[N.Gwinn]

My son has been home for nearly 4 years and is nearly 5 years old. Since the day we brought him home, he has been a somewhat reluctant eater (by my pudgy standards). When he was a baby, I questioned the doctor more than once about his unwillingness to eat and his thin frame (90% in height, 25% in weight). His answer was always the same, "He'll eat when he gets hungry. He is at a healthy weight and growing. Don't worry about it." But I worry. I'm a mom, it's what I do. Lately, the food issues seem to have escalated. He won't eat lots of food that I know he likes, such as pancakes, and pizza. I am wondering if this is about attention. I don't know. He really does look like he is at a healthy weight, but he does not eat without a battle. I am not way over concerned, but wondered it anyone else had thoughts on the issue.

[Withay]

Not being an expert I would say that the more a big deal is made about his not eating the more he will dig his heals in about it. Talk with the dr again and tell him your concerns. There may be something going on, or there may not.

[JustBarbara]

Originally Posted by Withay

Not being an expert I would say that the more a big deal is made about his not eating the more he will dig his heals in about it. Talk with the dr again and tell him your concerns. There may be something going on, or there may not.

I agree - no expert here. As a kid I was similarly slim but also eating became a way of control. If the ped is not concerned then I would not worry too much. I'd put a couple of foods on the plate and eat with him without mentioning that you know he likes this food, so please eat it. Good luck. This too shall pass - really.

[TweetyMom04]

I agree with the posters, don't make a big deal out of it, especially in front of him.

In private, okay to worry. I did!

-Start by plotting his growth; height and weight on a chart from the CDC, avail on-line. Do this on the same date each month.

-Don't 'helicopter' over him about eating. Make a note afterwards what he didn't eat. Glance at his facial expression when he eats. Could be a problem swallowing foods, texture could make him gag reflex, smell could be the same, gag reflex, teeth/gum problems, swollen glands can make it hard to chew and swallow. Whatever he does or doesn't eat, note it. Over time you may, maynot, see a pattern. Don't make any comment to him about what he didn't eat.

-If he snacks, make a note of what he eats, asks for.

-Make sure he stays hydrated, water, not sugar drinks.

-You'll soon see a pattern of what he eats and doesn't eat. Soft vs. hard foods. Break them out into categories. If he's having problems with hard foods, carrots, hamburger, crackers, etc., could be mouth, gland related. Tonsils, adenoids, teeth, gums, etc. Especially if he favors softer foods: mashed potatoes, green beans, diced foods, ice cream, etc. Texture is a problem, especially w/hamburger. Our boys at age 6, can chew and swallow hamburger or cheeseburger without the 'gag' reflex. They enjoy them! Additionally it could be a phase of trying new foods or he is grown tired of the pancakes and pizza.

-I found that documentation when going into Drs. office (s) helps to get your 'heard.' The more pattern or lackthereof, helps. They can see a pattern, read about eating habits, etc.

-Listen to your gut. If your instincts tell you something is wrong, pursue another Ped. Sometimes 'this will pass' is true, but in our previous experiences, it doesn't pass and only worsens.

Best O' Luck. I know it is frustrating and worrisome.
((( HUGS )))

[momraine]

I have a child with a true eating disorder. He will not eat when he is hungry. He will go days and days without eating anything. However, he was loosing weight and not growing so the doctors were concerned. If he is still growing and not loosing weight, I would not be too concerned. I would not offer something else if he refuses what is served. (especially when it's something he has eaten before) If you do that once or twice, it becomes a control issue.

[angelkisses0102]

I say trust your gut...I wish I did.

My son has been in feeding therapy for the past year...with no end in sight. He has maintained the same places on the growth curve since day one...about the 50th for height and the 3rd for weight. He was adopted at eight months old...and it took until a year ago, at his five year check up for the pedi to finally agree with me that something wasn't right.

My son's issues started as sensory issues...now those are overcome but we deal with the behavioral aspect. This is much, much, MUCH harder to overcome.

And I hate that doctors say 'All kids will eat when they are hungry.' NO.THEY. WON'T. Especially in the case of kids like 'ours.'

It can't hurt to have him evaluated...good luck!

[Kasey]

You got some great advice here, I think Tweetymom is right on, since he is growing and seems healthy, you probably have some time to document his eating and what is happening. have you asked him why he doesn't like certain things, like does the feel of it bother him, does his belly hurt after he eats? I defintiely agree though, watch him and get an eval, follow your gut!
Good luck!!

[N.Gwinn]

I hadn't thought about the texture issues. I am aware of the power and control stuff, but had forgotten about all the sensory stuff. I am going to get his teeth checked by the dentist next week, and then go from there.

[sak9645]

Trust your Mom instincts. Even in populations of non-adopted kids, feeding disorders may affect up to 10% of the children. While texture avoidance is one of the most common in infants/toddlers and children coming off of tube feeding, there are lots of other feeding disorders.

While the statement, "He won't starve; he'll eat when he's hungry" is true of the "normal" child, it is definitely NOT true of the child with a feeding disorder. Some children with feeding disorders actually do starve themselves to a point of significant illness if there is no intervention. Children diagnosed as "failure to thrive" often have feeding disorders.

I think you have gotten some good advice on this board. Don't act anxious, or you could wind up with some food wars that you cannot win. But keep detailed records of what is offered and what is eaten and drunk at every meal and snack, and observe your child's response to various foods and feeding situations.

It is important to be sure that your child is not suffering from any medical or dental issues. If you don't think your pediatrician is thorough enough, find a new one., ideally one with some adoption background. As an example, some internationally adopted children have feeding issues because they have an undiagnosed parasite or infectious organism (H. pylori, Giardia) that reduces appetite and causes stomachaches even though they don't have the "usual" symptoms of messy stools. And having a really good dental checkup is also important. Undiagnosed dental problems can cause pain and food avoidance. Lots of internationally adopted children have serious dental issues because of poor birthmother and orphanage nutrition, poor dental hygiene, etc.

Consider what is going on in your child's life. Does he eat less when he's alone or with friends? Was there some incident that precipitated his decision to avoid certain foods -- such as seeing something on TV, or hearing other kids use the term "fat" when calling people bad names? Has he been more anxious than usual -- for example, about starting school or going to a new day care provider? Has his behavior changed in other ways that suggest emotional issues? As an example, is he more confrontational than usual, or does he have more episodes where he is sad, moody, angry, etc.?

When it's NOT feeding time, and your son is in a good mood, drop a casual question about why he doesn't like pizza anymore. He may just grunt and say, "I dunno." But he may say that it smells funny, or that he's afraid he'll choke on the stringy cheese, and that will tell you something.

And, of course, check his growth. A child should stay pretty much on his growth curve. If your child STAYS at the 25th percentile for weight, that's perfectly normal. However, if he falls from the 25th to the 10th percentile, that could signal a problem. A child can be perfectly healthy at even the 5th percentile for weight, if all else is normal; some kids are just genetically skinny.

When you collect some of this information, if you see any things that bother you, consider going to a feeding disorders clinic at a children's hospital. These are multidisciplinary programs where gastroenterologists, developmental psychologists, child psychiatrists, nutritionists, speech pathologists, and others evaluate a child and recommend therapies, if needed. The visits are generally covered by insurance.

Your food logs will be reviewed, and you'll be asked for even more information. Your pediatrician's bloodwork and such will be reviewed, and more tests may be ordered if there is any suspicion of parasites, metabolic problems, etc. He will be evaluated for any physical development problems that could affect feeding. You may be asked to eat a meal with your child while a doctor watches through a one-way mirror to see how your interactions are. Any history of sensory issues will be recorded. And so on.

All in all, don't just let yourself be convinced that nothing is wrong, if you feel that things are not right.

Maybe you just have a picky kid who is naturally skinny. Some picky kids grow up to be gourmets! And it's better to have a naturally slim child than an obese one. If that's the case, let a real expert tell you so.

Maybe, because you are a good eater, you simply need a refresher course on how much food a child "should" be eating. You'd be surprised at how little it takes to meet a child's nutritional needs. We Americans are so used to "supersizing" that we often serve ourselves, as well as our kids, way too much food. For some children, this actually has the paradoxical effect of making them reject food, because they know that they can't eat all that.

But it sounds as if you suspect something else -- a real feeding problem that may be related to sensory or other issues going on with your son. And if so, the best way to find out for sure is to get professional assistance. And the best way to use professional assistance effectively is to come armed with as much documentation as possible of the problem.

Sharon