I went into the pediatrician who recommended that putting calories in her was the main goal and I should melt butter and put it on all her food. Initially this sounds like a great plan. You're getting tons of calories in them. However, in my mind, I looked forward to a year down the road and saw me trying to switch over to non-buttered food and pictured Ila throwing one of her epic tantrums. I decided this was a way I never wanted to go. We weren't looking for a short term solution, we were looking for a long term solution! After a few more pediatricians later and with help from a program Washington State offers, we got on WIC that helped supply a lot of Pediasure. The only thing that saved Ila during that dark time was the supplemental shake. She would drink about 2 a day. It wasn't much, but it was better than nothing.
Now, I'm sure at this point you're asking why in the world she did this. Control. Simply because of control. Some kids control potty training. Mine happened to control her food. We initially tried ignoring the behavior. It got worse. Then we tried to take back the control and it got worse. By the time we did all we could do, I was distraught. I was actually scared for her life! My precious child was starving herself and no amount of coaxing, bribing, yelling, screaming would help.
In this time frame, I found a ARNP that I really liked at my doctor's office. I felt she realistically knew what I was going through and we came up with a few game plans. Well, when things hit rock bottom, I called her and said, "If we can't get her on more of a level track, I see no point but to hospitalize her with a feeding tube." She agreed and suggested that we try a few sessions of feeding therapy. I agreed. To make sure the therapists didn't quickly judge me as a "bad parent", for 2 weeks leading up the appointment, I weighed her food, before and after each meal and recorded what she ate (or didn't in my case). I took pictures of each meal so they knew I was providing balanced meals but meals that were calorie rich. I have other kids that are small, so I knew how to cook a meal that were calorie rich, but still wholesome and healthy.
After about a month of going to feeding therapy and being on WIC, we were more on a level track. They determined it indeed was a control issue and that she did NOT have any aversions to food because of taste/texture. They taught me a few useful things in how to encourage the eating.
1) If your child refuses to eat the food, grant permission that they do not have to eat it, but they DO have to either kiss it or lick it. This allows them a chance to discover that it may not be as bad as they thought without being committed to chew and swallow it.
2) yep, that's about it. I had done everything else they recommended by that point.
So, as we started forcing around 5-7 Pediasures down Ila a day, her hunger cues starting coming back and we very slowly started to take control of her meals again. Now at the age of 5 (yes this was a VERY LONG battle) will eat a lot of what I give her, even the vegetables. I just never in my wildest imagination would expect I would deal with an anorexic 3 year old. It honestly scares me for when she's a teenager, but now that she's in school, it's giving me a realistic idea on how well I've handled the last few years. She has been doing a good job eating her food (even the vegetables) and coming home with an empty lunchpail nearly every day.
Here are some realistic ways to get your child to eat more or get more calories in them: (This in no way is a substitute for expert advice, this is just what helped my family)
*Pediasure is a great tool. My kids love it. It's a bit expensive if you're paying out of pocket for it, but it's so worth it if your child is malnourished.
* Never put more on your child's plate than what they can handle. For Ila, I will generally put 4 bites of meat that are cut to about dime-nickel size, a few tablespoons of rice, and 2 strips of peppers. Then after she's done eating that, then if she's still hungry, I'll bust out the fruit. I think for a young child, it makes sense to give them just what you expect them to eat than saying "You need to eat 4 more bites of rice and 2 more bites of meat before you can be excused" is really confusing for them.
*Kid's do NOT need Ranch to dip. Peanut Butter, Almond Butter, Nutella is a great, healthier alternative!
*Create a fun face plate that you can decorate with their food. I bought the plate at the dollar store and got inexpensive paint at Hobby Lobby for ceramics. You paint and bake and you're done!
*I created 2 different games my kids play
1) THE DINNER GAME- A "Candyland" style board with spots that say different things like, "Eat 3 bites, chair 1 and 3 sound like a dog". So each chair is labeled and if they eat there bites before the time runs out, they're rewarded with a charades show. At the end of the game, they roll the dice and have to take that many bites before the actually win. (this game is best for smaller kids) I used a white flat (but fitted works great!) sheet and drew with colored Sharpes.
2) DICE DINNER GAME- all you need for this game is a dice for each player. Everybody rolls their dice at the same time. Whatever number comes up, that person eats that many bites before the time runs out. The person that finishes their dinner first is the winner! (this game is best for larger kids)
The best part of these games is you can pile on the vegetables and they will eat them because they're compelled by the actual game and the will to win!
*One way to get more water in my kids is to stop in through a drive through. They all LOVE water if it comes from Taco Bell. For some reason the water at home isn't as great. ;)
*Trick your child by a giving them a cookie. What they don't know is that it's healthy! Here is my recipe below:
*Also, if all else fails, remember, while some calories are healthier than others- calories are calories. For example if your kid is sick for a week and has ate little to nothing, indulge them in whatever they want. Bad calories are better than no calories.
*If some old person gives you the advice "Don't worry, they won't starve themselves!" Tell them, politely (and maybe in your own words) to SHOVE IT! From my experience they CAN starve themselves and it is a very very VERY long road to get back to normal.
The following tables were found at: http://www.earthsbest.com/node/364
Please take a few minutes to look at REALISTICALLY what a serving size actually looks like for a toddler/child.
Below are the recommended number of servings and serving sizes, and representations of some of those sizes:
| Grain Group: Six Servings | ||
| One Serving: | 1 to 3-year-old: | 3 to 6-year-old: |
| Bread | 1/4 to 1/2 slice | 1/2 slice |
| Muffin | 1/4 to 1/3 muffin | 1/3 to 1/2 muffin |
| Crackers | 2 saltine size | 2 to 4 |
| Hot Cereal | 2 tbsp to 1/4 cup | 1/4 to 1/2 cup |
| Cold Cereal (Dry) | 1/4 cup | 1/3 cup |
| Cooked Pasta or Grains | 2 tbsp to 1/4 cup | 1/4 to 1/2 cup |
| Vegetable Group: Three Servings | ||
| One Serving: | 1 to 3-year-old: | 3 to 6-year-old: |
| Cooked | 1 to 3 tbsp | 1/4 to 1/2 cup |
| Raw Chopped | 1 to 3 tbsp | 1/4 to 1/2 cup |
| Leafy Greens | 1/4 to 1/2 cup | 1/4 to 1/2 cup |
| Fruit Group: Two Servings | ||
| One Serving: | 1 to 3-year-old: | 3 to 6-year-old: |
| Canned or Pureed | 1 to 3 tbsp | 1/2 cup total |
| Fresh | 1/4 cup total | 1/4 cup to 1 whole |
| Dried | 1 tbsp | 1/4 cup total |
| Juice (Full Strength) | 1/4 cup (2 oz) | 1/2 cup (4oz) |
| Dairy Group: Two Servings | ||
| One Serving: | 1 to 3-year-old: | 3 to 6-year-old: |
| Milk or Milk Substitute | 1/2 cup (4 oz) | 3/4 cup (6 oz) |
| Cheese | 1 ounce | up to 2 ounces |
| Yogurt | 1/2 cup | 3/4 cup |
| Cottage Cheese | 1/4 to 1/2 cup | 1/2 cup |
| Meat, Fish, Poultry, Dry Beans, Eggs & Nut Group: Two Servings | ||
| One Serving: | 1 to 3-year-old: | 3 to 6-year-old: |
| Cooled, Lean Meat, Fish or Poultry | 1 ounce | 1 to 1 1/2 ounces |
| Peanut Butter | 2 tbsp | 2 to 3 tbsp |
| Egg | 2 saltine size | 2 to 4 |
| Hot Cereal | 1 egg | 1 egg |
| Nut, Seeds, Soy Beans | 1/2 ounce | 3/4 ounce |
| Cottage Cheese | 1 ounce | 1 to 1 1/2 ounces |
| Dry Beans | 1/4 cup | 1/3 cup |
| Fats and Sweets | ||
| One Serving: | 1 to 3-year-old: | 3 to 6-year-old: |
| Butter of Margarine | up to 1 tsp | 1 tsp |
| Salad Dressing | 2 to 3 tsps | 1 tbsp |
| Sugar, Honey, Jam, etc. | use sparingly | use sparingly |
Sometimes the best way to understand what they really mean by a serving size is to actually see it. But actual size pictures are unrealistic for here, so try these relative comparisons to get the idea.
- A standard muffin is the size of a tennis ball
- One ounce of cheese is a pair of dice
- One ounce of meat is your ring and little finger
- Two tablespoons of peanut butter is a ping-pong ball
- One quarter cup fruit, vegetables, yogurt, etc is the size of a medium egg
Use standard serving sizes no matter where you eat. A study by The American Institute for Cancer Research showed that 67% of Americans eat what is on their plates, regardless of the serving size. Once you start ordering super size meals and deals, you'll eat it, even if you don't need it. And while young kids tend to eat according to hunger, after the age of five they become much more responsive to serving size. The more you serve them, the more they will eat. So, "toddler-hood" and preschool age is the most sensitive time to help kids stay in touch with inner cues of hunger and satiety. Encouraging them to eat more than they want, or serving unnecessarily large portion size will distort their intuitive understanding of how much they really need. Bring your understanding of portion size back to reality to help your child grow up eating appropriate amounts of food. It's a sure way to help prevent obesity and develop healthy habits.
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