[MissDaisyofTexas]

Hi..we've been home for about 2 weeks now, and I could use some advice. Our son was a very good eater for the 2 weeks that we had him in the hotel in Russia. The day after we got home here, we took him to the IA doctor, she asked if he had any eating problems, we said no (because we thought he didn't). However, now he is very stubborn about eating. We try to feed him 3 meals and 2 snacks a day (what our doctor told us to do), and usually the first thing he does when he sits down is push the plate or bowl away, even if it's something we know he likes and has eaten well before (like mac'n cheese). If we continue to sit there, he might take the bowl back in a few minutes and eat, or he may be stubborn and not eat anything at all. It's almost like he's testing us to see what he can get away with at the table? We don't want to force him to eat, but he is a really tiny guy and he needs a lot of calories.

Our in-laws were here this weekend, and they said we should feed him junk food all day long because "calories are calories". He will eat several packs of those gummy fruity snacks, but if we give those to him non-stop, how can we ever expect him to be hungry for something at a meal (or something with protein?)

We've tried to eliminate distractions while we eat--clear away the toys, turn off the tv...but we really get the impression that he's just too busy/having too much fun to stop his day to eat.

Anyways, just wondered if anyone has any experience with this or advice for us. I'm thinking it's probably best to stick to his meal/snack schedule, and if he's not hungry, then maybe he'll just be hungrier at the next sitting.

Thanks!
PS--we've had him tested for parasites, and his tests came back negative.

[cindyc]

Hi Miss Daisy. Welcome home with your new son.

We've been living this issue for the past 2 years. My son, adopted at age 12 months, STILL eats very, very little. He initially put on a pound a month, but he plateauted after about six months. We, too, had the tests done, but he's fine there.

My older daughter, however, happened to observe my son being force fed in the orphanage on trip 2. That experience seems to be a lot of the problem. We've dealt with this by keeping a calm, quiet environment while he eats. We also play a favorite DVD or show to keep him sitting at the table longer. I agree that junk food is not the answer. We try to give him cheeses, higher fat yogurt, peanut butter, and some other things that pack on a few more calories, but no junky stuff - his few bites are just too precious.

Good old Dr. Benjamin Spock's book had the best advice that we got. He has a long section on anxious eaters and how to get them to eat. I highly recommend it.

With that said, I should also tell you that an Eastern European friend looked at him and shrugged, "he's a skinny kid." She is a coach and pointed out that both my domestically adopted daughter and my 3 yr. old eat little but are very strong and athletic. (And I have to admit I've never worried about my daughter - she's just little and always has been.)

Our "fail safe" measure is to offer our son a sippy cup of whole milk mixed with vanilla instant breakfast. He almost always takes it, and it gets some nutrition in him if he doesn't eat anything at all at the offered meal.

Very best wishes. Let us know how the appetite comes along!

Cindyc

[randloar]

Ahhh, we can relate to that one!! Our 3 year old ate everything we put in front of him while in Moscow (veggies included).........since we have been home we went through what you are describing (and are still having issues but they are morphing). At first when we got home he barely ate, then got real annoying (best word I could think of) as everything became a game in his effort to control mealtime........still dealing with parts of this....BUT, since home, not a green thing has passed his lips and we had months of sooooo much mac-n-cheese that the smell started to get to me. Everything he loved he stopped eating and ate very little........

We didn't fully give in to the sweets (using the calorie is calorie logic) and let him start to get a little hungry.......eventually he started to try stuff but didn't mix flavors at first and what worked best for us was for him to not even know we had the carb (mac/pasta) ready, but to hand him pieces of chicken or whatever, get him to eat some of that first, then offer the second course of his favorite flavor........

Now 6 months later, we feel we have broken through on some level and he will try lots of things (we also are working on the no-thank-you-bite) where he is learning that he has to try what we offer and if he doesn't like it, he doesn't have to eat it..........it has found him several surprises he likes that he started off saying no to.......hoping to get to those veggies soon!!!

Hang in there, and know that he doesn't need much food to stay okay (our doc assured us he will eat when hungry), and also agreed that for ours there was some control issues going on (can't blame him, he finally has the opportunity for some control and is enjoying it) and we just have to outwait/outsmart hime!!!

[MamaChinch]

Randloar is right, they do not need a whole lot to keep going, and if your little guy is drinking milk, he is probably getting enough protein from that.....but this sounds all too typical !
Delaney ate everything in sight in Moscow and for months after coming home, now she is trying to pull the control thing. I think some of it in all these caes is a mixture of things... is control, is distraction, is that their little taste buds are constanly changing and sometimes their systems may not match when we are hungry. All this combined with their orpahnage experiences.
Sometimes Delaney will take a few bites something I know she likes and tells me she's done. I will tell her take another bite or two and she will, then I let her be done but make her wait until the rest of us are done eating to get down from the table. Sometimes she will end up eating a lot more. Other times, I say okay, but if she tells me she wants to eat a little later, I give her the same plate of food.
I think this is a quandry for a lot of us with toddlers and some of it is also just that....they are toddlers! UGH!!! You son may also just need the time to figure out this is the schedule. He has gone through so much recently, you may just need the luxury of time.
I wouldn't give in to junk food either, if they are hungry, they will eat fruit or veggies. Delaney will tell me she's hungry and wants candy or cookie and I will tell her if she is hungry you can have an apple or some carrots. I like to give her a choice of things I am happy with either. If you let him choose between two things, he may feel like he has some control and eat more. But at least you can choose between two things you can be happy with.
I am sure it will work itself out, you have not been home that long. Oh, along with what Cindy said, I put formula with milk in a sippy cup for her for her first six months home on my IA docs recommendation, if oyu are worried about making sure he gets enough nutrition.

[Kama]

I do not think this is necessarily a long term issue. We brought a 4 and 8 yr old from Poland last year and they refused to eat anything we put in front of them. The 8 yr old was more difficult, but our 4 yr old daughter was difficult as well. We did not have any problems in Poland - they were considered to be good eaters. In our case, they were just stubborn and we think this was a reaction to transition and adjustment to a new life situation, asserting their independence to a degree. With the 4 yr old, we would just explain to her that to be able to play, watch TV or whatever, she first needs to eat. We would feed her (that worked sometimes) and tell her "this spoon is for Mama, this spoon is for Tata (Dad), this spoon is for Zoe (family dog), etc." We did do McDonalds once a week or so, now we do not anymore, but that helped to make food fun since all kids seem to like it. We did not let them eat too much between meals, so they were hungry when it came to the main meals. We did prepare things we knew they liked, such as scrambled eggs, quite often. The key is to try a few things (bribing with sweets, toys, etc.) and finding out what works for him specifically. With the 8 yr old, we actually sent him to bed hungry once because he refused to eat what we offered, and wanted something else. He has never refused again. I do not think this would be appropriate for a 3 yr old though. I also started to cook simple things such as spaghetti, with my own pasta sauce (simple one: fry cut onions with garlic, add ground beef, then tomato sauce and some more spices). They absolutely love it and of course it is fun to eat noodles. They also like pizza, especially simple cheese pizza. I have never had luck with macaroni and cheese, by the way. They have rejected it even though I bought those with funny shapes, such as Scooby Doo. Good luck, it will likely get bettter!

[Kama]

One more idea: I think Russian food is to some degree similar to Polish food. Our kids just loved mashed potatoes with lots of butter in it... But they refused to eat the powder that is mixed with water, it has to be the real potatoes boiled and mashed with milk and lots of butter. We would serve this with chicken nuggets or broiled chicken. As a veggie, they like good cut tomatoes with salt and pepper. I think potatoes would be a good way to fatten your sweetie as well . By the way, I have seen your son's photographs, and he is a handsome little guy. Congratulations.

[waiting_for_nicholas]

Well I don't have my kids yet, but I have worked with kids this age for years & years. Adopted or not alot of kids go through a stage of not wanting to eat. My niece did this when she was around 3 and still will do it every once in a while. Her mom kept taking her to the doctor & he told her she would eat when she got hungry enough & not to worry too much about it. Hope this helps!

[sak9645]

For MOST children, the general rule of "he/she will eat when he/she is hungry enough" works. If a child refuses food and begs for candy, it's OK to say no. Or if a child demands potatoes, and then refuses them when you provide them, and asks for rice, it's OK to say, "Gee, I guess you aren't hungry for lunch. Maybe you'll be hungry at dinner. For now, I'll just give you milk."

HOWEVER, there are some children with feeding disorders of one sort or another. Some children, for example, have texture avoidance problems, where they refuse anything but liquids or purees. The normal strategies do NOT work for these children. Many will actually refuse food to the point where they do not grow.

I adopted my daughter from China; she was 18.5 months old when she was given to me. From minute one in China, I knew she had food issues. She refused every single food on the Chinese buffet at the hotels; however, she did accept certain American foods, such as soup, bread, and milkshakes. She weighed only 17 lb.

I thought things would improve when she got home, but they did not. She would turn her head away in disgust from most foods. She would eat only a few things, and then only certain brands. If you tried something new, or made something from scratch, such as soup, it would be refused. As a result, she failed to grow. Unlike most newly adopted children, who have a huge growth spurt when they come home, she stayed pathetically small.

The doctor wrote "failure to thrive" as a diagnosis. That's a REALLY scary diagnosis, and I told him that no kid of mine was going to be failure to thrive. I asked for, and was given, a referral to a highly respected feeding disorders program at a children's hospital.

The multidisciplinary program did a comprehensive evaluation, using a gastroenterologist, a pediatric nurse practitioner, a nutritionist, a psychiatrist, a developmental psychologist, a speech therapist, an OT, and so on. I completed food logs. Our feeding interactions were observed through a one-way mirror. She had a lot of lab tests done, including a second round of parasite tests.

In her case, so much turned out surprisingly normal. She was beautifully attached, and did not seem to have any psychological issues related to her abandonment or adoption. She was a smiley, easygoing, flexible child in every respect except for feeding. She was very bright and was actually ahead of her age in receptive language (understanding English).

She had good fine motor skills, even though she was a little delayed in the gross motor area. She was not texture avoidant, and didn't have any of the other common feeding problems. She had 14 teeth, with weak, pitted enamel, but no cavities or other painful problems. She may have had H. pylori at some point, but she tested negative at the time, and Giardia, which I suspected, never showed up.

But, of course, Becca also was astonishingly picky, possibly because she had a very strong sense of smell. To this day, she can often differentiate between two very similar items, such as Easy Mac and the local supermarket's private label equivalent, on the basis of smell and taste. Yet she did not meet any of the usual criteria for a diagnosis like sensory integration disorder.

However, as I met with the team for followup, I came to realize, even before they did, that Becca had no hunger cues. She would refuse food for two meals in a row, for some unknown reason, and then cry because her tummy hurt -- not realizing that hunger was making it hurt.

In Becca's case, the feeding team believed that the traditional rules about a hungry child eating simply did not apply. Because the primary goal had to be getting some growth going, they told me to throw out the nutrition book and give Becca the highest-fat, highest-calorie foods she would tolerate, even if that meant chicken nuggets, french fries, and milkshakes every day.

That helped. But quite apart from the feeding team, I also began doing a lot of mealtime coaching. Although it is dangerous to put too much pressure on a child with feeding issues, lest mealtimes turn into battlegrounds and control issues develop, I began to work on trying to get Becca to understand how much food she must consume in order to stay healthy. Obviously, that's not easy with a child under the age of two. But slowly, very slowly, I got her to eat something at every meal, and to increase her total intake.

In addition, I put Becca on a multivitamin and Pediasure. Pediasure is a complete food that provides all the nutrients a child under age ten or so needs. It also is calorie-dense. It's frightfully expensive, but even one can a day will help to get growth going. Pediasure comes in a variety of flavors -- my daughter preferred vanilla -- and kids generally like the taste.

It took a year or more for Becca to grow at anything like an acceptable rate. And she developed some tastes that nutritionists would hate; she still prefers white bread, salty canned soups, hot dogs, chocolate, and so on. But today, at 11, she is healthy and gorgeous. She is going through puberty and developing nicely. Her weight is in the 25th percentile on the American charts.

In your son's case, I suspect that he is just being a typical toddler/preschooler, eager to control his environment and to figure out how to get Mom and Dad irritated, since they make such funny faces and noises when they are mad. He may also have been forced to follow a fairly rigid eating pattern in Russia, and may be testing the limits of his newfound freedom now. That's fairly common with newly adopted children.

If your son is a basically normal kid, it probably makes sense to enforce some reasonable rules. Don't punish your child if he wants to eat his chicken before his soup, and accept that he may regress a bit for a while and want to pick up mashed potatoes with his fingers; many newly adopted kids go through regression. But if your son throws food, or first asks for a certain food and then says he doesn't want it, it's perfectly OK to end the meal. He won't die if he waits until snack time, or even the next meal, to eat.

Make all meals and snacks rich in calories and nutrients, so that when he DOES eat, he will get maximum benefits from the food. But DON'T serve junk food -- full of fat, sodium, and sugar and light on important nutrients -- unless a doctor concludes that he is so seriously underweight that drastic action is needed. Serving junk food will simply get him used to foods that aren't really good for him.

If you are worried about your son's intake during his "control freak" period, buy Pediasure and serve at least one can a day, as a snack or with a meal. As I said above, it's pricey, but it is really worth the cost if you have an underweight, picky child. A multivitamin might be OK as well; ask your doctor if you should use one with or without iron.

If, however, you really think that your son's actions go beyond those of a normal three year old adopted child, or if your son is not growing normally (for example, falling onto a lower curve on the weight chart), by all means talk to your pediatrician about getting him evaluated by a feeding disorders professional or team. Such testing is time-consuming and may not be fully paid for by your insurance, but it can be very helpful.

You will feel better knowing whether your perceptions about your child's eating behaviors are supported by a feeding team's findings. And if your son has feeding issues, the team can suggest many good ways of dealing with them so that he develops a healthy growth pattern.

Sharon

[Kama]

Sharon, clearly the issues here is not textures or smell because he ate the same foods just fine in Russia. I would guess it is an adjustment issue. Still, it will be good to watch and consult an expert if needed.

[momraine]

I also have a child with real food issues, but he did not eat normally in his home country either. This was told to me after. Though I did see signs of it during the bonding. We too are now seeing specialists becuase he is also very underweight and is not growing, and has not been growing for sometime. He is 7 and almost the same weight he was at 3. The orpahange did provide me with detailed information on his problems and the Physciatrists reports on him. Of course the sisters also informed me that they did not like what they were told to do and so ignored the advice. They also informed me that this was also part of the reason for his move to a new orphanage right before we adopted him. They thought the new environment would help his eating issues. He is actually doing much better and is starting to gain back some of the weight he lost in the last year. If it's just the normal todder stuff, then you can wait it out, but if it's not you will need to see specialists.

[ddahl]

My thoughts ....
He is probably emotionally and physically just wrung out. He has lost it all, smells and tastes he is accustomed to etc. Its over load for them when they come home. We went through this too. I hate packaged food but I did what I had to do. My son loved the stauffers trays of chicken parm, lasagna, or his favorite mac and chees or alfredo with chicken.also, mashed potato with heavy cream and butter mixed in. yummy and a million calories a bite.


My son ate at least 800.00 worth of room service in Moscow! He at everything and more. We put him on a bottle right away as well so he was eating and drinking at least 1500 calories a day. He got very picky when he arrived home and I was totally consumed with him eating well and properly. It was as though he hit full and was done. He refused meat as well of any kind and I swear he lived off of yogurt and mac and cheese for a month until I found some other solutions.
At 18 months we were giving him baby food in jars and natural fruits and veggies. Within a month he was ramping back up.

I would stop the snacks until he can make it through a meal or just do all healthy meal snack throughout the day. His tummy is not used to being full so its a new thing. I would do 3 meals or do snack meals until he settles in, so like 8 small meals in a day.
Typical food for him each day was something like this:
6 am- Formula bottle (powdered formula with whole milk)

7:00 waffle loaded with butter and very small amount of syrup milk or oj in a bottle and fresh fruit (strawberries, blue berries and banana)

9:00 yogurt and cheese

11:30 baby food veggies in jar with turkey smushed up in it. noodles with sauce or mac & Cheese

Nap

2:00 snack of fruit, cheese and another yogurt

5:00 dinner mac and cheese lasagna and he loved fetticcini alfredo from Stauffers he could eat an entire tray! Fruit and grean beans or corn

7:00 snack cracker with Peanut butter or string cheese or rice pudding.

8:00 formula bottle or two

I love in laws and grandparents in general but at 3 junk food may cause a nasty chain reaction of poor behavior. He needs as many calories as possible with NUTRITION in them. Every calories is critically important. Be creative with him too. Add splenda to things he does not seem to like to sweaten them and gradually wean him off. Give him carrot sticks with Peanut butter and jam and let him have a dip fest. Give him turkey breast chunks and let him dip in ranck or buttermilk dressing. Fun and he will likely love it.
Make a cheese and cracker castle with him on a cookie sheet then munch it away. Try graham crackers with apple slices and peanut butter dippers too. Another thing I do is slice an apple into square pieces then stick a piece of cheddar or again slather it like a peanut butter sandwich.
My last trick is sprinkles like you would get on an ice cream. Looks horrible but put it in apple sauce or let him put them on himself.
Any meat pies or quiche went over very well too.

Make little sandwiches and use whipped cream cheese instead of mayo. Turkey and cream cheese is one of my sons favorites. You have to be creative with these little guys. Use whole cream when you can.

We have averaged about 1 lb a month since we have been home.

Good luck with everything.

[ddahl]

I am a huge advocate of the baby bottle for two reasons. One, with a fast slow nipple you can get a lot of protien and calories in. Two, it helps jaw muscle development. thanks for letting me share.

[MissDaisyofTexas]

Thank you everyone for your comments and suggestions. We are going to stay patient and get creative.

[jimpol]

I second the Pediasure idea.

Our son was labeled as "failure to thrive" when we left the orphanage. He was only 19 pounds at 17 months. He was only fed out of a bottle in the orphange. They pureed his food. Like others have said in Russia after we took custody of him he ate everything he could put his hands on, but when we got home things changed drastically. He wouldn't even eat stage 3 baby food and only a few of the stage 2's. We got help from Georgia's early intervention program called Babies Can't Wait (eating issues were the only thing he qualified for) and started working with an occupational therapist. He made a few strides with her.

Basically we continued to supplement the small amount of food he would eat like yogurt, applesauce, stage 2 baby food, etc. with Pediasure for the next couple years.

Now, at 5 years old and a kindergarten student, he will eat practically anything. If he doesn't eat it he will still try it. We chose to not make a big deal and now we feel like we are good.

Good Luck!

[cindyc]

Thanks, jimpol, for the "5 year" view. It makes me feel better to hear that eventually, a child from a background such as our kids' does actually "eat anything."

My child actually ate a big lunch today!!!! (Yesterday he ate next to nothing.) Is this food stuff a lesson in patience or what?!

Bon Appetit to all,
Cindyc