For now, I'm posting anonymous for my dd's privacy. She's nine years old and has always been on the thin side. This spring she was sick two different times and lost a total of almost ten pounds. Since she was only 61 lbs at the time, this has been pretty significant. It's been three months since her last illness and she hasn't gained any weight back.

She used to have a pretty healthy appetite and made very good food choices, snacked on lots of fruits and veggies, yogurt and string cheese, small amounts of meat and a moderate amount of carbs. Now she's barely eating a half bowl of cereal for breakfast, half a PB&J sandwich and a couple of apple slices for lunch, and three or four bites of chicken, a spoonful of rice and a couple of bites of veggie. She drinks milk with most meals but isn't snacking at all.

I've talked to her about food being energy for her body and that she needs to eat in order to swim, play soccer and ride her bike. She seems to understand but says that she gets full so fast now. I asked her if she wasn't eating so that she'd stay skinny but she said that my DH told her she'd probably always be skinny (he is) and seemed surprised by the idea of girls not eating to be skinny. If I push her to eat even a bite or two more, she ends up lying down after eating until she feels better.

Her doctor doesn't seem concerned and didn't offer much in the way of suggestions for other food options. I realize that kids eat different amounts at different stages but her height and weight now put her BMI at 13 and in the 2% for her sex and height so this is obviously more than just a slow recovery from the illness. Do you have any recommendations for high-calorie foods or ways to get her eating a little more?

By Ginny~moderator on Monday, July 10, 2006 - 06:06 pm:

Anon, if it were me, I would demand that the doctor give a referral to counseling. It sounds to me (and especially if you have posted on this topic at other times) that what is going on is at least partly a psychological/feeling issue, not just a diet issue. And maybe a referral to a gastroenterologist.

By Anonymous on Monday, July 10, 2006 - 06:19 pm:

I haven't posted on this topic before. I know that other dds here have had this problem, which is why I'm asking how to help her eat more. I don't know how to properly convey it here but I'm 95% sure that this is NOT a psychological issue. She just doesn't care how she looks and is completely comfortable in her skin, doing the things she likes without regard to others' opinions about it. She's semi-athletic but seemed completely unaware that others work hard to stay thin by exercising, dieting or any unhealthy means. She gets hungry around mealtimes and will serve herself a healthy amount of food and then just can't finish it. A case of her eyes being bigger than her stomach but it's this way all the time. I'm more inclined to see a gastroenterologist than a counselor, simply because I'm that sure this isn't the beginnings of an eating disorder.

By Vicki on Monday, July 10, 2006 - 07:12 pm:

Dd had some issues about a year and a half ago now and one way they had me help get some weight on her was to drink slim fast or ensure or something similar WITH her meals. It really helps in getting extra calories. She also wanted her to eat a bowl of ice cream every night before going to bed. If not ice cream, some other high calorie snack that would add some calories right before going to sleep since they aren't burned as fast. It can be a hard cycle to break. YOu have to get her to eat more so that her stomach can get a little bigger so she can eat more if that makes sense. Some other high calorie things I did was extra mayo on her turkey sandwhiches, ranch dressing for dipping everything in (she likes cauliflower, chicken and pork chops with ranch for dipping) extra butter and peanut butter on toast.... get as many high calorie things as yu can in her. You can really boost calories without adding tons of food and that helps get her body working right again and getting hungry. Add cheese to every sandwhich if you can... gosh, I can't remember what all now but if I think of other tricks, I will post them. If took dd about 3 to 4 months to come back to a normal eating pattern after her weight loss. But it took her about 6 months to gain all her weight back. Also, try not to stress too much about it in front of her. I was a wreck about it and when I eased up talking about it and just sneaking those high calorie things in there, she started eating better. Trust me that I thought about it at every meal and with every snack, but just didn't say much at all about it to her. LOL They also wanted her to eat every three hours. Small frequent meals.

By Luvn29 on Monday, July 10, 2006 - 09:14 pm:

My son had problems with being able to eat, even though he would be hungry, he couldn't eat very much. He's very skinny, but he was also only in Kindergarten, so I knew it wasn't anything pyschological. I finally insisted on taking him to a pediatric gastrologist, and after being put on some simple meds, he improved dramatically. We can't believe how much he eats now.

His problems came after being sick with a virus. His doctor said sometimes for some people, having a virus or some other illness can put their stomach and stuff out of whack afterwards, and they may need meds for a few months to get it straightened back out.

I'd definitely see a ped. gastrologist. His regular pediatrician didn't take it seriously and act concerned. I knew something was wrong. He's a new little boy now that he has medication to make him feel better.

By Vicki on Monday, July 10, 2006 - 10:01 pm:

Oh lord I forgot about the meds that they put dd on. They did give her a medication that was supposed ot help increase her appetite. That was very helpful. We went to her ped which referred us to a child phycoligist. They did talk to her at length about it being a body image type of thing and ruled that out. She was 10 when this happened and in 4th grade. Her episode followed a very stressful 4 months or so that included her very first ever stomach flu. But prior to that, she had been through many things. Death of a classmate etc. She had a couple of couseling sessions and then we only had to see the nutritionist and check in with the dr every month or so for a weight check and a brief checking in.

By Mrsheidi on Monday, July 10, 2006 - 10:21 pm:

Read this book
"How to get your kid to eat, but not too much."

It has been a godsend. It talks about how it's our responsibility to present the food and it's their responsibility to eat and how much.

There's more to it than that, but it really takes the pressure off the parents and has totally changed my attitude with feedings.

By Vicki on Monday, July 10, 2006 - 10:53 pm:

I really mean no disrespect heidi, but a 9 year old that is only in the 50's for weight is much more serious than reading a book. It can come to a point (believe me I know because I had it happen to dd) that they CAN'T eat. Dd would ask me to make her something and then just push it around on her plate. You could tell by looking at her that the thought of putting it in her mouth made her feel sick!! Letting it be their responsibility to eat and how much would be fine for a normal weight child who is just being too picky, but if I would have done that to dd, she would be dead right now I have no doubt!! It wasn't a matter of her not wanting to eat, she couldn't eat!! There comes a time that you have to step in! They told me that her body was going into a anorexic state!! It can be very serious!! There was a day that her finally eating a half of a granola bar made me literaly cry out of joy of her finally eating something. As I said, I am sure that is a great book for dealing with a picky eater etc., but I think she is looking at a medical issue myself!

By Anonymous on Tuesday, July 11, 2006 - 11:50 am:

Heidi, I have to respectfully agree with Vicki here. I'm sure you have the best intentions but I've dealt with a picky eater as long as I've had kids and we have a similar philosophy (I decide when and what food will be served, they decided how much of which foods will be eaten) that has worked for all these years. This goes way beyond not wanting to eat what I put in front of her. She WANTS to eat and is willing to try almost everything I put in front of her. Vicki, I know exactly the look of being sick at the idea of putting anymore food in her mouth that you mentioned. It's a matter of getting more food (and high calorie food would be best) into her, at this point.

Thank you for all of your advice. I think I'll be calling the pediatrician and pushing for a gastro- appointment. I've had that gut feeling that this might all relate back to her illnesses a few months ago and she could be mimicking Adena's ds's situation with all the similarities. I'm glad to know that the idea of her being unable to eat isn't so farfetched. Vicki, I've been pushing whole milk and real butter but I'll try a few of your other tricks. If you remember any others, let me know.

Again, thanks to all of you!

By Vicki on Tuesday, July 11, 2006 - 12:26 pm:

I also bought chips and chip dip for her, I forgot they had me give her whole milk too, believe it or not, grapes are good. I think they have 10 calories in them, so eating only 10 gives her 100 calories, pancakes with butter and heavy syrup. Try to think of what you might do to save calories and do the opposite with her. Dips etc are a great way to add calories without adding tons more food to her diet. The boost in calories will help boost her appetite also. Work on that first and as her appetite increases, you can add some more food. Please do look into calling your doctor about it again and getting her seen by someone. Meds might be a huge help for you also! They are safe and dd only took them for a few months, so it isn't real long term or anything.

By Vicki on Thursday, July 27, 2006 - 07:53 pm:

Just bumping this up and I hope you see it and update us. I know what your going through and just wondered how things were going??

By Anonymous on Thursday, July 27, 2006 - 08:58 pm:

Things still aren't going very well. She's had a couple of great days where she's eaten a little at a time but eaten all day but most days, I'm still finding that I have to ask her all day long to eat a couple of bites or really offer treats in order to get a little bit of food in her. My other kids are picking up on it now and are wondering why she gets to eat nearly anything she wants when they don't. We've just gotten back from vacation and she didn't have her usual amount of energy so I plan on calling for a doctor's appointment again. I've been keeping a food diary (not easy to do without her knowing about it!) so that I can show her ped. just how little she's really eating. Thanks for your concern, Vicki.

By Vicki on Thursday, July 27, 2006 - 09:08 pm:

Oh dear, I was really hoping that you would have better news for me! I am so sorry that your going through this, I know how hard it is to watch your child eat next to nothing. I was worried sick over it and stressed about it for a few months even after things got better. Even now I still find myself watching how much of her lunch she eats etc. She has some days now where she eats from sun up till sun down and other days she doesn't eat much at all. I KNOW that is the normal cycle for kids, but on the days that she doesn't eat much I still think about it and just hope we aren't going backwards!!

I think calling the doctor again is a great idea. You want to get this at least somewhat going in the right direction before school starts. I know that nerves can play a big part of how dd eats and most kids can get nervous starting school back up!! It is also hard because you can't see how much of the lunch she eats etc.

This can be fixed and there are great meds out there to help. I am not saying she should be put on them, but if it is recommended, it is a great tool in getting them going again!

Please update me often as to how she is doing. I do think about you both often and am keeping you both in my prayers. Believe me, I know how hard it is on you as well as her!!

By Mrsheidi on Thursday, July 27, 2006 - 10:26 pm:

What do you mean by "She wants to eat but she won't." ? Do you think it's more psychological/anorexia or more of a physical problem? You weren't specific with her recent sicknesses.

And, like I said, there was more to the book than that. I do believe books help. I'm sure you've started reading a few. Sometimes your local doctor doesn't always have the answer. I'm proud of you for looking into it though.

By Anonymous on Friday, July 28, 2006 - 12:36 am:

Heidi, I don't think I said that she wants to eat but she won't. She tries to eat, serves herself a normal portion of food or asks for a normal amount (a ham sandwich, nectarine and cheez-its for lunch today and ate only a third of the sandwich, three bites of the nectarine and didn't touch the crackers) and feels ill if she pushes herself to eat past when she feels full but she feels full after just a few bites. I do think it may be something physical but was hoping it was just a matter of needing to "stretch" her stomach after her illnesses. She had a virus two different times about two months apart with a high fever (104.8), headaches and a lack of energy. Both times she was tested for strep (negative) and checked for an ear or sinus infection. I have read several books and have done a lot of online research. I'm finding that there are many children like Vicki's and Adena's that simply can't eat enough after having a severe virus.

Vicki, I know what you mean about stressing over it and watching her day after day. Tonight she only ate a third of a small chicken burrito and I called my dh at work and just cried to him. I don't know what to do and I can tell that she knows it worries me. At least she has no idea how much I worry. I've kept my talks with her about food very light-hearted and casual and usually in the company of the rest of the family so she doesn't think I'm singling her out. I do want to get some progress made before school starts. Luckily, we still have a month to go until then. Thank you so much for thinking of us and keeping us in your prayers. It's nice to know that there is someone else out there that's been through the same thing and understands that it isn't all in her head!

By Vicki on Friday, July 28, 2006 - 07:57 am:

I know that you said she didn't have her usual amount of energy during vacation, but does she at least have some energy? Dd went downhill pretty fast and got to the point where she had next to no energy and had dark circles under her eyes and all of that. It also affected dd's sleeping. It doesn't sound like you are there yet and that is a good thing. I think you are getting enough in her to somewhat maintain herself. Have you weighed her lately?? How is the actual number on the scale doing? I do understand that it isn't all in her head and there is a big difference between won't eat and can't eat. It is a real problem!!

By Anonymous on Friday, July 28, 2006 - 12:03 pm:

She does still have some energy but it seems like she is conserving it from one activity in order to do something that might be a higher priority for her. For instance, she didn't care much about playing beach volleyball or paddleball with DH but she loved bodysurfing in the ocean so she'd lay and rest for half an hour before playing in the water for a while but she'd have to come back to the blanket and rest up again before chasing the seagulls with her siblings. She's always tended to have dark circles under her eyes (they're hereditary) but they are more prominent and she's more pale than usual. How did this affect your dd's sleep? My dd is having trouble falling asleep and for the first hour or two, her sleep is very restless and light. She's waking at her usual time with no problem but she still seems to be tired in the morning. I just got her on the scale before we left on vacation and her weight isn't moving much, up or down. It's great that she's maintaining but she's using less calories along with taking in less so I'm not sure how happy to be about that fact. And, regardless, she's still not putting on weight, which is what she needs. Unfortunately, all of my dks have come down with hand, foot and mouth disease in the last 48 hours and I know that is affecting her appetite. *sigh* I just want my little girl back!!!