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What do people do about light eaters?

Food is a constant struggle in our house, and we get our older one (3yrs) to eat about 700 calories a day through a combination of vigilance, threats, distractions, and bento-tricks. He remains at the 3rd percentile for weight/height, and is short for age (he stopped growing completely for a while)

The only advice we received from Drs was to add oil or butter to his portions. He's starting to be more like a classic picky eater, but for the most part, he eats anything, just only one bite at a time.

We are big Ellyn Satter fans in our household. I also really like Katja Rowell's blog. My understanding is that doctors get less than a day in med school on nutrition. If the doctors are concerned about his eating, they should be referring him to a feeding specialist, not telling you to add butter.

Michaela, thanks for starting this thread. I was going to comment on the other thread but felt like that would be hijacking the op's thread. DD is a preemie, 4lbs when we brought her home. She is between 5-10% at age 3. It is NOT EASY to feed her. She knew how to use a spoon properly at 14 months but refuses to self feed except ice cream. We use distractions as well- books, or she does an activity ( painting, lego, stickers, etc) while we shove food into her as quickly as we can. We hired a nanny and decided to send her to part time preschool because I worry that if she misses even one meal, we would have a skin hanging on a skeleton child. I make sure everything she eats is high calorie but not unhealthy. Veggies are stir fried in almond or olive oil, lots of full fat yogurt (no milk due to allergies), all kinds of nuts. The only "bad" food she eats is ice cream twice a week. I have decided to ignore all studies on ill effect of eating while distracted bcos at this time my top priority is a kid that stays healthy. I will worry about the other stuff later.

Thought this was timely:

http://www.huffingtonpost.com/mobil...b_2768810.html?ncid=edlinkusaolp00000003

A personal favourite from a knowledgable Spanish paediatrician who references the updated 2006 WHO Child Growth Standards:

http://www.amazon.com/gp/aw/d/1780660057/ref=redir_mdp_mobile

I'm growing more accepting of the fact that, with free access to nursing and a wide variety of nutritious, whole foods, my son (16 mos) won't go hungry. He didn't grow at all in weight from 10 to 14 months but continued to top the charts for height and head circumference.

Frankly, other than offering a nibble tray for grazing and respecting his requests when he'd like to leave the table, I don't know that any of my actions have had an appreciable impact on his eating. We prioritize proteins and produce in our home, and I'm mindful to select more calorie dense options for DS wherever possible.

I suspect the root of my son's-- and others' childrens'-- limited eating is their constant interest in doing EVERYTHING.

I'm inclined to agree. I've been lucky to have fantastic doctors, but I really don't think they talk about nutrition enough (maybe because we don't have health concerns relating to it? I don't know).

My two are picky, although DS8 is better than DD10. She's, um... well... awful. What I do is make homemade snacks (cookies/muffins, etc) to put in their lunches. I load them with grains like quinoa, oats, wheat germ and flax, and throw in some chocolate chips for good measure. I also make protein shakes with whey isolate, banana, cocoa powder and vitamin D drops (you have to measure the protein though because too much is hard on their kidneys). I've tried steaming and pureeing veggies and mixing them into sauces, but DH can always tell (he's the worst one!!) sigh.

I don't know. It's hard. (They get a multi vitamin every day, lol) I'd love it if they would just eat whatever I give them, but no such luck.

@CCN: No need to worry about protein intake and renal function. There is no compelling clinical evidence of renal damage in healthy patients from protein consumption.

Here's a popular press article written by a Canadian PhD in nutritional biochemistry, John Berardi.

http://www.bodybuilding.com/fun/berardi80.htm

I'm not the only one struggling with this..... big sigh. I hate hugging my son and feeling all his little bones. I try to offer food every two hours, mostly fruit or meat is what he'll eat. He has a lot of food allergies which make it hard too, but sometimes I let him cheat because I just desperately want him to eat something, anything. I do have the eventual goal of us all sitting down at the table together with no distractions, but my first goal for now is increasing his food intake, however I can. I like the blog http://mealtimehostage.wordpress.com because it talks about selective eating, the category way beyond picky.

I'm wondering if we will get a referral to a nutritionist at his next appt, which is very soon. He's only had one appt since the one where they told us he wasn't eating enough, and at that one, the progress update was "Things are going a bit better." This time, I'm going to have to report that we've been at a plateau since then.

He did catch up his height a little when he started eating (and had the growing pains to prove it), but he's still loosing ground against average, I think. People generally guess he's a year or a year and a half younger than he is now, which doesn't help the confusion when he starts discussing evolution.

We try to get protein into him in the morning, because that seems to set up the whole day. We also try and get him to eat at least one large (for him) meal all at once every other day or so. It seems like sometimes he tapers off his eating until his stomach shrinks -- and that's when things get really tough.

We've also established some rigid routines... we have tuna melts on Tuesday, beef at the science center, etc. Because that sometimes helps him get organized to eat. He still won't necessarily eat more than one bite, but the routine seems to make that first bite easier.

ok, off to follow links

Okay... understand that some of this is going to be unpopular advice.

I do understand the concept of "limited" amounts of particular foods, because this is my family's reality with several food proteins for which there is some limited tolerance... however... NO offense-- but please, please, please call it something besides "allergy" if your child can consume the food in limited quantities. The reason that I ask this of others is that when families like mine say "allergy" we need for other people to understand that we don't mean lactose intolerance or behavioral problems. We mean possible fatality just from a food TOUCHING the wrong kind of other food. We need constant cooperation from other people just for very basic safety. This is why I no longer refer to my DD's limited tolerance for milk protein as an "allergy" though it technically is. (She just has a very high threshold dose now.)


My DD is still VERY thin-- VERY-- and small for her age, and this is due to life threatening food allergies that limit her consumption of a lot of high-calorie foods. Her growth curve is delayed-- her physical age is behind her chronological age by over a year at this point, and this is not uncommon for children with milk, soy, or wheat allergy. Those allergens limit a LOT of food.

We have chosen to NOT make food a battle of wills. Ever. We have also chosen not to coax or bribe with food, because that is, ultimately, giving the child a lever with which to exert control. Most of them will opt to use that lever at some point...

There is some evidence that this kind of thing can lead to disordered eating, because food becomes about a lot of things other than food. If it is a locus of control; that's a red flag.


My DD does not like vegetables. She does not like many whole grains. She cannot eat many foods which are calorie-dense, or naturally high in protein/fat. We let her eat as little as she chooses. Period. We make purchasing decisions, and we make notes/verbal asides about vitamin needs and other nutrition.

We control what (well, somewhat, anyway), she controls 'how much' and that's that. DH and I were both forced to eat food that contained or was contaminated with our allergens as children-- and I have to be honest here, kids know their own bodies better than ANYONE else can. My DD has often been proven right about a sudden/peculiar food refusal. Either she's developed an allergy to it, or something in the processing has shifted and she's refusing it because it is now cross-contaminated. She's pretty much never been wrong there when we've investigated.


Being very thin isn't the worst thing in the world. I say that as someone who has been living with this for over a decade, with a child who weighed less than 20 lbs at a year old, and it got MUCH worse from there. Family history being what it is, we'll take that over Type II diabetes, thanks.

I also suspect that we've become (societally, I mean) conditioned to expect kids to be.... er... "plump." I'm not sure that this is physiologically intended by nature, or at least not for all children.

It distresses us when DD goes for 8-14 hours without eating, or for a day or two without doing more than nibbling, but she really DOES seem otherwise healthy, and she's reasonably active and alert. Her caloric intake varies dramatically over a week or two-- some days probably 2000+, and others, more like 600.

I'll also say that when she was younger, we OFTEN made the mistake of pushing food too frequently. Why is this bad? Because they NEVER really eat much unless it's a "treat" that they truly love. Why would they? These are very intelligent children-- by two or three, my DD had figured out that she didn't NEED to eat broccoli, because "muffins" would turn up sooner or later. Why not wait for the good stuff? Besides... this never really gave her a chance to GET good and hungry. She never felt "sated" either, at least unless we offered her unlimited amounts of a "treat" when she didn't have much else to distract her... but we were constantly offering her food, so of course she wasn't HUNGRY.

My tips?

1. Make mealtimes about food, and make them some fixed (age-appropriate) length. You don't have to EAT, but you do have to be present for the meal's duration... your choice, and the environment can't provide innate reward for NOT eating. I realize that this is contrary to the notion of feed while distracted, but as others have noted elsewhere, I'm fairly uneasy about that particular pattern of relating to food... besides, this is going to backfire badly once they discover the joys of socializing with friends on the computer, where they will want to save both hands and all their attention for gaming/chatting. DD eats far LESS if we don't get her away from the computer. Caveat emptor. Just sayin.

2. Involve kids in food preparation, and make eating only a part of that process.

3. Let go of worrying. Most pediatricians and nutritionists will freely admit that they've never seen a child without underlying medical problems voluntarily starve themselves into any kind of health problems... but if you provide the wrong KIND of food (just because they will eat "that"), it can result in some vitamin/mineral imbalances/deficiencies. I realize that minimizes the natural parental concern... but... uh... I guess I am saying that for most kids, this isn't as big a problem as it seems to us as parents when they are 2-5yo. (I remember this concern, by the way.) It's not just about the calories, though. Important to know.

4. LET. THEM. GET. HUNGRY. This was the hardest thing for DH and I to learn. We had to wait until DD said she was hungry, or let her wait until meals. We had to let her learn what it felt like to be hungry. She really does have excellent self-regulation now. Even in a restaurant setting, she just eats what she wants, and then takes the rest home-- even foods she really loves. (Oh, and secondarily, following your kid around at the playground with a bag of mixed nuts is creating a pretty severe hazard for about one family in fifty, so there is that, too. ) Genetics has most of us human beings adapted for fairly lengthy fasts. Without a metabolic quirk in play, it's okay to NOT eat, even for an extended period of time (a day or two). We now just ask "have you had enough?" and "So what did you eat for {meal}?" to make sure that she is paying attention to her nutritional needs.

In case you're thinking that I must not understand these concerns, my DD at almost 14 is just over 5'2" tall (with parents who are above average height), and weighs about 100 lbs soaking wet. This is a far higher BMI than when she was 4-10 yo. She is allergic to several foods, and actively loathes a fair number, as well. She's not now, nor has she ever been, a "good eater." We tried a lot of things to budge that, and frankly, none of it really worked. Mostly, this was parental problem-solving in search of a problem that the CHILD didn't see as a problem. I think that most of us here can identify how successful extrinsic leverage tends to be there. LOL.