ASD and never feels hungry - How do I get ds to eat food?

[coppertop]

10yr-old ds (ASD) has always had a limited diet but it wasn't a problem because he would still eat. Until now.

Not only is he turning down more and more of his previous favourites, but the amount he will eat in a day is probably less than a typical toddler would eat. Breakfast on a good day is literally two or three mouthfuls. Packed lunches come back home with only a couple of bites missing from a sandwich. Evening meals aren't much better. Most of his calories come from drinking milk - and he only has a couple of glasses a day of that.

He just doesn't seem to ever feel hungry and so doesn't eat. I'm trying hard not to make it into a big issue but even dh is starting to worry.

The usual tactics just aren't working for him:

• Getting him involved with preparing food makes no difference. He enjoys the process but doesn't eat the results.

• Having food from/at school was a marginal success. He will eat his absolute favourite meal but hardly any others.

• He rarely eats sweet food (unlike me ) so can't be tempted with those.

• Apart from a milkshake now and then, he only drinks plain milk so no chance of giving him a meal replacement-type shake.

His logic tells him "Not hungry so won't eat". Perfectly reasonable for most people, but not when you're someone who just doesn't feel hungry.

His usual Paed is no longer there, and ds is on the priority list of another one. No one knows yet how long the wait will be. I'm not even sure what they can do for him. Is there even such a thing as an appetite stimulant for children?

He takes a multi-vitamin every day but it's not really a substitute for actual food. So how do we get him to eat food?

All ideas gratefully received. :)

I haven't read it all, but started reading this last night which may have some insight for you?

Have you spoken to the doctors about this. It sounds like some professional input could be needed as you have tried lots of different ideas already. Wishing you luck - sorry I have no answers.

My ds also struggles to eat. It's a real worry.

You haven't said if he is underweight or looks unwell.

Some children really don't eat that much at all - DD is one of them. She can live on what appears to be fresh air and fruit for weeks but she is generally in good health just doesn't feel hungry.

DS (ASD) on the other hand is constantly hungry.

if you're worried about his calorie intake then ordinarily I would suggest calorie dense but nutritionally sound food like avocado, oily fish etc, but when you're dealing with ASD then its a whole different ballgame I realise.

coppertop, have you read Can't Eat, Won't Eat?

it's quite good.

no answers (when are there ever any answrs? ) but some good strategies to try.

you say your ds will only drink plain milk - how much of this does he drink?

1. is he drinking enough? if you are slightly dehydrated, you don't feel hunger. I have spent most of my life not feeling hungry, and then fainting - because I don't drink enough.

2. if he is drinking alot of milk, it is very filling - it is possible he isn't hungry. not that he doesn't feel hunger (slight, but important distinction), but that he is already full.

if 1) then you need to work on getting him to drink more. I know what a pita this is (dd1 has issues with drinking - stopped for 9 months once). I'd work on another liquid - might as well kill two birds with one stone.

if 2) could you water down the milk? if he is filling up on milk, then if you can thin it out it might leave some room for food.

sorry, you have probably tried both those things. we did all sorts with dd1 when she stopped drinking - lots of playing with water, dripping it about, using a calpol 5ml syringe to squirt it at each other, and in each other's mouth etc.

it worked eventually.

she is currently not eating at school

no idea why. she is fine at home, and even eating new foods, but will not eat at school.

Thanks for the replies. Sorry to hear that others are having similar issues.

I'll have a go at answering the questions:

• It's genuinely difficult to know how/if it's affecting his health. He looks pale and thin and has little energy, but tbh he's always been that way. He has lowish muscle tone so seems to use up a lot of energy just by sitting upright, walking etc. he was like this even as a toddler when he had a fairly healthy diet.

Lately he's been asked a few times if he's feeling unwell, even by people who've known him for years and are used to his general paleness. He looks washed out and has dark rings under his eyes, not helped by his inability to sleep much (another thing to talk to the Paed about). He insists that he feels fine though.

• Does he drink enough/too much? Now that I'm really thinking about it, I don't think he's drinking enough. It's another thing that he has to be reminded to do, except for when he first gets home from school. I'm going to give extra reminders I think and see what effect this has on his appetite.

• Other drinks? Slightly tricky in that he will have specific drinks in specific situations. So only milk at home, but will use the water fountain at school and drink from a water bottle if doing PE/sports. It's worth trying to get him to use a water bottle at home, but this will definitely take time. One of the many joys of ASD. :)

• I've never read "Can't Eat, Won't Eat" but will find a copy on Amazon asap so thanks for that too.

It's the ASD that makes it so difficult to unravel. If it was my NT dd1 the first stop would be a trip to the GP to ask for a check-up and maybe a blood test to rule out anything obvious. Ds1 would go to pieces if a needle came near him. Even a recent straightforward dental check-up was a nightmare because he got upset by it all.

And I can definitely relate to the refusal to do something in one setting that they're fine doing elsewhere.

You've no idea how much this is helping. Thankyou!

Can you work on making smoothies, perhaps?

If they are more satisfying although he doesn't register 'hungry' he may register 'full' and this is a step forward.

My ASD DS doesn't register hunger very well and if he's having a busy day he doesn't really bother. If he more bored he will eat and eat - which kinda makes up for it.

Will also be buying 'Can't Eat, Won't Eat' - thanks for the tip.

Honestly? I have very low levels of hunger and from the age of 18 to 28 would subsist on most days on one packet of crisps or an apple until about 9pm when my DH would remind me I hadn't eaten and then I'd have some pasta or something. Before that I had my parents making me eat, which isn't meant to suggest that's all you need to do, just that I personally needed the guidance of someone setting out the meals as well. What changed was getting pregnant and realising that even though I wasn't hungry, I had to eat properly for the baby's sake. I still have low levels of hunger but am in the habit now of eating properly. And I like cooking and experimenting.

my ds used to be like that he was under weight too, his diet is extreemly restricted he only likes certain things in certain way as they do and cooked to a certain colour but now hes 10 DS is suddenly hungry and wants to eat constantly and is getting podgy as the things he wants to eat his favorites ie swiss roll (one in a particular wrapper only)and asks for them about every hour im not sure which is worse eating too little or too much

Spinkle - Ds point-blank refuses smoothies. I'm not sure if it's the texture or the taste but the nearest he'll get to something like that is a vanilla milkshake from McDonalds. (Now I want one too...)

Bullet - your description sounds just like ds! He'll eat a packet of ready salted crisps or a satsuma. Otherwise it's plain pasta, although he's even eating less of that now.

Bailey - I have another ds who sounds like yours. No shortage of appetite but only wants to eat one or two things. He's a nightmare just before a growth spurt is due!

Forgot to add a link to Can't Eat, Won't Eat just in case anyone else is looking for it.

With ds2 he gets dark rings under his eyes when he is constipated. He doesn't want to eat much because of the constipation, obviously, already full up! He also is much more lethargic, bad tempered and uninterested in chatting and communicating.

When he eats more sugary stuff every day he is no longer constipated and the dark rings go away. His cheeks pink up and he becomes his normal self, chatty, funny, more active and interactive with us.

He refuses to have roughage type food so I have gone with the fact that sweet things (Crunchies) help him stay unconstipated.

I give him tiny dishes with different things in each one and only cook hot food when he is keen and ready for it, so there is no argument about him ignoring and wasting it. I get upset by waste...

I hope this helps.