Should I be concerned (Sorry Long)

Question
I have a 5 year old boy, he has never been a big eater even as a baby.  He has had failure to thrive at 16  months old, he has high functioning autism with sensory issues hence part of the food problem when he was younger.
He will not eat a whole lot and when I make something he thinks he doesn't like he will sit at the table and cry I don't like it and if I make him take a bite he will start gaging until he has to spit it out.

In the past we have worked with a feeding clinic but no longer because they said he is happy and healthy even though at that time he had lost 5 pounds in 6 months time.  He had reflux for almost 5 years, but for 2 of those it was undiagnosed, he had been taking pediasure as his main source of nutrition since he was 17 months old and in May, 2006 at his last GI specialist appointment he told me to take him off of it becasue he was doing great, his weight was good for an almost 5 year old and he had no concerns.

The last time he was weighed he had lost a couple of pounds, we all thought it was due to him having had a really bad case of strep thorat.  Lately it seem like he is loosing more weight, you can see all of his ribs again and he was finally starting to get a little belly on him.  I don't know if he is not eating becasue he thinks if he doesn't eat he will get the pediasure back.  Even though he has not asked for any for a while, when we first took him off of it he would ask a couple times a week.  I can not weigh him at home becasue I will not allow a scale in my home due to me having had eating disorders in the past, none since I have had him though.

Pretty much all I can get him to eat is milk, yogurt, sausage, turkey, chicken and mac and cheese even though he will not eat regular cheese, he also likes bread with butter on it and he has to have mayonaise and black olives on his turkey sandwiches.  He does not get a lot of sugary treats and he gets 100% fruit juice along with water.  He will eat some veggies mostly corn and green beans and some fruits like grapes, pineapples, oranges and apples.  I can not get him to eat any  other meats and I don't know if he is getting enough protien.  I have started giving him a multiple vitamin with extra C and he will also eat peanut-butter.

He is a very active little boy always on the go and never seems to wind down even at bedtime.  He is even active when he is sleeping tossing and turning alot!  The amounts he eats are pretty much one serving spoon or less mostly a few bites, then he says he is done.  My question is this something I should be worried about or as long as he is healthy he is fine.  He has a doctors appointment next week and I will be checking with her, but in the mean time I need to know what else I can do for him short of forcing him to eat then we would really have problems.  Sorry this is long, but I wnated to sort of give you a picture of what we have been dealing with. Thank you for your time.

From
GV

Answer
Hi GV,

First, just to reassure you, many perfectly healthy children don't seem to eat much, at least not as much as their parents think they "should". Because your son has a history of failure to thrive, you are naturally going to be more sensitive/concerned about his eating habits and food preferences.

From what you describe, he is eating a fairly good variety of foods (at least one or two foods from every food group). I can't tell you if he is definitely meeting all his nutritional needs without more specific details on exactly what foods and quantities he is eating. Usually, if a child is healthy, active and growing appropriately, there is not too much reason to be concerned. You are right in thinking you don't want to "force" him to eat, this is absolutely the worst thing you can do for your son't relationship towards food (and your relationship towards one another!) Even though it may be difficult, you need to be relaxed about eating and make mealtime an enjoyable experience. If your son senses you are upset or stressed about his eating, he may eat less as a way of exerting "control" over you. The approach I suggest is to offer a wide variety of healthy choices and let him choose which foods and how much he will eat. I highly recommend Ellyn Satter's books: _Child of Mine: Feeding with Love and Good Sense_ and _How to Get Your Kid to Eat...But Not Too Much_ (these should be available at your local library).

If your son does need to gain more weight, you may want to consider having the Pediasure around as one of the foods he can choose to have (without him having the feeling that it is a "better" or "worse" choice for him to make). You could also try Carnation Instant Breakfast as a less expensive option instead of the Pediasure, if he likes it.

Hope that helps!

Karen
www.getfitwithkaren.com  

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