Posted by: KC | 2009-01-11

Fussy Toddler Won' t Eat

Hello Dr.
I really don' t know where else to turn. I am so worried about my 14 month old baby boy. He is such a poor eater and I am really battling to get him to eat. He refuses all baby cereal' s as well as the toddler variety. He has never taken to cereal so breakfast is always a fight. If I am lucky I can get one spoon of yoghurt into his mouth but after that I have to trick him to open his mouth and it becomes a fight which I try to avoid because I don' t want meal times to be tense and unpleasant. During the day he refuses any meal I make. He might have a taste of whatever I have made but after a few chews he will spit it out and whatever he can' t spit out he will try and take it out with his hand. During the day he will nibble on a few pieces of fruit and cheese but it really is a nibble. Maybe three grapes or a few pieces of dried fruit, a strawberry or so and a few small blocks of cheese (on a good day). I try yoghurt, purity fruit, sandwiches, toast, french toast, egg, pasta, chicken EVERYTHING... but he just spit it out or throws. He will even spit out a piece chocolate or biscuit! He seems to like sour/citrus fruits. What worry' s me is that he will see me making something to eat, or walk past a banana and he will cry for the food and ask for it. And he looks really desperate for the food but when I give it to him he tastes it then spits it out and then loses interest. Dinner time is the same and he will maybe have two small bites if I am lucky. He does not want anything soft and mushy. He has three milk bottles a day and one bottle of pediasure (advised by the clinic) and probably drinks about 400 to 600mls in 24 hours. Inbetween he loves water and will drink about 100 to 200mls a day. Starting solids did not go too well and it took a long time for him to take to it. He started eating really well at eight months and I had no problems at all but it only lasted a month and a half and then he stopped eating completely and it has been a struggle ever since. He can go for days on end without eating anything substantial and then out of the blue he will eat a few spoons of something and really enjoy it.
He is a very tall boy. I have not measured his height in a while because he is so busy but I think he must be close to 90cm. I weighed him a month ago and he was 10.5kgs. The clinic seems a little concerned and thats why they suggested the meal replacement but my paediatrician said he is fine and I should not worry at all.
Where do I go from here? I will do anything to get him to eat a decent meal or even to snack properly.
Thank you so much, I would really appreciate your advise.

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Our expert says:
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Dear KC
Because you have had your son assessed by a Paediatrician, I presume that there is no underlying physical problem that can be causing him to refuse to eat solids. In such cases it may be a good idea to have him assessed by a Paediatric Psychiatrist because infant anorexia is rare, but can occur. You mention that he cries for food, but when you give it to him he spits it out. If for some reason your son is highly stressed psychologically be could be using his refusal to eat as a "silent cry for help". Ask your gp or Paediatrician to refer you to a Paediatric Psychiatrist or Psychologist because he may require play therapy and/or medication to assist him to eat normally. His height is normal for a 14 month-old child, but he is a bit underweight and must be starting to develop deficiencies if he is eating so little. I would also recommend that you consult a clinical dietitian because it is possible that he is drinking too much milk and Pediasure (I can't work out from what you say if he has 600 ml of milk and Pediasure in total or 3 bottles of milk plus 600 ml of Pediasure, which would be a very large quantity of liquid food and thus prevent him from wanting to eat solids). Let the dietitian work out his nutrient intake and assist you to possibly reduce his liquid intake (milk and Pediasure) and to introduce solids.
Holding thumbs for both of you

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