Four And Not Growing: Follow Up

Back in February, I posted a plea for help for the mother of a soon-to-be-four year old boy struggling with eating. Up until this point, eating always involved some form of pressure. With some ongoing mom-to-mom support through the transition, Mom removed all sources of pressure from meals and started learning how to trust her son with eating. I know you’re all on the edge of your seats wondering how this story turned out so without further ado…

February 20
Not sure how to handle the finger twisting and more recently, the constant need to use the toilet, like every 5 minutes. Do I address it or ignore it? It doesn’t happen at any other time, only during meals. We were always told his pocketing food was a behavioural issue or trouble with chewing and swallowing. After reading Amari’s story in Love Me Feed Me, now we understand it’s not a chewing issue, more a don’t-put-any-more-food-in-my-mouth issue.

February 25
Things are going okay, slow and steady, with a happier child and a happier atmosphere. Where I’m confused with no pressure meals is the decrease in the amount of food he has been eating. A granola bar at 8:30am, and then nothing until the 2:30 snack. He says, “No thanks, I’m not hungry.” This weekend i had him try orzo (he opted to lick). Gag city! From a single orzo!

He has dark circles under his eyes. Does less intake mean a happier but less nourished child? I’m sitting here, crying, I’m so worried for him. He was sick about 3 weeks ago and hardly ate anything. Now everyone is noticing and commenting to me that these dark circles are because of our “new plan” with feeding. Then I freak out. This is so hard!!!

Today was an eating out day. The pizza lady cut his slice into 32 bites. He ASKED for his apple sauce AFTER pizza (gasp!) and is allowing me to put yogurt drinkables back into the mix.  Progress, yes, but I want him to enjoy SOMETHING! He’s worried about being asked to try the cupcakes that will be out for his sister’s birthday this Saturday.

February 26
Thank you for this post. (Copied from Ellyn Satter Associates‘ FaceBook page:)

Thoughts on a 3 year old simply stating he’s not hungry for a meal or snack before it’s been prepared? I mean, if we say, “It’s snack time!” and then he says, “I’m not hungry,” and we say, “Okay. There won’t be anything to eat until dinner and that is about 3 hours from now,” and he says, “That’s okay,” should we go ahead and make something or not?

Answer: Good question. I would suggest you go through the motions first – get the meal or snack on before you announce it. Then tell him, “you don’t have to eat but you do need to sit with us for a bit.” That bit might just be 2 or 3 minutes, but it will be long enough to interrupt his flow and give him a chance to discover whether or not he is hungry.

We will add this in our mix. I usually do prepare, show him, but I may make him sit to keep me company 2-3 min and see…

February 27
Breakthrough. He requested peas in his pasta ONLY if he could make them (maybe to be sure that’s all that was going in) and ate them. All of them!

Today, he let my mom feed him and the whole meal only took 10 minutes! Tonight, he said, “Mommy, I’m full, can I get up now?” He’s never said it on his own. I’ve always had to ask him repeatedly when I see him fidgeting.

Feeling good that he trusted my mom to feed him, and that he trusted the pizzeria the other day. He’s been an overall happy kid all day…and the last huge success: He ate 3 popcorns at school! The forbidden place!

March 5
Doing well…. Really well. He smelled a meatball yesterday. Progress. Stimming/anxiety is minimal …peeing thing stopped. No anxiety at his sister’s birthday party… He ate nothing, but also no stress. He’s been smiling a lot. Good days of eating and sometimes not eating. I have an appointment with the pediatrician to discuss what’s been going on with his eating and to discuss the coloring under his eyes…. Teacher asked me if he’s getting good sleep.

March 6
Is it possible to be overwhelmed by buffet style? I made him plain pasta, a bowl of mixed fruit, (his preferred) yogurt, our pasta, chicken and broccoli. Before I called him to kitchen I said, “Your favorites are on the table, you only eat what you want.” He took one look at the table and smacked his own face so hard, I needed to go cry in a room. He was yelling that fire ants were on his face. I’m beside myself.

March 12
We spent hours at the pediatrician appointment. He did his finger twisting staring thing there for the doctor to see. No gained weight since age 3, or growth, but nothing lost either. Tested negative for anemia and lead and mono. The doctor is 100% on board with the trust model feeding approach, and wants to book an appointment with a GI, and child psychologist. I’m thinking all but the GI sounds good. The doctor loves that we always have 2 preferred choices for him and wants me to add in 2 snacks a day, even if it’s junk food, just for calories. The doctor also suggested I leave his plate out after meals.

Basically the one needing the most help is ME not to get frustrated or “remind” him to eat when he sits for sooo long. The “stims” are anxiety/stress and I’m getting him to a psychologist. GI booked for April. He hadn’t eaten or drank since 1pm yesterday, so he was sluggish and had no energy. Glad the doctor saw him at his worst. So we continue… follow his cues, re-define mealtime as happy. The days when he doesn’t eat are scary and I don’t know what else I can do for my son. I just cry and hope.

The doctor said the dark circles could be poor diet, but no signs of anything serious. Ironically, his sister’s blood count, the breastfed, meatball-eating one, showed very low iron. Go figure!

March 17
I’m not completely “sold” the psychologist can help. Based on what I said, she agreed he has some form of an eating disorder though in “all her years” my son would be the youngest. I will add the psychologist (is it considered a formal diagnosis?) has labeled his eating behaviour as OCD to explain the avoidant eating disorder and failure to thrive. She began educating me about charts, reinforcers, timers. I stopped her.

“I’ve heard this ALL before,” I said, “I’m committed to the trust model. I’m committed to saving my child from pressure and fear. I don’t care if he eats granola bars for the rest of his life, as long as he continues to thrive and FUNCTION.”

She agreed with me, and told me I was better educated as a behaviorist and she didn’t feel a need to have us back. She gave me her goals, I told her mine. We left on a happy note. Her strategies were ABA based.

Today, for the first time, my boy just made, touched, and ATE his own pizza. Glimmers of a happy happy boy!

I think the crazy bad week we had is really him saying,  “wtf? A few weeks ago, I got in trouble. Now, I can get up, and there’s choices!! How far can I push to see WHEN I get in trouble.”

This battle with meals was ruining our marriage. Our dynamic. Our family. We have lots of undoing to do.

March 20
“Mommy, what did my sister have for breakfast while I was at school?”
“Grilled cheese.”
“I’d like one too.”
Jaw Drop. My heart seriously skipped beats.

March 22
We are a month in to the trust model. This has been the hardest few weeks, and the best few weeks. There was a lot to undo. My son never knew eating without pressure. In the beginning, he would go a few days without eating (1-2 days). He would stim less on certain days, a lot more on others. People told me I was failing him.

Transitioning to the trust model had him going crazy, had him eating less (buffet style). I kept saying, “Give it a chance. Give US a chance! You cannot undo 4 years in 4 weeks!”

Today, offered him cashews as I was snacking.

“No fanks, I’m not to keen on it.”
“Hear that crunch? It’s crunchy in my teeth, take a sniff!”
“Mommy, I’d like to lick it.” Sure!
“Mmmm, THAT WAS GOOD.” Oh my god, is this happening???

A handful later, it sure did.

Now, will he ever eat any of them again? Who knows, but THIS has never happened in 4 years. Never. He has about 20 safe foods including water and snacks. THIS is working!! Everything gets worse before it gets better, and this week is our better.

For the first time this week, I’ve watched him sit, talk and enjoy the company of others around food. The dark circles under his eyes are fading and his overall colour is improving. Doesn’t look like we’ll need the GI appointment after all. Whew!

March 24
Last night and this morning, he is self feeding without help! Another HUGE step for us. My parents noticed a huge change in him last night at dinner. Calm. Relaxed. Eating on his own. (Is this the same child?!)

March 27
5 minutes late picking up from school, which is usually catastrophic because he has to be in the room where the other kids are eating lunch. I walk in, he is sitting at the table, not eating, but OMG sitting with his friends! And fine. No anxiety. This is another huge step.

He’s on his second meatball now. I’m scared to get too excited!

April 14
Looking better. Doing better. The scale at home says he has gained 1.4lbs!! He is having more good days than bad. We are doing more of the helping him serve himself because choosing from the buffet seems to stress him out. It’s never one size fits all, right?

May 8
He is turning 4 tomorrow. He picked out 2 safe snacks to share with his school friends for his birthday. That would be the first time he comfortably sat among other kids with no anxiety and ate. I talked to him about how it felt to have a safe food somewhere other than home…and that’s how it would feel to bring in a safe lunch from home. New year, new beginnings.

May 11
He independently ate pizza and licked frosting at his party. With all the kids!! My family’s mouths (and close friends) had to pick their jaws up …. Everyone was tearing up!

May 13
Crying for joy! Since March, he has gained 2lbs and grew 1 inch!

This mom’s brave journey to trust her son with eating was frightening, emotional and ultimately rewarding. Feeding issues are stressful, not only for the child, but for the entire family. Parents need support to successfully make the transition from feeding with pressure to feeding with trust, and that support is readily available on FaceBook from Ellyn Satter Associates, creator of the Division of Responsibility, The Feeding Doctor, author of Love Me Feed Me and from other moms who have gone through or are going through the transition at Mealtime Hostage – The Group.

There is hope and there is help.

“All children want to eat. It is errors in feeding that make them seem they don’t, and those errors can be corrected.  From birth, some children don’t eat much, show little apparent interest in eating, or have atypical hunger cues. The transition from semi-solid foods through the almost toddler to the toddler years is full of pitfalls, any of which can concern parents, make them put pressure on feeding, and cause food refusal. Then parents, in their desperation to find food the child will eat, begin casting about for brands that are acceptable to the child. Children are not innocent in all of this. Children naturally and unconsciously strive for control, and what better control than to have parents running around trying to find something the child will eat? Kids, don’t you just love ’em?” ~Ellyn Satter

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