Food issues with 12 year old

[Loowit]

I am really struggling with what to feed my youngest and could use help, though I am not feeling hopeful.  If by some miracle anyone has a solution I would love to hear it with the caveat that suggesting he will eat when he is hungry enough is not going to happen, so please don't suggest that.

 

Problem:  DS had a lot of food allergies as a toddler - dairy, soy, eggs, peanuts, and tree nuts.  His main source of nutrition until he was about 2 was breastmilk.  Once he outgrew his dairy, egg, and soy allergies we started to introduce those foods into his diet.  He hates eggs.  He can't stand the texture or flavor.  He likes milk okay, but has now developed lactose intolerance and can't have dairy again.  This cuts out many of his favorite foods, many of which involve cheese.  He is no longer allergic to peanuts, but can't stand being around them. The smell of them makes him sick to his stomach.  He is deathly allergic to almonds.  He can't have red 40 dye, although most "real food" doesn't have this anyway.

 

Foods he will currently eat:  chicken (nuggets, tenders, strips, deep fried, or once in a blue moon baked with no crust), fish sticks (must be breaded), pancakes (once in a while), waffles, sausage links, homemade breads (rolls, pretzels, etc.), french fries and tater tots (if cooked "right"), carrots, strawberries.

 

He has seen three nutritionists in the past.  None of them were helpful at all.  I have tried bribing him with no luck.  Many foods are a texture aversion that make him throw up. He is willing to try things, but has a hard time with so many of them.  It has been getting worse over the last year rather than better. He used to eat a lot more foods, but he says now that they taste bad to him or the texture bothers him.

 

His current diet is very unhealthy and I am doing everything I can to offer nutritious foods, but he can't or won't eat them.  If he could handle dairy his options are a bit wider, but he just can't.  We have tried the medication that is supposed to help digest lactose but he says it makes his problems it worse.

[prairiewindmomma]

I know you've seen a nutritionist; have you seen a therapist specializing in sensory feeding issues?  All of the foods that you mention have a similar texture.  The fact that he is "losing" foods is concerning.

 

I would look at bridging techniques---if he is eating breaded chicken and fish, then I would try breading steak (chicken fried steak).  If he is eating potatoes that have been fried (crisp texture, soft inner), then I would try something like breaded & fried zucchini or pressure cooking sweet potatoes and serving it with brown sugar and some vegan butter (like earth spread). 

 

I'm also a little bit concerned that some of these aversions may be hinting at a return to allergies. Has he had panels done recently? I mention this only because of my own experiences with food allergies.  I was having a number of intolerances and they did smell off or make me hurt in a vague way.   I recognized it as an adult, and was able to tie it back to some heavy duty antibiotics I had during a hospital stay that combined with my autoimmune dysfunction were causing issues. I might try adding some probiotics to his diet....really good quality ones for a period of 3 months. My body was able to re-regulate and I no longer have those intolerances.

[Lecka]

https://www.amazon.com/Food-Chaining-Feeding-Problems-Child%C2%92s/dp/1600940161

 

I went to a presentation that mentioned this book, the presenter had a good opinion of it.  

 

[Loowit]

He has not seen a therapist for feeding issues.  He did go to an occupation therapist for about a year to deal with some other issues, feeding was brought up but never touched on because the other more pressing issues.  I can ask his ped about it though.

 

He had allergy testing done about three weeks ago, but it was only for environmental allergies.  He was not tested for any foods.

 

I will look into the probiotics.  That sounds like it would be worth trying.

[LucyStoner]

How involved is he is picking out and cooking his food?  My son was a very limited eater until he was about 12.  We are talking breads, cheese, fruits but mostly apples, carrots and plain meat or fish. That was basically it except for some desserts.  He's on the spectrum so sensory issues were a huge part of it. At that time, he expressed irritation with how limited his diet was and I just gave him money and let him start buying things he wanted to try and finding recipes.  It wasn't a magic bullet but he's pushing 15 and eats a much wider selection of foods now.  

[Lecka]

It would be great if you could get a referral for feeding issues.  

 

I wanted to add, keep in mind realistic expectations.  I linked that Food Chaining book, but the cover makes it look like "oh he'll eat anything if we do this program."  That's probably not a reasonable expectation.  Expanding to eat some more foods would be a great outcome for a lot of kids.   

Edited February 27, 2018 by Lecka

[amo_mea_filiis.]

Behavioral feeding therapy. So a program designed by a board certified behavior analyst.

 

If that’s not possible, a good book is Treating Eating Problems of children with ASD and developmental disabilities, by Keith Williams and Richard Foxx.

 

A lot of the book wouldn’t apply. But table time, food chaining, minimum bites, plate A plate B all would help.

 

You can behaviorally teach a sensory issue and it’s faster.

 

Mine is 13. Had serious sensory issues all around. At their age, it has to be quick and dirty because they’re old enough to understand.

 

My 17yo daughter is running a few of her own behavioral programs. One for food... she’s forcing herself to tolerate eggs.

[SKL]

Wish I had a good idea, because my 11yo sometimes won't eat anything but ice cream and pizza. 

 

One thought - what about baking veggies or fruits into breads?

[SparklyUnicorn]

My picky kid learned to make his own food pretty early on.  It didn't change his pickiness, but he was at least in charge of his own meals.  I don't have to make separate food.

 

 

[Lecka]

I would not only look at a behavioral program for feeding.  There is so much that could be going on physically and medically. 

 

I think a feeding specialist is going to be a lot more appropriate than a BCBA (board certified behavior analyst) for most kids.  And then a lot of kids who are seeing a BCBA will be seeing a speech therapist or OT too, anyway, and then you have a team approach anyway. 

 

Just for background, my son sees a BCBA because he has autism, they are a specialty that often work with children who have autism. 

 

But I would look more for someone specialized in feeding therapy, probably a speech therapist or OT, who also included some behavioral aspects as needed. 

 

And then if you aren't going to see a specialist ------ I think that's okay, too, there are good suggestions here. 

 

 

Edited February 27, 2018 by Lecka

[Farrar]

I know from our perspective that it looks horrible, but I have to admit... chicken prepared in a reasonably healthy way, homemade bread or homemade French fries, and carrots and strawberries every day seems okay to me. I mean, it's a pain for you to have those things all the time. And it would drive any omnivore nuts to eat that day in, day out. But he's got a little of most of what he needs in there.

 

I don't want to discount the behavioral feeding therapy stuff - therapy can do great things. But I wouldn't try to do it on your own if you're going to do it. I was an extremely picky eater at that age and it really was about control in large part. And the most surefire way to make me limit more was people fighting with me over it - either in a bribing, cajoling way or in an overt punishment way. I'd rather have gone hungry than give in. In fact, I did once spend a week at summer camp pretty much eating almost nothing. I freaked everyone out at the camp. My mother had to have a long conversation and tell them all to back the heck off.

 

Basically, if you don't go the professional therapist route, I'd just keep feeding him those things with as little judgment and pressure as possible. Make him do the prep though. He's 12. He can make his own food.

[SparklyUnicorn]

I know from our perspective that it looks horrible, but I have to admit... chicken prepared in a reasonably healthy way, homemade bread or homemade French fries, and carrots and strawberries every day seems okay to me. I mean, it's a pain for you to have those things all the time. And it would drive any omnivore nuts to eat that day in, day out. But he's got a little of most of what he needs in there.

 

I don't want to discount the behavioral feeding therapy stuff - therapy can do great things. But I wouldn't try to do it on your own if you're going to do it. I was an extremely picky eater at that age and it really was about control in large part. And the most surefire way to make me limit more was people fighting with me over it - either in a bribing, cajoling way or in an overt punishment way. I'd rather have gone hungry than give in. In fact, I did once spend a week at summer camp pretty much eating almost nothing. I freaked everyone out at the camp. My mother had to have a long conversation and tell them all to back the heck off.

 

Basically, if you don't go the professional therapist route, I'd just keep feeding him those things with as little judgment and pressure as possible. Make him do the prep though. He's 12. He can make his own food.

 

Seems ok to me too.  Yes, I'd love it if my kid would break down and eat a vegetable, but he won't.  So it is what it is. He is healthy.  He's expanded his eating a little (a veryyyy little) over the years, but he has. 

[Nemom]

How is his health otherwise?  Does he have ongoing issues or complaints?  Headaches; stomach aches; sore legs; overall fatigue level?  Does he have trouble swallowing? Feelings of the food getting stuck in his throat?

 

I have a child who was once labeled a picky eater (with food allergies) who we learned later actually has a disease called Eosinophilic Eosophagitis.  She did/does not have the typical symptoms so it was hard to nail down a dx and took several years and lots of pushing from me.

 

http://apfed.org/about-ead/egids/eoe/

 

May be something to look into since your son has a history of multiple food allergies.

Edited February 27, 2018 by Nemom

[displace]

With sensory pickiness, food chaining can help (eating foods very similar to current accepted foods), as well as sensory desensitizing. Start with juices of fruit he likes, switch to sweetened cooked purées, or jams, move to purees with a little texture in them, then chunks, etc. Use sneaky chef recipes for some foods (muffins with pureed banana or applesauce), puréed fruit popsicles and shakes/smoothies.

[Lecka]

I have heard back-and-forth about whether it's better to see a speech therapist or an OT for feeding.  I think it depends.  I think both can specialize into feeding therapy. 

 

If you look into it, I think ask around for recommendations!  You will need somebody who can do really well with your child.  It's a very personal kind of thing and it requires a lot of trust. 

[AK_Mom4]

Quick look says he has a couple of proteins, carbs, two veggies and a fruit.  It could be worse.

 

Is he willing to taste-test some juices?  One of my kids actually LIKES the no-sugar-added carrot juice and beet juice.  It's an easy way to add a bit more veggies and fruits to his diet.

 

Some cheeses are naturally very-low lactose or lactose-free.  Naturally-aged Cheddar comes to mind.  And Kraft has a recipe for dairy-free mac and cheese that tastes quite a lot like their boxed Mac-N-Cheese. Or you can just make their regular stuff with dairy free milk and margerine and the lactosecontent is SUPER LOW.

http://www.kraftrecipes.com/member-recipe/dairylactose-free-mac-n-cheese-368453.aspx

 

If you can get him on juices with veggies and fruit, I would let him drink some calories that way.

 

ETA - Hang in there.  Food issues are no fun for anyone and can turn into huge battlegrounds sometimes.  Enlist him to do some "trials" to see if there are things that might be added into his diet.  Chicken fingers work - would he try steak fingers?  Strawberries work - could he try blueberries?  Or grapes?  Carrots work - try dipping them in hummus?  We found "trials" worked best if done NOT at meal time.  2pm in the afternoon was our magic time when a new food could be "tried" because he wasn't super hungry then, but could tolerate a snack.

Edited February 27, 2018 by AK_Mom4

[ebrindam]

Look up SED/ARFID eating disorders. Both my 15 year old son and I struggle with this issue. There are support groups and lots of info online.

 

[prairiewindmomma]

One last thought....

 

If it's lactose, then lactose free milk should be ok.

If it's milk protein, then that's another ball of wax.

 

Do you know, definitively, whether it's one or the other?  We had to do an 8 week food trial to sort that out.   Mozzarella, swiss, cheddar, and parmesan have low levels of lactose, comparatively....a similar amount to lactose free milk.

[amo_mea_filiis.]

I would not only look at a behavioral program for feeding. There is so much that could be going on physically and medically.

 

I think a feeding specialist is going to be a lot more appropriate than a BCBA (board certified behavior analyst) for most kids. And then a lot of kids who are seeing a BCBA will be seeing a speech therapist or OT too, anyway, and then you have a team approach anyway.

 

Just for background, my son sees a BCBA because he has autism, they are a specialty that often work with children who have autism.

 

But I would look more for someone specialized in feeding therapy, probably a speech therapist or OT, who also included some behavioral aspects as needed.

 

And then if you aren't going to see a specialist ------ I think that's okay, too, there are good suggestions here.

We saw BCBAs that only did feeding. If needed during eval they pull in OT and SLP. But we had done the gentle approach through OT and speech for too long.

 

By 12, it should be known if there are physical difficulties. Sounds similar to mine with the allergies and then having issues.

[City Mouse]

The therapy stuff has already been covered, but there is lactose free milk or the supplement to take when consuming regular milk products. Fair life milk has lactase added but it still bothers my DS. I get Store brand lactose free milk at Walmart or Smiths (Krogers). Or little local store only carried the Lactaid brand. Yoplait has a lactose free yogurt

[LucyStoner]

I know from our perspective that it looks horrible, but I have to admit... chicken prepared in a reasonably healthy way, homemade bread or homemade French fries, and carrots and strawberries every day seems okay to me. I mean, it's a pain for you to have those things all the time. And it would drive any omnivore nuts to eat that day in, day out. But he's got a little of most of what he needs in there.

 

I don't want to discount the behavioral feeding therapy stuff - therapy can do great things. But I wouldn't try to do it on your own if you're going to do it. I was an extremely picky eater at that age and it really was about control in large part. And the most surefire way to make me limit more was people fighting with me over it - either in a bribing, cajoling way or in an overt punishment way. I'd rather have gone hungry than give in. In fact, I did once spend a week at summer camp pretty much eating almost nothing. I freaked everyone out at the camp. My mother had to have a long conversation and tell them all to back the heck off.

 

Basically, if you don't go the professional therapist route, I'd just keep feeding him those things with as little judgment and pressure as possible. Make him do the prep though. He's 12. He can make his own food.

 

This is the approach we settled on for our son until he wanted to branch out.  It's not like all he was eating was sugar or chips.  He stayed healthy enough.  We chose to not make food a struggle, and I am happy with the longer term outcome.  

[Loowit]

Thanks for all the thoughts.  It has given me some new directions to explore.

 

I do have him help a lot with cooking.  He actually enjoys doing a lot of the cooking and baking with help.  He will help me prep a whole meal and then not eat any of it.  I have him give input on menu ideas, but he usually just ends up frustrated.  We sat down a couple weeks ago and listed out all the foods he eats, and a list of foods he will not eat.  We talk about foods he likes, foods he doesn't really like but can eat, and foods he can't eat due to texture or allergies.  He is on board with trying to come up with a solution.

 

As far as his health, he has acid reflux. He was on medication for over a year, but I started to become worried about the side effect, especially since he is a growing child.  I am concerned about the long term effects of being on it.  He is overweight.  He has been tested for cushing syndrome, and it was negative.  He had a sudden weight gain when he was bout 9 years old, before that he had been a very healthy weight.  He had no change in diet at that time or in the amount of exercise.  He started gaining weight about the time he went on medication for OCD, but I am not sure if that was coincidence or not.  He has been off that medication for about 9 months and his weight gain has stopped and he is actually losing a bit.   He also has asthma and is on medication for that.

 

I am not opposed to seeking therapy if it would help him.  It will have to wait a bit though because I am having surgery next week and will not be able to do much until I am recovered.  I may email his allergist and see if he thinks it would be a good idea to have him retested for food allergies.  Or maybe I should do an elimination diet, but I am not sure I can really eliminate much for him.  I fear it could be wheat that is part of the problem, but he will not eat any of the gluten free stuff, so I have no idea what I would feed him if we gave that up.

[Clemsondana]

You said that many foods were texture issues - have you tried frozen for things like fruit or even green peas? A friend suggested frozen blueberries and frozen green peas when my kids were teething, and they still have foods that they prefer frozen. Also, if he used to like smoothies or milkshakes but can't have dairy, maybe pureeing frozen fruit? I sometimes make those and my kids eat them like sno-cones.

 

Will he eat other things fried like French fries - breaded squash, sweet potato, etc? I'm in the south - we can deep-fry anything. :-) Some things, like asparagus or broccoli, can be roasted until crisp - it would be considered overdone to most people, but I always pick the most done parts when I roast a pan for my family since I like crunch. The veggies would probably be a harder sell than the fruit, but I thought I'd mention it.

[kroe1]

DS37 was born in an age of fast food and a mom who didn’t cook at all. His diet was limited to beige foods and still is to some extent. I just gave him a vitamin everyday and called it quits. He is now an ER physician and extremely healthy. His wife was able to broaden his diet a little, something I never even attempted. Back in the eighties society wasn’t as health conscious as it is now. I was more worried about a kid getting overweight than the healthiness of the food going in the mouth.

 

The moral is to pick your battles. If his food aversion is insurmountable, give him a vitamin and move on. Also, can he take lactaid and eat the cheese he loves?