2 year old with food aversion

[DaisyDay]

I have a 2 y/o old foster son who has been diagnosed with failure to thrive. He is a terrible eater and will only consume sweet foods that are of a pureed consistency (think level 2 baby food fruit). I've been trying to be creative with unsweetened applesauce, yogurt and baby cereal or jars of baby food all mixed up and he does ok with that, but I know he's not getting a balanced diet. He does drink Boost (also loaded with sugar) for added nutrition.

 

For the first few days he was with us, he was literally starving. He wouldn't eat anything. He reminded me of a flower that was slowly drooping more and more each day. There's some old-fashioned advice that says "he'll eat when he's hungry enough." Guess what? He won't. He won't touch anything that has to be chewed. I was finally successful with a Gogurt that came in a McDonald's Happy Meal and I was able to work a little from there.

 

But here's my question: I'm thinking of getting a small food processor and using it to try sneaking in new ingredients and extra calories. Has anyone done this? Any advice for a frustrated foster mom?

 

I forgot to add that speech therapy is already involved and he had a swallow study done today.

Edited January 14, 2016 by DaisyDay

[zoobie]

Get him evaluated by an OT. (If not a full developmental eval from Babies Can't Wait) In the meantime, absolutely I would purée food for him. Avocados are high in good fats and purée smoothly. Use full fat Greek yogurt. The Gogurt tubes are low fat and mostly sugar.

[TeenagerMom]

I have a 2 y/o old foster son who has been diagnosed with failure to thrive. He is a terrible eater and will only consume sweet foods that are of a pureed consistency (think level 2 baby food fruit). I've been trying to be creative with unsweetened applesauce, yogurt and baby cereal or jars of baby food all mixed up and he does ok with that, but I know he's not getting a balanced diet. He does drink Boost (also loaded with sugar) for added nutrition.

 

For the first few days he was with us, he was literally starving. He wouldn't eat anything. He reminded me of a flower that was slowly drooping more and more each day. There's some old-fashioned advice that says "he'll eat when he's hungry enough." Guess what? He won't. He won't touch anything that has to be chewed. I was finally successful with a Gogurt that came in a McDonald's Happy Meal and I was able to work a little from there.

 

But here's my question: I'm thinking of getting a small food processor and using it to try sneaking in new ingredients and extra calories. Has anyone done this? Any advice for a frustrated foster mom?

 

Absolutely try that!  DS was diagnosed as Anorexic at age 5 because after he had a major surgery, he refused to eat anymore.  He dropped completely off the growth chart and was a 1/2 lb away from a feeding tube when his weight loss finally plateaued.

 

He ate 2 foods.  Chocolate pudding and Macaroni & cheese. He would only eat 3-4 bites of those foods.

 

We did Chocolate milk with Vanilla Carnation Instant Breakfast mixed in to make a 400+ calorie drink.

We added Polycose to ANYTHING and EVERYTHING. (similar to this

http://www.amazon.com/Solcarb-Powder-Oz-Can--Case/dp/B00DYVSHLG/ref=sr_1_1?ie=UTF8&qid=1452735983&sr=8-1&keywords=solcarb)

 

 

You probably also need to get him evaluated for Occupational Therapy so he can start getting some feeding therapy!

 

[Ali in OR]

My disabled dd didn't want to eat much when she was a toddler. We used Pediasure--is that better than Boost? She liked it enough that we supplemented occasionally with that until just the last few years. Dr. also had me make Haagen Dazs milkshakes.

[Acadie]

I think your food processor approach, slowly and steadily introducing new things, sounds really good. Would he eat a little chicken soup pureed into sweeter foods, slowly increasing the amount of soup?

 

I'd also sneak in probiotics. Craving only sweet/simple carb foods makes me think his gut flora is off, and he's hungry for those foods to feed yeast or some other unhelpful gut flora. 

 

I wonder if you could add powdered stevia (get the kind that doesn't have additives) to real yogurt to help him transition from sugary foods to more diverse nutrition.

 

Thank you for taking such good care of your sweetie pie!

 

Amy

 

 

 

 

Edited January 14, 2016 by Acadie

[EKS]

When you puree the food you want to make sure that *all* the lumps are out.  I found out the hard way that what seemed pureed to me wasn't actually lump free.  After that nasty incident (involving a large quantity of vomit), I used a strainer.

[DaisyDay]

Get him evaluated by an OT. (If not a full developmental eval from Babies Can't Wait) In the meantime, absolutely I would purée food for him. Avocados are high in good fats and purée smoothly. Use full fat Greek yogurt. The Gogurt tubes are low fat and mostly sugar.

Yes, OT and PT are also involved but I think the ST is the one who will be working with his feeding issues.

 

Agree about the Gogurt. Nasty stuff. WIC provides a whole quart of the full fat plain yogurt every month. I think of it as a base to stir other stuff into.

[applethyme]

Have a speech therapy evaluation.  Our last foster did not know how to eat foods properly because he had been fed chicken nuggets and hot dogs starting at 6months.  Mom told me that she thought he was "such a smart baby" that he could handle foods.  As a result he developed poor oral habits and could not manage certain foods in his mouth.  Occupational therapy should also be consulted to assess for sensory issues.  My son developed a food aversion due to sensory issues.  There are a few textures that he will not eat even after 5 years of therapy, but eats enough variety that he gets proper nutrition. 

 

Duocal.  It mixes with pretty much everything and is a great way to add calories.

 

There are some wonderful books and resources about food chaining.  We used food chaining as a way to get my 100% orally adverse, tube fed, failure to thrive son to eat.  It works well.

[DaisyDay]

 I'd also sneak in probiotics. Craving only sweet/simple carb foods makes me think his gut flora is off, and he's hungry for those foods to feed yeast or some other unhelpful gut flora. 

 

I wonder if you could add powdered stevia (get the kind that doesn't have additives) to real yogurt to help him transition from sugary foods to more diverse nutrition.

Excellent idea! I think I have some Florastor or something similar in the med cabinet. Not familiar with stevia though. Need to research that.

 

 

Also, I'd like to add that foster son's skin and hair tend to be dry. I know this is diet related--proteins or fats or both.

[prairiewindmomma]

I assume if he's had a swallow study and you're working with OT....either OT or the SL-P will handle the feeding issues. Make sure to get a full sensory eval if this turns out to be sensory in nature.  At least you have the texture and sweet thing figured out.

 

I had a dd with motor-feeding issues.  The food processor idea is a good one.  You'll need to figure out if you have to have it be completely smooth or if you can have some lumps in it.  Some foods are hard to get completely smooth.  Adding avocado or olive oil is a good way to add calories.  You'll want to make a check list to make sure you're getting a wide variety of vitamins in, or get a good oral vitamin supplement. Corn starch is a good thickener for savory foods.

 

Sneaking in new ingredients may be hard if it's sensory in nature. Sweet potato tends to not have a strong flavor, is nutrient dense and slightly sweet. You might start there. Spinach is also pretty easy to hide. Look to green smoothie recipes for inspiration.  The hard part is you are going to need a fair amount of fat---whole yogurts, avocado, and olive oil will be your friend in creating balanced meals.

 

Also look for dysphagia recipes. A number of them are decent. Not all.

[Junie]

Seconding the advice on adding olive oil.  My littlest one was diagnosed with failure to thrive.  She was sickly looking.  We started adding a tablespoon of olive oil to her stage 2 baby food and you could actually see the difference in her face in just a couple of days.

 

 

[AndyJoy]

Butternut squash also has a sweet flavor and might help as a less-sweet transition. I used to make a soup of pureed butternut squash and chicken broth for my toddler.

[TechWife]

You might find the book Child of Mine: Feeding your Child with Love and Good Sense helpful. My son's ST recommended it to me when he was in preschool. The same author also wrote How to Get Your Child to Eat: But Not Too Much. There may be more current books out there now. 

 

I think your idea of trying to expand his diet in a texture that he can tolerate is a good one. There is a whole process we went through to introduce new foods - food texture was (and still is) a big deal with my son.  

 

Hopefully the speech therapist that is working with you is a feeding specialist or at least knows a lot about it. How did the swallow study go? 

[AndyJoy]

You could also add peanut butter or another nut butter to plain yogurt with banana smoothies. A dash of cinnamon helps things seem sweeter.

[DaisyDay]

 

 Hopefully the speech therapist that is working with you is a feeding specialist or at least knows a lot about it. How did the swallow study go? 

The swallow study results were mostly good except for some mild abnormality when he takes large gulps of thin liquid. They suggested he use a coffee stirrer/small straw or that we pinch a larger straw a little bit when he drinks to slow him down some and help avoid the possibility of choking. They tried to get him to eat a piece of graham cracker with contrast on it but I could have told them that was a no-go and I would have been right! :-)

 

 

 

Thanks everyone for all the great suggestions. I'm taking notes!

[dsmith]

We found a speech language pathologist who specialized in feeding issues when my son stopped eating due to major sensory/anxiety issues. He was older, though, but that shouldn't be an issue. She had very specific methods for working with different textures and introducing new foods. Between her work and medications that treated the anxiety (which had the side benefit of making him very hungry, not a benefit now!!) he eventually started eating a more varied diet, although I don't think he will ever eat lettuce and certain other foods. One problem that we still deal with: it was easier to get him to try unhealthy sugary or fried foods, and the mentality of any food as long as he is eating by all of us including the doctors and therapists translated to a teen who is not a very healthy eater, although he is improving.

 

I found it interesting that although we were dealing with out of control sensory issues, some of his therapy was the same that she would use for stroke patients or with swallowing disorders.

 

ETA: I realized I didn't actually address your question, lol. I've heard a lot of good things about the Nutribullet. My sil says it really breaks everything down, better than her food processor. If he really wants smooth texture, it may be worth checking out.

Edited January 14, 2016 by dsmith

[knoxinsox]

Have you heard of the Ellyn Satter method and ARFID? My son is this way, and he too will literally wilt rather than eat foods that are not on his safe list.  He is now 10, and although still a Selective Eater, he is chaining new foods and has added about 10 new foods in the last year since we have implemented her methods (link below). Its been very hard and we've tried disciplining, bribing, etc. and he will not eat unless it is his safe food.  DOR keeps it very low-key and non-threatening.

 

http://www.ellynsatter.com/resources/DORfeeding.pdf

[Rosie_0801]

My son's food aversion fluctuated depending on the severity of the retained reflexes of the mouth. That might be one of the contributing factors you have going on. Stroking his face, mouth and chin can help. Not quickly, definitely not quickly, but it can. They won't go away entirely until the prerequisite reflexes are completely gone.

[mommymonster]

Absolutely start blending! You can make just about anything into a "smoothie" or "ice cream".

 

I help to run a nonprofit that helps people on feeding tubes "eat" real food that is blended up into pureed consistency. We have a number of kiddos who just "eat" purees via bottles or spoons. This website discusses blended diet for kiddos who need purees --http://lovingamiracle.blogspot.com/

 

Here is a link to a list of calorically dense foods -- http://www.foodfortubies.org/inspiration-calorically-dense-foods/-- these are foods that have a goodly amount of calories, but don't take up a lot of space. (These ingredients might require a blender, not just a food processor, to get them smooth enough.) For example, avocados might be just the thing for your little one. You can make a yummy pudding with avocado, cocoa powder and a bit of sugar or agave. :-) 

 

This book on Food Chaining helped us to transition our son from a feeding tube to eating table food -- http://www.amazon.com/Food-Chaining-Feeding-Problems-Child%C2%92s/dp/1600940161

 

In any case, I'd do what I could to get food into him... once he's eating he'll hopefully feel better. If he's newly in your care, this could also be a situation of him trying to control his environment. It could also be that he was only fed yogurt and sweet things before coming into your care... This is going to require a goodly bit of patience on your part...  :grouphug:

[kbutton]

My son's food aversion fluctuated depending on the severity of the retained reflexes of the mouth. That might be one of the contributing factors you have going on. Stroking his face, mouth and chin can help. Not quickly, definitely not quickly, but it can. They won't go away entirely until the prerequisite reflexes are completely gone.

 

Rosie, do you have a link for good exercises or touch techniques? We're starting feeding therapy soon. I am curious if this will be incorporated. My son has retained reflexes all over the place, and we're having dramatic results with any that our vision therapist can tackle, but they've not been for the face and mouth at this point. We are seeing changes almost daily with my son, so if we can do the same for his oral motor and speech motor systems, I would be very happy about that. 

[OneStepAtATime]

Agree with all of the above.

 

Are you wanting the full sugar version of Boost? I couldn't really tell from your post if the hugh sugar content was a positive or a negative in this situation. I was going to say if you don't there is another Boost version that has 16 grams of protein but only 4 of sugar...and it still tastes very sweet.

 

Hugs and good luck.

[amo_mea_filiis.]

Blend and pediasure as a band-aid, but look into a feeding clinic as well. My 11 year old is picky to the extreme, and just went to a feeding clinic last summer. Had I pushed the issue with his docs at 2 and 3, it would have been much easier to fix!

 

General OTs and SLPs can all do some amount of feeding, but I've found them to useless for us. (They're good at what they do, but none have had extensive feeding training or experience)

[Rosie_0801]

Rosie, do you have a link for good exercises or touch techniques? We're starting feeding therapy soon. I am curious if this will be incorporated. My son has retained reflexes all over the place, and we're having dramatic results with any that our vision therapist can tackle, but they've not been for the face and mouth at this point. We are seeing changes almost daily with my son, so if we can do the same for his oral motor and speech motor systems, I would be very happy about that. 

 

I don't know anything about better or worse quality touch techniques. I only know about doing it or not doing it. No style here, I'm afraid.

[Carrie12345]

Puree, yes.

Therapy evals, yes.

 

But PLEASE also push for a Ped GI or nutritionist.  At 2, I would be extremely worried about immediate (and I'm guessing long-term overdue) nutritional needs.  While I have used Boost and Pediasure to supplement two extremely picky eaters, I have doubts that it would be enough for a FTT toddler at such a crucial point in development.  Our Ped GI prescribed special formula with specific dosages that were contrary to the label, but needed for our FTT baby. She worked with us for 9 months, until he was able to be on a completely "normal" young toddler diet. I am certain that my 5yo would still be facing repercussions today without her guidance and close monitoring after several months of serious deficiencies. 

[sassenach]

In addition to ST, you need a nutritionist involved, and possibly an OT.

 

The nutritionist can help figure out how to hide more calories in his food and make a plan for the future. In the meantime, yes, I would try to sneak anything I could into him. Contact blendtec. With a dr note, you might be able to get a blender through their medical hardship program.

[Minerva]

:grouphug:

[DaisyDay]

In addition to ST, you need a nutritionist involved, and possibly an OT.

 

The nutritionist can help figure out how to hide more calories in his food and make a plan for the future. In the meantime, yes, I would try to sneak anything I could into him. Contact blendtec. With a dr note, you might be able to get a blender through their medical hardship program.

Thanks for the tip. I just emailed them.

 

And for those suggesting a nutritionist, foster son has a doctor appt next week and I will ask about that.

 

Will update next week. Thanks for all the awesome web sites and suggestions!

[Katy]

I haven't dealt with this precise issue, but before I got married I did used to babysit occasionally for a family at my church. Their youngest girl had lead poisoning. She was very small, and a picky eater, and for years we did stuff like mix "chocolate milk" for her that was really a meal replacement mixed with half and half instead of milk, and snuck 30% (by volume) cream into every pureed food we could for calories and a smoother texture. Last I knew she was still small for her age (teenager now), but had managed to get back on the charts, growth wise.