Skinny toddler & dietician advice

[onesteptwosteps]

Wondered if anyone had experience with this.

Dd has always been skinny (2nd centile) since dropping down two centile as a baby with reflux. She saw various doctors and dieticians and had special milk but never regained the weight and has since gone along on this curve. They are happy with that. To achieve this we have fed her as much high calorie/nutrient dense food as we can. She is not interested in eating so the main way we get it into her is using iPad and feeding her, which she accepts but otherwise she has two bites gets distracted and goes off.

She is now 3 and we want to try to follow dietician advice eg no iPad, we choose food but toddler chooses how much they want to eat. We want her to develop more normal eating habits and be able to feed herself. However we are obviously worried that doing this she will, on a good day, eat about half what she would eat if we fed her while she was distracted. Maybe less. A lot of the information suggests toddlers will eat what they need but this is hard to believe when they eat so little and are already tiny.

Does anyone have any reassuring advice?

Stick to a strict meal and snack routine so that she gets in the habit of eating at a particular time.
Keep her focussed on eating by talking to her about her food while she’s eating it. For example, while she’s eating broccoli, ask her if they look like trees. When she’s eating peanut butter, ask her if she thinks monkeys eat peanut butter etc...
Have meals as a family as much as possible, and insist she stays at the table until everyone has finished eating. If she’s sitting there but not eating, ignore her.
Start teaching her the importance of different types of food. She’s old enough to understand that food will help her bones grow, give her energy, make her strong etc...
If possible, meet up with friends who have children of a similar age who are good eaters and make a big deal of them when they are eating. Hopefully they will set a good example.
Get her involved in the cooking - for example, shelling peas or squishing burgers into shape.

Thank you so much, that's all helpful advice and reassuring that we are doing most of it already! And will continue to try all of it.

She will still only feed herself a few mouthfuls each meal though, even doing all of this! I've been told that this is fine and she will get what she needs. Is that true? I'm just worried she'll lose weight.

My ds ate very little, was easily distracted and very fussy. We found removing all stress and pressure from meals was the best. I would encourage him to eat a little more, try this, ooh isn't this tasty/funny looking/do you think panda (his snuggly) would like this? Etc. Some meals he ate very little. When he did this I would offer a small snack about 45 minutes later, cheese and crackers, peanut butter on crackers/apple slices, yoghurt etc. But with no pressure. I also found that a whole plate of food would be too much, he got very easily overwhelmed at the thought of having to eat it all. Instead while I was preparing his dinner I would give him a little pot of peas, then a few carrot sticks, then a piece of ham/cheese etc - all of which would have been on his main plate. Then when dishing up I could put down a handful of pasta and some bits of chicken etc and know that he'd already had something so much less pressure. Our number one aim was to prevent food becoming a battle. He is now starting to get much better age 6.

Thank you, that's helpful to know there ma be light at the end of the tunnel! Did your ds maintain his weight ok?

Good point about the full plate, I will try to reduce the amount.

Is giving a snack soon after dinner ok?? I thought that might be seen as encouraging them not to eat dinner because they know something else will be offered?

My DS was like this due to allergies and reflux. Small portions and allowing him to eat independently helped. We did a strict meal times with (mostly)no snacks apart from fruit as he would then refuse lunch if he had eaten in between. Lunch and dinner come with pudding of cake, custard to get as many calories in as possible.

The key, I think, is I always gave (and still do) food he likes. He has a pretty limited diet due to allergies anyway but at 8, is now has a massive appetite and very healthy diet. He's still low on the centile charts so I still have to monitor, add calories etc or he drops.

@ploumpima thank you that's helpful. In terms of pudding, was he able to have that irrespective of how much dinner he ate?

He stayed more or less the same line, he would dip then catch up. Pudding has always been offered regardless, it's not a reward, food isn't good or bad, just energy for growing bodies. My main focus was on not making food a battle ground so I didn't worry if he didn't eat all the dinner. As an adult I don't always want a full plate or to eat exactly what everyone is eating. My hv helpfully told me to watch what he'd eaten over a week rather than a day. Some days he ate much less, some days more. As long as a good balance was achieved over the week then it was ok.

Yes always pudding, it's just become part of the meal. Usually has fruit with it too, just to balance it out a bit.

Ok great. I think the main thing I'm struggling with is in general she's eating so much less under her own steam than she did before but I suppose the proof will be in the pudding (pardon the pun) to see if she follows her line. She's not actually that fond of desserts but I will routinely offer it.

Dessert are really just to add calories, if you could do that with olive oil, butter, cream, cheese or whatever she enjoys I would just stick with that and give her what she likes.

Guys she is refusing to eat any of her dinner, even try one mouthful even though we know she likes it. We've not said anything and just let her decide that.

How can we carry on like this though? She hardly had any breakfast or lunch either. I guess we just have to let her go to bed hungry 😭

My youngest wasn't so bad that he needed any professional intervention, but meal times were always a battle with him. He never ate a lot. Even now, he still doesn't and he's five.

I don't have the answers, but I think you just have to trust them to eat when they want to. One thing I will say is that I think with DS is it did become a battle of wills and I think he picked up on that. And that made him worse.

Can she drink any form of milk? I used to always give DS milk to drink to try and bump his calorie intake up. I do think he is like others posting, he is overwhelmed by a lot of food at once and I do tend to give him small portions now. He still prefers little and often.

It is hard and I used to want to punch people who said a child wouldn't starve themselves. They had evidently never met my son.

How is she doing today? Remember to look at how much she has eaten over the week rather than an individual day. If she hasn't eaten much I would give her a glass of milk and a rice pudding/fruit and custard/bowl of cereal for supper. Don't stress. Don't make it a battle. Hope today has been easier for you.

Thank you @ThatBitch

Actually she woke up at 4am hungry because she'd only eaten a pea for dinner, but then refused to eat either of the breakfasts I made for her (that she likes). I was at my wits end and I'm afraid I cracked and let her watch a cartoon while eating some toast. Lunch wasn't terrible but dinner didn't eat much at all. Offered pudding but refused it. It's clear she is prepared to starve herself! I don't think I can stomach allowing her to eat so little, she's tiny as it is

@fatted yes we do give her milk at bedtime although worried that she maybe holds out for that rather than eating properly?

I am trying desperately hard not to make it a battle of any kind but it's very very hard not to be worried and frustrated