Seeking Help with 21 Month Old Son Who Doctor Wants to Put on Medicine

Have you checked into taking him to a feeding clinic. We take our son thru the Easter seals of Berks County. They usually have a lot of good ideas to try. Sometimes meds are required but we have not had to do meds.

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T.,
I only ask this because my son began the same way with foods. Is your son autistic or has he been evaluated? My son was diagnosed last Feb 07 (he was 2 1/2) and has had eating "issues" since he was around 16 mos or so. He has gradually stopped eating virtually all vegetables, fruits and will only eat certain foods. He has been seen by a great doctor who specializes in autism and developementally disabled kids and their nutrition. No meds, but rather tests are run to see their toxitity levels in their bodies. Then, a "customized" diet with supplements is introduced and the success rate is phenomenal. Some resources to check if you haven't are DAN!, Tacanow.org (i think) and google all you can about the subject. Good luck to you and your son!

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Are you sure it's not a sensory issue with textures in your son's mouth?
My child had issues, but it was sensory based?
Just thinking outside the box on that one.
My child is on a stimulant and it worked but it made him moody, so I only gave it to him as needed.

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Have you seen a dietitian and/or feeding therapist. Some docs want to medicate everything rather than get to the heart of the matter.

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I think I'd seek a second opinion from another doctor. Does he have a diagnosis or is the doctor at a loss and trying to find anything that will work? I know some kids have sensory issues. I don't know how they treat such issues but I think I'd look into that first.

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Hi

This is not to scare you....but we struggled for a very long time getting my son to eat table foods. He was on formula and did absolutely fine. When we changed to table foods that is when the struggles started...he would gag and vomit. He had no other developmental delays. Pediatrician dismissed it as he was a picky eater and his refusal was behavioral. After 2 years of seeing many different specialists, the GI team at CHOP found he had eosinophilic esophagitis. Basically food allergies, where the whote blood cells attack the esophagus. See APFED.org for more info. The only way to diagnose EE was via an endoscopy. You may want to reach out to the GI team at CHOP (Dr. Liakorus) to have you soon evaluated and hopefully rule out any GI tract/stomach issues. Because the kids can't verbalize if their belly hurts and sometimes like my son he never knew that food was not pain-so nothing was ever said. Not sure putting your son on meds without knowing the real cause of his food refusal is the right way to go...better to find the real cause and get a comprehensive plan in motion.

Good Luck and let us know how you make out!

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T.,
I'm so sorry to hear of your difficulties. Without having gone through this myself, I would say to look into Kim's advice as well as the advice of the other mom who mentioned the feeding clinics. Medication should only be administered when a definitive diagnosis has been made. But that's just my opinion for both children and adults alike. It's not right how many people are diagnosed through the use of drugs.

Anyway, you have received some great advice ... including a second opinion as well as requesting certain tests. Remember you are the patient representative and the Dr works for YOU. ;)

Blessings,
Rolinda
Wife, Mother, Friend

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Personally, I'd think as long as the boy is getting his nutritional needs met, who cares where he gets it?

Not like he'll be going to college with his baa baa.

If you make it an issue, then you'll generate resistance. Even 21 month olds have their own body wisdom and way too often doctors forget about that.

Tough call. I'm not saying I have an answer here, just a possibly different perspective.

Best of luck!!!

P.

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Hi T.:
Sorry to hear you're having such a tough time. My input is limited, but I wanted to be sure to write you...
While I'm not familiar with the side-effects the drug your doctor recommends may have, I do know that most meds carry a scary list of possible side-effects that very seldom apply to users in real life. Side effects of some things which were prescribed for me were worrisome, so I can only imagine how you must feel as a mom contemplating such a decision for your child.
However, what I have read, and what our pediatrician mentioned to us when our little girl was about to begin solids, was that there is a window that nature has built into our genes - during that time children can best learn to swallow and chew their food. If a child waits too long to become proficient, it can become a difficult skill for them to pick up. It's tied to development of the tongue and palate. Somehow, the body is programmed for this skill to develop during a certain period of time, which I believe ends by around 24 months.
Don't quote me on this, but it might be a good topic to discuss with your childs' doctor, so that you can make an informed decision.
Best of luck!
S.

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hello, my son is currently admitted to the CHOP feeding and swallowing day hospital program , we actually were admitted today. He is also on the same medication that you were talking about. It used to be used for anithistimine but people were not happy because they kept gaining weight so they put it back on the market as an appetit stimulator. My son did get sleepy in the beginning but now he is ok with it. overall, it didn't really get him to eat any better though, i will talk to the CHOP doctors about whether he needs to contine taking it now that he is starting this program. The program is very intensive, it is from 8:00 am ntil 4:00pm every day for 4-5 weeks. Fortunitly, I am not working now so I can go, yo have to be present every day. They use b.f. skinners behavior therapy to help them increace their eating. My son is also still on the bottle b/c he gets 16-20 oz of pedisure everyday and will not take it in a cup. It is more important that he gets the ntrients than to get off the bottle, but the program will help get him eating more foods, therefore he will need the pediasure less. my son is 27 months old. He also has texture "issues" such as prefering harder and crunchier foods such as pretzels and does not even touch mashed potatoes, etc...I agree that if he is eating strained foods or anything then give him whatever he will take, it is better than nothing at all. Believe me that i know how frustrating feeding time is and how annoying people incl., dr's who make judgements about how and what your doing and not doing. We KNOW that we are trying everything at home with or kids and they are just determined to do what they want. I'm hoping this program will work with my son and if you want to consider it check out their website www.chop.edu or call Marilyn Drukin the manager at ###-###-####.Best of luck to you and your family. keep us posted on his sccess!

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T.,

I would recommend seeking an Early Intervention Evaluation before you let this child be put on meds. Contact your county offices. The service is free. I'm in Butler County and could provide you with that number or help you get the number in another county.

You've listed several concerns that might lead me to think the child has sensory procssing disorder. The not sitting, not eating...wanting to suck on a bottle. Sucking is an organizing activity for children with sensory issues.

Other things I'd look at:

Does he come unglued in chaos? Does he meltdown with a busy and loud (or brightly lit) environment? Does he have parts of his body that he hates to have touched? (back, shoulders, feet, head,whatever). Is he highly emotionally reactive? Any trouble getting him to transition from one activity to another? If he's playing and you need to get his shoes on, does he flip? Does he dislike certain fabrics or styles of clothes? (cuffs, hoods, tags).

The Early Intervention program will evaluate where you child is with speech, with age appropriate gross and fine motor skills, etc. They will come to your home and evaluate and if your child qualifies for services, it is also free and provided in your home until age 3. Then he'd transition into the Intermediate Unit.

I'm here to chat or offer info if you need me. ____@____.com

Just a tidbit...if your child has sensory issues, no trick, no punishment, no reward, no medicine will make him eat. An OT or a feeding clinic (Children's Hospital and the Children's Institute both have great programs) can help.

Good luck.

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T. it sounds as if your child has sensory/tactile issues. By your letter it is unclear whether your child has sensory issues outside of the food realm, but that is normally the case.

Medication is not the best way to go in my opinion. You should try and find a really good Occupational Therapist that understands sensory issues. There is also a book called the out-of sync child. Don't be upset or turned off by the name . It gives a lot of insights and ideas of how to parent through the quirky things. If you have any questions, you can contact me at ____@____.com

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I don't like to diagnosis or guess-a-nosis with little information but I would highly recommend that you see a child psychologist. It may not be a gastro problem at all...I would explore every avenue. If you stimulate eating and it's not an eating disorder than wouldn't it just leave him more hungry and frustrated!?!?

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I would avoid the meds if possible. Maybe you should go see another ped. and see what they say. You could also ask the opinion of someone that deals in natural remedies for things.

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Have you done any other research besides seeing a gastroenterologist about his eating? When you mention texture as a problem with eating and specific preferences like the bottle and little interest in what you are eating--also the lack of interest in sitting, you may want to explore other issues before just trying to stimulate his appetite. Is he underweight? Are you worried about his nutrition? Does he give you a difficult time with other things that he dislikes or prefers not to do or is it just with eating? Is he social and happy to interact with you? Does his ability to sit increase a great deal with an activity of choice? I teach young children and several possibilities come to mind that may or may not have a great deal to do with eating habits. I also have a college age daughter that would eat nothing but Kraft macaroni and cheese, American cheese, and corn for the first about 8 years of her life. My pediatrician said she is growing just fine, is not over or under weight, and is not only eating junk so let her go and continue to offer her everything we eat. Eventually she branched out and is now a vegetarian who eats very healthily. We also supported this eating change (that does not match the family eating habits) as it seems pretty small when they get older and you have to begin choosing your battles.
Good luck--sma

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One of my professors (Dr. Keith Williams) runs the feeding clinic through Penn State Hershey Medical Center. They have an inpatient and outpatient clinic depending on the severity of your son's eating difficulties. Not sure where you live but Hershey may be closer than Philly (CHOP)and they should have all the same resources available. They have the ability to check on medically related problems with feeding and use behavior modification techniques to gradually shape up eating different textures, tastes, using cups, etc. If you're not crazy about using the medication (and I can't blame you) I'd start looking into some of the feeding clinics. Good luck!

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I don't know about the medicine...but I do know that a two year old should be eating solids at every meal. If I were you I would really look into at least trying the meds for a limited time frame, watching for side effects closely of course.
As for the bottle, put them away. When he wants a drink only offer him a sippy cup or a juice box...he will use them if he doesn't have any other choice sooner or later.
You have to be strong! As long as he knows that you will cave in and give him that bottle he'll fuss for it. If you take the bottles away and keep them away he should be fine after a few days. The longer you let him have the bottle, the longer and harder it will be to break him from them. Good luck and best wishes.

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