# 18 mo hates eating, is underweight



## gentlebird (Jul 12, 2014)

First post here, hi mamas!

My LO is 18 months and screams and cries when we put her in the high chair. She turns her head and bats the spoon away. She holds the puree'ed food in her mouth and refuses to swallow it. Once in a blue moon she will eat without fussing, as much as a whole jar of Stage 2 baby food at a sitting, so we know she CAN manipulate food, swallow normally, &c.

She is about 15 pounds, so, ped is worried. Have referred us to OT but therapist simply says to keep offering, keep trying, & not get visibly upset. Not very helpful.

I EP'ed for 15 months then dried up so LO takes bottles of cow milk in between the solids meals. We do purees since she cannot handle textures and will not self feed any finger foods (OT recommended many, have tried them all). It's pretty well force feeding with the spoon at this point, while she screams and tries to get out of the high chair. Ped is not comfortable letting us back off & go back to something like formula only at this point. 

Suggestions? How to reverse a bad association w/ solids? Have tried DVDs during feeding, different places to feed, feeding in lap, while crawling, you name it. Am open to any suggestions that do not involve stopping the spoon feeding because ped and OT both said don't do that because weight is in danger. Anything else we can do? I hate mealtimes now! They are so miserable!


ETA: LO has two OT teams and both say that we need to push through the defensiveness of her texture and oral aversions (had a feeding tube at birth) and that a critical window for solids acceptance is about to close for her. I understand that we need to push the spoon feeding because of this. My main question I think is: how can we make feeding fun for her? Or get back to a place of food acceptance?


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## SweetSilver (Apr 12, 2011)

My feeding therapist would not have recommended pushing the spoon feeding. Her top priority for kids who have negative associations with food was to get them to accept the food. Any food. Oreos. Yup. When you are closing in on the crisis stage that is the first thing, according to our therapist.

She did recommend sitting at the table, even for a minute. I'm not so sure that I needed that, but I let dd eat what she wanted, when she wanted it. No restrictions on any food you keep in your home. Let her approach food in her own way. Does that mean she's going to eat ice cream all day? Probably for a while. But you could do worse, and it would pack on some pounds.

ETA: I think pushing the spoon feeding *slightly* would be OK for the average cautious eater. But neither of my girls were the average cautious eater. My first (the one we sought therapy for) hadn't learned to associate food with satiation until she was four years old. The other, a great eater as a babe and toddler, became my picky eater, super sensitive to any sensory violation and is still that way. Oldest is picky-ish but adventurous in her own way.


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## gentlebird (Jul 12, 2014)

Thank you for your reply. She will not self feed at all. When they told us to wait her out & wait for hunger signals, she woke up after sleeping through the night and would not eat any of the food I put in front of her all day (at the table, on the floor, on my plate) until she finally melted down out of hunger at 4:00 p.m. and I gave her a bottle. We have tried cookies, ice cream, chocolate chips, she will simply not willingly put things into her mouth.

She was rejected from early intervention services because once out of every 5-6 meals she accepts the spoon and eats, so they say it is an emotional thing and not a physiological thing.


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## SweetSilver (Apr 12, 2011)

What does she eat? What will she take almost no matter what? Is there anything? I disagree that there will be a "window". I'm not a doctor, but I think that if she accepts a bottle, for example, give her the bottle if that's what she wants. 

It's good that she recognizes hunger signals, though she is capable of ignoring them (picky eaters are good at ignoring hunger signals!) so you don't have that battle to fight.


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## One_Girl (Feb 8, 2008)

Will she play with the food? If so I would put her in the high chairaand give her food to just play with at times without pushing for her to eat it. Pudding is great for this. Giving her markers and papers can also make the high chair a fun place plus she'll look.cute covered in marker. If she's exploring things by picking them up and feeling them orally I'd give her teething biscuits, those baby apple rings and miniature cracker type things from the baby isle by just leaving them on a surface she can reach and seeing what she does.


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## SweetSilver (Apr 12, 2011)

One_Girl said:


> Will she play with the food? If so I would put her in the high chairaand give her food to just play with at times without pushing for her to eat it. Pudding is great for this. Giving her markers and papers can also make the high chair a fun place plus she'll look.cute covered in marker. If she's exploring things by picking them up and feeling them orally I'd give her teething biscuits, those baby apple rings and miniature cracker type things from the baby isle by just leaving them on a surface she can reach and seeing what she does.


Make sure she knows there is zero pressure to eat this stuff. While she is exploring, her sustenance should be elsewhere, otherwise she might reject this.


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## One_Girl (Feb 8, 2008)

If you haven't already I also suggest trying non traditional foods she can hold and gum while having her watch you eat dinner. Then move to feeding her afterwards. Bacon, brocilli, hard bread given whole not in pieces, and cheerios were my dd's first foods but aren't typically recommended as finger food. I would actually avoid giving it as finger food to see if that helps, I has a couple one year old infants in my class who would only eat whole pieces of food that looked like what the teachers were eating.


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## waywornwanderer (Jun 14, 2012)

So sorry to hear about your troubles. That sounds tough! I'll be following along. My DD (17 months old) is at this point still almost exclusively breastfed, and has many food aversions (and a couple of allergies as well).


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## Nightwish (Sep 9, 2008)

I would look for a second ped's opinion. Your therapist said to keep *offering and not get upset.
I have no exprerience with formerly tube-fed babies, but I can understand why your bb hates food.
I would start screaming too if someone strapped me in a chair and pushed stuff down my throat.


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## gentlebird (Jul 12, 2014)

Thank you so much, mamas. It is SUCH a relief to know that other people are out there listening.

I wish I hadn't dried up. Ped said to give her no more than 15 oz of whole milk in bottles a day, which I guess is standard advice for an 18 month old. I would feel much better about all this if I still had breastmilk to give her. I pumped every 2 hours for 15 months and took dom. and then my body quit on me. 

Now she has started holding food in her mouth. We spoon feed her, she holds the food in her mouth and just sits there and cries. The food dribbles out. She will hold food in her mouth and not swallow for 30-40 minutes, wailing the whole time. It is breaking my heart.

Ped says don't give her more bottles. Ped also says she is dangerously underweight. Nutritionist says go right to table foods if she hates being spoon fed, and yet LO refuses to self feed. I let her play with everything and she plays and plays in the high chair, but nothing goes in her mouth. Ever. OT therapist says PUSH the spoon feeding or else she will never learn how to chew and will be on a feeding tube at age 5. That scares me to death. 

Help! How do I make her eat? Or be curious about putting things into her mouth? Or not hate the high chair? How do I force her to swallow the food in her mouth? She NEEDS to take in more calories but she absolutely refuses to eat solids. I get so angry when she spits her food out or refuses to swallow it. I am so scared.


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## Nightwish (Sep 9, 2008)

...


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## SweetSilver (Apr 12, 2011)

I disagree with no more bottles, and personally I would put her on formula, if she would take it, simply so that it would match the calorie intake of breast milk. 

"Never learn to chew and be on a feeding tube at 5". Does the OT have clinical cases of this happening? The OT has determined with absolute assurance that her mouth is able to process the solid food easily? That her tongue and swallowing mechanisms won't get confused?

I would seriously find other health care providers at this point. When a child is underweight, if she loves something you do not limit it!!! You let her eat it to her heart's content. You keep letting her play with something on her tray.

The only time I knew of a child with a feeding tube who didn't eat food at all, except breastmilk, was one who had had a kidney transplant. (She's 11 now, and I can assure you, she chews!) I'm not saying your HCPs aren't right at all, I just seriously question their doom-and-gloom predictions. I question it enough to find new professionals that might have good advice but not the terrify-momma-hardline approach. 

There are no hard lines. Feed your child what she wants to be fed, as much as she wants of it, and find new help. Hopefully help that will work with your child, not against her.


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## SweetSilver (Apr 12, 2011)

I mean, I just don't get this: limit a food that an *underweight* child will eat while forcing her to eat what she doesn't want to eat and then scare the momma that *OMG Your Child Is Underweight!!!!!" Refusing to offer a child food that is in the house and having her drop weight while you can battle a refusal to put solids in her mouth? Essentially, starve the child and torture her with a spoon.

I think these people should babysit your daughter for a week while you sit by and give them advice and see if they don't realize that it's the most nonsensical advice on the planet (if the don't strangle you first).


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## gentlebird (Jul 12, 2014)

YES! I WISH they would babysit her and see how it s!!! She will sit in the OT office and eat when the OT feeds her, so they don't see how she is at home. She absolutely refuses. Holds food in her mouth and screams.

I believe it when they say it is me. She eats for them without any problem at all. 

She is below the 0 percentile and has classic underweight symptoms - big head, tiny stick legs and arms, not hitting developmental milestones. She also has a team of developmental OT thearpists but was rejected from early intervention because she's not 50% behind. All the specialists say that she can't be on only bottles anymore and needs solids to grow and catch up. I don't know where I would even find other doctors, these are the only specialist teams in our town/insurance.

She eats nicely for my mother also (who lives out of town). This must be me. How do I break the negative dynamic we've got with each other & get back to spoonfeeding? I am wracked with guilt.


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## SweetSilver (Apr 12, 2011)

"She needs solids to grow." The age old myth that leads parents to put rice cereal and baby food in bottles. Breast milk and formula have more calories than most solid foods per serving, except the fatty ones.


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## SweetSilver (Apr 12, 2011)

Stop the battles at home and maybe she will eat for you. They should try force feeding the spoon to your daughter for a while and see how long that willingness lasts.

ETA: Sarcasm. Not really!


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## One_Girl (Feb 8, 2008)

I disagree with the formula thing too. There is formula for toddlers and some pediatricians recommend it for the first two years of life. I strongly suggest getting a different pediatrician. If your baby is malnourished fixing that is priority number one, it's what your instincts are telling you and I suggest you go with them. 

It sounds like there are some negative associations going on when you feed her and breaking out of that habit is what I would focus on. I think you may have better success if you give bottles of formula for a month and back off of trying to feed her, still put the food on her tray but don't push at all. When you eat give her a bowl and spoon of her own and table food but don't feed her yourself. After that slowly try offering.

I also don't believe that your child will be on a feeding tube if you aren't able to push through this. She eats when others feed her and she will probably slowly eat more, not less, especially if you are able to change this cycle.


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## SweetSilver (Apr 12, 2011)

One_Girl said:


> I disagree with the formula thing too. There is formula for toddlers and some pediatricians recommend it for the first two years of life. I strongly suggest getting a different pediatrician. If your baby is malnourished fixing that is priority number one, it's what your instincts are telling you and I suggest you go with them.


I'm guessing you meant to "agree" with my formula suggestion? And "disagree" with the doctor?


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## gentlebird (Jul 12, 2014)

LO won't take formula. Or pediasure in milk. She hates the taste. She takes plain milk in her bottles. Rejected the vitamin drops that doc said to add to the bottles too. Maybe she's a supertaster?


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## SweetSilver (Apr 12, 2011)

Very possibly. The formula suggestion is only about the amount of calories per ounce. While just whole milk isn't very balanced, I think that it is better than going without calories. I would still give bottles. The child needs calories in whatever form is palatable for her. Once my daughter had plain, sweetened soy (allergic to dairy) she wouldn't go back to soy formula, even when I tried to put her back on it when her weight dipped.


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## Nightwish (Sep 9, 2008)

Can you have someone else feed her?
If she eats just fine for other people, maybe you should work on your approach. I would definitely stop force feeding. It is traumatizing. I understand you are terrified but this way of feeding has the opposite effect of what you want to accomplish.


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## JamieCatheryn (Dec 31, 2005)

I wonder why they won't do a swallow test or anything? I guess they really don't see how bad it is at home. You could use cream and whey protein to bulk up the whole milk a bit without changing the flavor much. Maybe some strawberry blended in might meet her approval. If she branches out to juice you could get a juicer and make some fresh so it has nutrition left. Check around for local moms to donate some breastmilk.

You can put out a tray of different snacks within her reach and ignore it with regard to her eating it, not even offer or encourage her to eat it, snack from it yourself some, see if she gets curious. My pickiest eater (5 years) does like yogurt, fruit, and anything grains, my 18m old likes those things best too. My 18m likes to eat applesauce pouches on his own. Meanwhile I encourage meat and veggies but am happy with what I can get into them.

There's no such thing at 0 percentile or 100 percentile in comparison charts, that's been a relief to me since my middle son is on the bottom end too. They can't technically score below 1% or above 99% because of how those statistics work.


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## gentlebird (Jul 12, 2014)

I will try that,with the foods left out for her to play with. Thank you!


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## babydanielsmom (Jan 18, 2008)

That's an awesome idea of bulking the milk up with heavy cream !


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## babydanielsmom (Jan 18, 2008)

A couple more thoughts...

-Ditch the high chair ...sit the food out where she can get to it and eat when she wants. 
- Go for fatty foods cream, butter, peanut butter, eggs, packets of carnation instant breakfast to mix in the milk. I personally would let her drink a lot more (whole) milk than 15 oz per day...I would also bulk it up with cream.

My kids love this whole milk yogurt. You can get it at walmart and it's thick so she can scoop it up and feed it to herself. http://www.greekgodsyogurt.com/24oz-products/honey-flavored/

-what about getting her her own cute plate/spoon/fork set ..like this


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## OrmEmbar (Oct 25, 2012)

Offering hugs!

My little ones refused all store bought baby/toddler foods. I don't know if you are making your own or purchasing foods, but I thought I would put that out there. 
I, too, would put the high chair away for at least a month, and get completely different utensils, in case the sight and/or feel of these things are triggers for anxiety. ( for either of you)
It may be that your little one really just needs you to hold her and bottle feed her, starting first thing upon waking. 
I got a lot of flack for feeding my picky eaters the narrow range of foods that they would eat. People said I should just let them go to bed hungry once or twice and they would realize they just needed to eat whatever was placed in front of them. I was never a picky eater so this was a whole new world for me, but I am so grateful I followed my instincts after those first couple of nights when my oldest actively chose to go to sleep so hungry that I could hear her tummy growling. After many years of eating an extremely narrow range of foods she is now a good cook and eats like she was raised a non-picky eater. Her younger sister seems to be on the same path. 
My toddler refuses baby food. He also does not like sweet foods - no bananas or carrots. Apples only if they are whole and he can hold them himself. ( I cut the peel off of 1/3 and he gnaws on the peeled area). We recently learned that he likes salsa and non-sweet salad dressings. We are having a hard time adjusting to his palate after our picky eaters who only wanted sweet foods!

Have you tried avocado or full fat coconut milk?


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## macrandall (Feb 1, 2013)

ACK. I would seek out a second or third opinion until it feels right. I would be uncomfortable stopping the bottles at this age. I would be very upset using the high chair or spoon feeding AT ALL in this situation. Often we allow our twins to just roam around their play space with food and eat at their leisure. Especially the pickier one. And it works beautifully. They've never liked being strapped down to anything. They don't use the high chair regularly. My advice it to try this with your baby and give her as many bottles as she wants. There is no harm in this, in my opinion. Mine are 16 months and get 2-3 bottles a day (depending on the day, since they don't like bottles at day care) and we'll continue this for the foreseeable future. We practice good oral hygiene and I'm happy with the research I've done on prolonged bottle feeding. If I were you, I'd give my child access to food, but not force it. Dry foods, whole pieces of bread, etc. Allow her to build trust with food again and form a good relationship with it. At this point, I don't think it much matters what she eats. Just that she does and thinks that it feels good and benefits her in some way.


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## SweetSilver (Apr 12, 2011)

OrmEmbar said:


> I got a lot of flack for feeding my picky eaters the narrow range of foods that they would eat. People said I should just let them go to bed hungry once or twice and they would realize they just needed to eat whatever was placed in front of them.


Besides being a hard line tactic, people don't understand truly picky eaters. 1. They can disregard hunger signals because their issues with food are that powerful and 2. Some children don't recognize hunger signals as being something to solve with food. That children will eat when they are hungry enough is a myth. It is a learned connection, that most kids do make in their early days of life, but some kids don't make that connection, usually if there is pain associated with feeding. To withhold food from this child would be pretty cruel. My daughter didn't make this connection until she was *4.5yo*. That's *years*, not *months*.

So, kudos for ignoring the hardliners and going with your instincts. ("Once or twice"--HA!)


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## OrmEmbar (Oct 25, 2012)

Ha indeed! It's so nice to know there are other parents out there feeling he same way I do. I didn't have access to this on line community back then. What I can say now is that I am so happy to see my picky eaters blossom into their own person. They still have their own issues - texture being a big one for one and low blood sugar issues with the other - but right now my oldest is cooking an onion zucchini carrot stir fry. She is excited because a friend showed her how to cook zucchini in a way that she likes. Awesome.


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## OrmEmbar (Oct 25, 2012)

Just checking in to see how you are doing @gentlebird
Are feeding times getting any easier?


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## anwanie99 (Jun 19, 2009)

Yes, it is possible that a child can never learn to chew and be on tube feedings for....well, basically forever. It is possible. 

My daughter also is severely underweight (16 pounds at 20 months) and would refuse all food. Every time we would feed her purees or a small piece of table food, she would vomit. Yes, vomit. Vomit everything. Our house smelled like vomit. Our car smelled like vomit. Everything. We tried all the OT and SLP therapies involved in feeding therapy and it wasn't enough for our daughter (she is our third child and our other child have no problems in this area at all). She was later diagnosed as having a functional problem (the inability to chew), along with a sensory problem (texture aversion), that led to a behavioral problem. We ended up choosing a behavioral feeding program and seeing them on an outpatient basis for many months. It was decided that attending their 2 month day treatment program was going to be best for her. And we did it. I moved to another state with my daughter (leaving my husband and 2 other children behind) to help her eat. She now chews and swallows food pretty consistently. 

Does she have a joy for eating? No way. Does she like to eat? Not one bit. But we never gave up and we never allowed to regress her back to her bottles of milk (I pumped for 18 months). She is now 26 months and 20 pounds. You can do it. But sometimes you need more than a soft approach to it. I am speaking from experience.


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## MzFitz (Mar 21, 2013)

Thanks for posting this. I'm so frustrated. My son't in a slightly better place weight wise, but that's because I quit my job to work one on one with him. He only eats purees, will occasionally pick up food and eat it. We believe that it began as a result of silent reflux. I'm hanging in there, and am looking forward to an appointment we have with a different OT. The therapy we've been doing for 6 months requires that he watch TV shoe he eats. I hate this. I didn't want to expose him to TV at all until he was at lease 2. The OT and psychologist couldn't understand why I didn't want this. Now we've created a monster.


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## anwanie99 (Jun 19, 2009)

Mama, I sent you a PM.


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