5 year old Refusing to Eat Solid Food

Since having a stomach bug nearly a week ago, our five year old is refusing to eat solid foods. She's lost significant weight and has sunken eyes. We got her to drink smoothies as a way to get some calories and nutrients but she is refusing solid foods, even after a visit to the pediatrician where the doctor told her she needs to be eating a fist-size amount of food at each meal. She is a very strong-willed child with a strong desire to be in control, and rewards/punishments don't work with her. If you have any suggestions, including child therapists and/or parenting experts related to food control issues in young children, I would appreciate them.

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Hi! I'm sorry - that sounds so stressful. When my little one was younger we had a few issues getting him up and running on solids and our pediatrician referred us to Priya Ingram. She is based in San Francisco but we had two meetings with her and she was wonderful and we got a lot of support and helpful tips. https://www.connectedkidzsf.com/priya-ingram

Hope your little one is eating more, soon! Take care!

This must be hard to go through. I was a picky eater around that age (lasted years!) and it drove my parents absolutely bonkers. It's a subject I've paid a lot of attention to as a new mother. The best resource I've come across is Solid Starts. There are lots of resources - guides, courses, an app (and a great Instagram page) - that can provide tips to try and practices to avoid. It is geared towards babies and toddlers but maybe the picky eating behavior content is relevant for you. I saw recently that they are also considering some 1:1 coaching but may require an email to them for more info. Best of luck and hope your little girl is back to her usual self soon! 

This is a tough one. I am no expert other than parenting 2 kids of my own, but what about her favorite foods? Even if you just got her to eat a slice of cake you'd be better off by getting calories in her and getting her used to eating again. A trip to a favorite bakery? Candy store? Go see a movie and give her ice cream?? That's the route I'd go. I don't know too many 5 year olds that would pass up ice cream or cake or cookies, etc. At this point it doesn't even have to be nutritious as long as she's getting calories in (and will help if you can supplement with ensure or other liquid with vitamins).

Beyond that, I would let her know that if she can't manage to eat food she will have to go to the hospital and get an IV - I was never above telling it like it was to my kids, even at 5, which is surely old enough to understand what that means. My kids knew what hospitals were and what they were for from a very young age. The reality is that if she refuses to eat she's going to get pretty sick, so you might as well be honest. Good luck!

Has she expressed to you why she doesn’t want to eat any solid foods? She might be remembering how awful her stomach felt during her bout with the stomach bug and is avoiding foods because she doesn’t want that feeling again. I know when I had the stomach flu as a young kid, I couldn’t face any of the foods I had eaten at the time of getting sick for a long time. Similarly when I was pregnant, I couldn’t stomach the smell of swordfish for almost 2 years after giving birth, so I can relate. 
Does she tolerate soup or semi solid foods? I would start with something bland that doesn’t smell or cause irritation to the stomach (ie chicken broth and saltines) and build up to more flavors. If she is accepting of the smoothies, lean into that and make sure to add protein and other nutrients to supplement her until she’s eating more. 
 

If this persists, this is a question for medical professionals and they can refer you accordingly if they are concerned. 

Sorry to hear this!  She may have ARFID (Avoidant Resistant Food Intake Disorder) triggered by the virus.  There are a lot of good podcasts on the subject and eating disorder specialists or child therapists who can help, especially Cognitive-Behavioral therapists.  Hope she improves soon.

If it hasn't even been a week yet, and she's well hydrated (and drinking smoothies!), it's safe to back off. Don't make it a power play. Children will not starve themselves, she's rightfully wary of food at the moment, and will work her way back. It's your job to offer foods off her "safe" list (the foods she usually loves) and it's her job to decide if and how much she eats. She likely just needs a few more positive, gentle eating experiences to prove to herself that she won't get sick again. Stomach bugs are super powerful experiences for little kids! 

HIGHLY recommend you refer to the Good Inside website/podcast/Instagram for this - SO MANY resources that will change your perspective on this struggle for life. I promise you won’t regret it

What a frightening situation. I'm sorry.

I wish I had specific practitioners to direct you to, but I don't. What I can offer is some potential understanding. ARFID is a condition that may describe what your daughter is experiencing. There are three types; she may fit into the post-traumatic category. AFRID was only entered into the DSM in the last update. Not many practitioners are familiar with the term, much less how to treat it. At least, that was my experience with my son. He was diagnosed at the Stanford Eating Disorder Clinic several years ago, but we were not able to find appropriate follow up care. My hope is that with the passage of time, more practitioners are familiar with this condition, and you will able to find one in your area.

At any rate, I hope this information lets you know you are not alone, and this is a serious situation that needs attention, care, and compassion. In my limited experience of one, the root of the problem was emotional, not physical, and needed to be addressed as such. My son is much older than your daughter, very strong-willed, and has found ways to manage his highly restrictive eating.

If she will tolerate smoothies then you can also add blended oats to add calories, flax seeds, chia seeds, veg etc to add nutrition and work with her to build up flavours and textures. Find out what it is that is off putting to her and use gradual, low pressure exposure to ease her into solids again. Soft healthy muffins may work? Maybe involve her in cooking if that helps?

If it persists then I would probably ask for help from a pediatric nutritionist  

good luck!

When out daughter was seven, her dad was hospitalized with necrotizing fasciitis and she got the mistaken idea, from listening around the edges of adult conversations, that it was from something he ate. So she stopped eating. After a week I found a therapist and eventually got her eating again by making a list of what she thought were “bad” foods, that I promised not to put on her plate. Her diet was unhealthy and very restricted for months, but with her dad in the icu, I didn’t have time to focus on her lack of nutrition. Over the next six months she broadened what she’d eat, and as long as I didn’t make a big deal about it - she would eat. Especially if I let the kids eat somewhere different, like the backyard or with the tv on, it was almost like the novelty distracted her. She’s now 19 and apart from living junk food too much, her diet is fine. Try to figure out what she thinks is safe & then build from there. 

My son had his first stomach bug around 4yo specifically after he ate a plain arepa and since then, he won't eat arepas (it's been 2 years). I am sorry that your daughter has developed strong aversion to solid food at the moment. I don't have good advice for getting professionals involved, but have you tried involving your daughter in food prep? In general this has really helped me kids get involved with eating, when they are meals they have prepared. Maybe something simple like spreading nutella on toast. Good luck!