up at other meals.

Also I'm finding they're naturally less hungry at the moment as they're obviously not going out / running around as much. So I wouldn't worry if he refuses the odd meal.

The other thing both of mine have always done since being babies is not being hungry if they've not pooed for a day or two - then once they have, they're hungry again! Only mentioning that as you mentioned him not pooing.

Overall I think the no-fuss approach is best, but I know it's really hard.