5 y.o. Refuses to Eat; History of Reflux & Sensory Integration Issues

First of all, kids with reflux and sensory issues really will stop eating and begin starving. The whole, "they will eat when they are hungry" trick doesn't work here and can cause further issues.

My DS has severe reflux and we used to be followed by OT for sensory & feeding therapy. Until I got so frustrated because he was getting worse not better and I told them not to come back. Yes he lived off junior formula mostly for a bit but he slowly started eating things here and there.

Depending on what your frineds LO has sensory issues to begin with the easier things that he will most always eat. For my guy it was ritz crackers or goldfish. Lots of reflux kids prefer crunchy snacks becuase the dry consistency doesn't come back up as easily as wet foods do. Also, does your friends LO have and swallowing deficiencies such as dysphagia? That will cause some pretty bad food aversions as well.

Anyways, have her try the staple things even if they are not very nutricious for now (I assume they are supplementing his diet with a junior formula or pediasure type of thing?). Try always eating together at the table and don't offer or push him to try anything other than what he wants off his own plate. We did this and each week our son would take a bite or two of something new. Now, over a year later most days he will eat quite a bit and is actually less picky than his older brother.

also point her to:
http://www.kidshealthsupport.proboards.com/

they are a wealth of knowledge on sesory issues and got us through this tough time.

Good luck!

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Personally I wouldn't starve my child for 5 days, and I would get a new pediatrician ASAP!! The pediatrician obviously doesn't understand sensory processing disorder. The child is not fighting a battle of wills. He's battling his own body and needs support and loving guidance. Without proper intervention, these children WILL starve rather than eat something that makes them gag, vomit, whatever. The mom can start by asking the OT for information on eating camps. This is a good time, with summer coming up. If she doesn't know of any, ask her to research and ask colleagues. In the meantime, I'm not sure what the specific eating issues are, but Pediasure (comes in a lot of flavors) can help the nutrition gaps and increase caloric intake. Smoothies made at home with extras to boost calories and nurtirents: banana, yogurt, PB (strong flavor though), spinich (essentially no flavor - add a little bit or the whole thing will turn green. But then my kids thought "mint" smoothies were the greatest), and can use soy or almond milk. She should also talk with a registered dietician, who can help her figure out how to best get her son what he needs. Good luck to her!

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Get a new pediatrician ASAP. Ask the OT for referrals to specialists who can help with the food issues.

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I am not sure where your friend is located but in New jersey their is a feeding clinic in Paterson (St Joseph hospital) which has elaborate outpatients programs for various feeding issues.your friend can google and find out similar
feeding programs near her place.

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Yes, I went through this with my now 13 year old. I don't think a lot of people understood me when I said she ate a limited diet. At certain points she was down to two food items. Just two. Once it was Cheerios and graham crackers; she washed it down with water, not milk. She was never underweight but she ate from an extremely limited range. I remember it as a lonely and terrifying time because nobody seemed to understand that this was not about her being picky and me being a wimp. It was a developmental problem that was bigger than the both of us.

Definitely seek a second opinion if not a new pediatrician. No disrespect intended, but general-practice pediatricians do not always have the specific knowledge of feeding and sensory issues necessary for the tough cases. It's good that the child is already seeing an OT but he might need to branch out to an OT with an expertise in feeding issues; it's a specialty area.

We were able to expand our child's diet through a gradual process of introducing new foods -- as a first step, we simply worked on getting her to be able to tolerate the smell without gagging. Working up to her taking a small bite could take weeks if not months. A no-pressure, low-anxiety approach was essential. Often these issues go hand-in-hand with a high level of anxiety. For us, your pediatrician's advice to make it all or nothing would actually have made things far worse.

It is NOT easy and it is not about the child being stubborn, as other posters have said. Tell your friend to hang in there. Improvement does happen but you can't lose your cool (as this pediatrician apparently is doing) because it is a long process.

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I agree that she needs a new pediatrician. I would not starve a child even without these special issues, but especially not when he has them.

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I agree with some other moms that when people say that they will not starve themselves they are WRONG. Kids with these issues will simply not eat. My son had a lot of feeding issues and lost weight and ended up with a feeding tube that he has had for 4 years. He simply does not take in enough orally to where it became a nutritional problem. At this age they need their food for healthy growth and brain development. My son has sensory issues and ASD and he sees a whole GI team which includes a GI Dr, a psychologist, a nurse, an OT, a SLT, and a dietitian. I think it sounds like this kiddo needs help from a team who specializes with feeding disorders. Pediatricians are great, but they deal with such a broad, general spectrum of kiddos. When it comes to specific issues go to those who specialize in it!

This book called "Just Take a Bite" also really helped me: http://www.amazon.com/Just-Take-Bite-Effective-Challenges...

Feeding problems are so pervasive and challenging!!! Good Luck!!

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They make the Pasta Plus pasta that has lots of protein in the noodles. I don't know if he eats pasta. Since you do not say what he does eat it's hard to come up with ideas.

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My son lives off cereal mostly. And yes its the gross sugary kind usually, I make him brush his teeth every time he eats and give him vitamins. He would have starved otherwise. He just started trying peanut butter and jelly. The one surprising thing he does like is Quinoa!! Its a grain like rice but is a whole protein!!He tasted curried lentils once and loved them. Go figure, I think he needs foods with stronger flavors and crunchy textures, I keep trying but each child will be diffferent, Smoothies with banana only for him he dosent like the taste of other fruits in a smoothie. Sooooo frustrating but you just keep trying and you find things new to the whole family. I try to see it as an adventure and a challange (otherwise I'd go crazy)
Please dont ley him starve! My son is 9 now, it does get better one step at a time. Feel free to e-mail for support and sharing info.
S.

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This combination of problems is beyond the scope of a general pediatrician, and I would only follow the recommendations of a pediatric GI doctor who is experienced with this situation. Sounds familiar to us with my daughter's situation. The folks (therapists and GI doctor) at the Swallowing Disorders Center at NYU RUSK Hospital worked wonders with us in less than 6 months. Now (2 years later and us following all the techniques we learned there) she eats a wide variety of foods. Don't know how far your friend lives from Manhattan, but it would be worth the trip to at least get an initial evaluation and some suggestions, even if she can't bring her son there a few times a week for therapy.

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Suma, he needs a different OT. One who specializes in feeding problems. Is there a children's hospital in her area. I'd try there.

Is he a tiny thing? It sounds like it. I have to say that I'd be very worried about the five day thing the ped is recommending without working with a team of experts in a children's hospital. I also think that other than the physical difficulties, I'd worry about him getting more of an aversion to food than he already has. A child psychologist should be part of the team.

Good luck to her,
D.

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Hopefully she can find something helpful here :)

http://www.sensory-processing-disorder.com/picky-eaters.html

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Is their a system of rewards for eating in place? Mine has sensory issues. He also will not eat things that don't visually look appealing to him. Even specific colors of food he does not care for. I had to start a system of rewards for good eating, and it helped. If their was something he did like, I would tell him that he could have it if he would eat at least as many bites of something as how old he was. If he was 5 years old, he had to eat 5 bites, etc..Also, if he likes a specific color, pick out some foods that are that color. Sometimes it can be fun, and it also will help him get familiar and comfortable with smells and textures of foods. My son's favorite color is yellow, and he loves bananas, macaroni and cheese, eggs. Once they start that, they usually are more comfortable at eating more foods.

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My co-workers grandson was diagnoset with Eosinophilic Disorder. She is running a fundraiser for him. He does not want to eat and when he does he complains of stomach pain and he feels like something is stuck in his throat. They had to put a camera down into his stomach and found lots of ulcers caused by the foods he had been eating. He is allergic to everything. Poor guy, he is only 8 yrs old. Maybe if you go to www.apfed.org they may have some more answers. I wrote this down from our kitchen bulletin board.(fundrasier) Hope it helps. Good Luck! :)