Anyone been to a feeding clinic?

[Arabica]

DD (19 months, GDD) doesn't eat solids anymore--she stopped eating in November/December during a bad cold, and hasn't ever regained her interest/appetite. She has had a succession of colds/viruses ever since, but is on the mend at the moment and nothing has changed.
She exists on a high-calorie formula called paediasure plus which provides just about enough calories, although she is slipping down the centiles.
Our dietitian says although the formula might take the edge off her appetite it's unlikely to be responsible for the complete lack of interest.
We've tried all the strategies we can think of: ensuring that we are not stressing out a tmealtimes; offering food to play with and not fussing if she spits it out; offering food first thing rather than milk; but still nothing is going in. And I mean, NOTHING. Not (as I read on another thread) a Weetabix for breakfast then nothing, I really mean absolutely bugger all. Maybe at most 2 or 3 sneaky spoons of yoghurt when we distract her attention, and a sliver of cucumber to nibble at and then throw on the floor. Otherwise she'll put the food in her mouth and then just let it fall right back out again.
So now the dititian is going to talk to the paeds about what to do next and maybe get her on the waiting list for the feeding clinic at GOSH. Anyone been/have experience of a similar clinic--or got any ideas to help me before DD loses even more weight?It's ironic considering I have a history of compulsive eating and have been struggling to lose weight ever since she was born!

There's a good book called 'can't eat won't eat' published by jessica kinglsey. It's about autistic children not eating- but probably the issues are similar/identical (sensory at a guess and perhaps some motor). It also describes some of the stuff that the GOSH feeding clinic recommends. I think you would find it useful.

As a way of encouragement ds1 used to have a very limited diet. he would go an entire day without eating if we gave him an unacceptable food. He now eats reasonably well. I would never have imagined that as a possibility at one stage.

Arabica - hi. dd has always had eating issues; we used to see the dieticians at Birmingham but not a feeding clinic as such. She was ng fed so getting the calories in wasn't a problem but getting her to actually take solid food was. Because of the tube we could afford to be relaxed about it although there were HCP's who thought that the tube was actually the problem.

You sound like you are doing all the right things - the food play is probably the main thing you can do especially if it's a control or sensory thing. dd would not allow anyone else to put things in her mouth (probably a reaction to the having the tube, weeks of vent/suction?) so only improved when her motor control allowed her to this herself. She went through a 'beige phase' at around 2 I think. I can laugh about it now but at the time it nearly pushed me over the edge TBH.

Did she eat well before? I do think that the high cal milks can take the edge of the appetite but it's a hard choice to back off with it and risk hard earned weight dropping off.

An online friend of mine took her child to a clinic in Austria for help with his feeding issues. He was tube fed but there was no medical reason why he wouldn't eat. The Professor who runs the clinic has done a lecture at GOSH and I believe that they are using some of her techniques. There is some info here and you may find some ot it helpful even though dd isn't tube fed. The basis of it is letting the child get hungry (tough one this) and giving the child autonomy so nothing really revolutionary to my mind.

You have my sympathy Arabica - nourishing your child is a real basic instinct and when it's not working - for whatever reason - it's very stressful.

It must be very depressing. If she will eat a small amount of yogurt, could you focus on just that and forget about real solids for a while? My DS had a phase at about 14 months when he was down to yogurt most of the time but now he eats very well. Grated cheese and grated carrot worked well too - or anything that is closer to melt in the mouth texture.

Yes - it's not very 'mumsnet' but dd's only solid foods for a while were quavers and chocolate buttons.

Thanks--I have tried everything I would never have fed DS at this age, including Quavers, Wotsits, chips, pizza, chocolate buttons, muffins, cream cakes, tomato soup (the canned sort) and baked beans.
Saggars, I saw a documentary about the feeding clinic in Austria and thought it was fascinating. I've just read the clinic info, though, and it seems very specific to tube feeding and children who have never eaten solids. DD was only tube-fed for her first five weeks. Then she kept ripping out the tube so we asked if we could give up. I used a combination of breastfeeds (she didn't really get any milk but I think it was comforting for us both). Then she began to eat solids, but doesn't any more.
Moira, I would try and give her yoghurt and forget it, but she's just not eating enough of it. Three spoons of yoghurt today, and one nibble of toast.

Thanks for the recommendation yurt1. I think DD would like to eat the washing machine and the shiny silver kitchen bin--she's always trying to chew them. Have even considered covering them in Nutella. That's how desperate I am.

my ds (nearly 4, non verbal with Quad Dystonic Cerebral Palsy)stopped eating Xmas day 2006 and didnt eat again till we passed an O'briens during the Easter week 2007 and he started making loud noises and looking over at it, we went in bought him a cheese toasty and that was him eating again

during the time he wasnt eating he survived purely on 3 or 4 cartons of pediasure a day until we discovered (just before easter) that he had a milk protien intolerance!
cue loads of vomiting on the pediasure!

he ate well all year but around xmas again this year he got very fussy and will only eat certain things usually junk, specifically KFC, chinese or indian curry or pizza!! if we manage to get him to eat anything vaguely healthy he just throws it back up something he never does with the junk food

the doctor reckons its his way of controlling things and as he cant use his arms/hands or speak then this is his way of being in control, needless to say he is rapidly losing weight and is now on the list for a PEG, not because he CANT eat but because he WONT eat, this will make sure he gets all the nutrients and calories he needs and he shouldnt loss his swallow reflex as we can still give him the foods we know he will eat while knowing he is getting what he needs throught the tube.

doctor says this will take the pressure off at mealtimes so that if he doesnt eat the carrots, potatoes etc we can take it straight away rather than trying to force it into him and maybe after a while once he sees he isnt in control he MIGHT start eating normally again and if he does the tube is totally reversible.

incidentally every time he stopped eating it was during/after a cold, doc reckons the cold puts him off eating which then upsets the balance of acids etc in his stomach and makes him not want to eat so its like a viscious circle, she recommended small meals and often to get him eating again which did work until the stroppy controlling toddler phase kicked in!

That's interesting about the control issue. I don't think paediasure makes DD vomit, though, because she only does it when she has a lot of phlegm.

And the small meals don't work as she doesn't eat anything so we only put the teeniest bits of food in front of her (eg one slice of kiwi, one cracker, one Wotsit)

Hi Arabica. I am the mother of a 4 year old Paediasure addict, so I know where you're coming from.

If it helps, dd at 4 is very much on the 50th centile, however at 9 months she was around the 20th (she is on the 95th for height) and I was getting lots of pressure from peads. I recently had to start letting out the elastic bands on her trouser waists, which was a first for me!

Eating has got better over time, as dd has developed. I think she found chewing really hard.

Wish I could say something more helpful other than in dd's case it has got heaps better (as has her weight).

I found this book really useful:

Eating & Drinking Difficulties in Children

Thanks chonky! Amazon say it's out of stock but I will search for this book in the library/elsewhere.
Could you remind me what dx your DD has (if any)? Sorry if you've already mentioned it. I'm a bit concerned that children who go off the idea of eating at DD's age (around 18 months) generally seem to be on the autistic spectrum--I didn't think DD had any relevant symptoms.
DD ate a raspberry today! One whole raspberry. We were so pleased. She also had about 6 spoons of yoghurt and a slice of cucumber--a good day.