Food issues with 5 yo with potential ADHD diafnosis

[Anonymous]

We took our daughter for an evaluation and while it is still too early for anything formal, psychologist said that she most likely will receive a diagnosis of ADHD over the next year or two. With that being said:

We were overly permissive for years and basically let her run the show at meals. As a result, she eats a very limited number of foods, some are healthy but almost all are snack type. The ONLY hot meals she will eat are fast food, and an alphabet pasta dish that a nanny was able to get her to start eating after a lot of tears.

This is becoming a big deal, both in terms of our day to day life and refusing to participate in meals, but it makes holidays awful and embarrassing, and I am sure that her poor nutrition is contributing to the ADHD symptoms. After gentler approaches have failed, I decided to go cold turkey and we have been forcing her to take a few bites of what the family eats. If she doesn't want any more, she can go hungry.

If it matters, I have noticed two big problems- she seems afraid to try foods that she hasn't eaten in a while, but what is more annoying is that she will wake up randomly and decide she is "done" with a certain food for no reason. This morning it was waffles- a totally normal food.

My question, is this the right approach? Sometimes we have a babysitter here for meal time. I'm not sure how I can avoid the challenge of sticking to what I have planned for her to eat, and the ensuing screaming match. With a babysitter here. No way to really get around he babysitter bc of our work. And I think this is how we ultimately got to this point, where PB sandwiches for dinner were fine and became the norm.

[Anonymous]

Read Ellyn Satter.

[Anonymous]

Babysitter should do what you request. If they can't, find a one that will. You are paying them after all.

Both of our boys must try a new item or the item that they can't remember eating in the past. If they genuinely don't like it, then we will offer some other non-snack food or another vegetable. If they refuse or are just being difficult about eating, then they can leave the table and don't get a bedtime snack. My boys aren't starving, are a healthy weight, and have no food-related health problems.

[Anonymous]

OP, I would contact a feeding specialist. You said that she seems "afraid" to try foods she hasn't eaten in a while, this is not pickiness. This is anxiety. Get professional help with it before it gets worse.

Unfortunately I know exactly what you are dealing with and when people (doctors, well-meaning friends, family members) think that I'm talking about "pickiness" then they have all sorts of advice. This isn't about that, this is about a child who has anxiety about eating and that requires professional intervention.

[Anonymous]

OP Here, thank you. I like the idea of a feeding specialist although I know my husband will roll his eyes. He does not think this is a problem. I agree with it being an anxiety issue. Or maybe a combo of anxiety and need for control. Do you have a recommendation for someone to contact?

[Anonymous]

Dear OP -
search "sensory food aversion" and/or "just take a bite" in this forum and/or google. You will get lots of 411 on feeding issues that can be co-morbid with adhd. The feeding issues were primary for us, so that was our first diagnosis, followed by EOE (gi condition), followed by ADHD. Child doing great now - almost 8 years later. Lots of work on our part and child's part. Please note that there is a huge cognitive and therapeutic difference between positive encouragement to take a bite and forcing a child to eat. One must take an extraordinarily long view of where you want your child to get in terms of food choices when sensory food aversion is present.

after years of taking it slow, my kid eats more veggies than the average child and other parents always notice his healthy choices. that is certainly not where we started. But i have seen many neurotypical children totally give up on a food group once they are forced to try it.

Kids with sensory food aversion will starve rather than eat what they fear and forcing them to eat will not change that cognitive issue. Best of luck.

[Anonymous]

Anonymous wrote:OP Here, thank you. I like the idea of a feeding specialist although I know my husband will roll his eyes. He does not think this is a problem. I agree with it being an anxiety issue. Or maybe a combo of anxiety and need for control. Do you have a recommendation for someone to contact?

I'm sorry I don't know of anyone in this area. Need for control comes from anxiety so it is both. And anyone with a special needs will tell you that in most cases the mother is the one looking for answers while the father is convinced everything is just fine. If rollling eyes are all you have to combat then you are lucky!

[Anonymous]

Anonymous wrote:Babysitter should do what you request. If they can't, find a one that will. You are paying them after all.

This is a long standing question and unfair to expect a babysitter to handle it when the parents haven't been able to solve it. OP, you'll need to work on this issue for all the meals where the babysitter isn't present.

[Anonymous]

Our OT offered feeding therapy and some speech therapists do as well. SLPs seem to focus on oral motor issues in feeding while OTs do texture/sensory issues. I'd look for an OT based on what you described. Good luck.

[Anonymous]

You are dealing with anxiety. This is not being picky. Your child is extremely anxious about the foods. Please get a therapist to help your child.

[Anonymous]

I highly recommend Lauren Mazel or Michael Lemieux at Skill Builders in McLean/Annandale! Both work on anxiety and sensory issues related to feeding, and work closely with parents/caregivers on home programming!

[Anonymous]

Also, there is a decent NPR article discussing how difficult it is to get neurotypical kids to eat veggies and non-processed foods. THe bottom line is POSITIVE exposure - which can mean food education (going to a farm to pick veggies, growing a garden, just visiting a grocery store and talking about the different food smells, tastes, textures, going to a farmers market and letting the kid sample anything they want, .....), playing with food (food stamps), "helping" in the kitchen even if they make a hot mess of it (it gives them exposure to smells, touch,....). Mashing a cooked food and sneaking tastes is how my son discovered he liked a lot of things. And guess what - you can ask a kid to mash anything - veggies, fruit, chicken.... the mashing releases the steam and you kinda get a smell/taste combo that might incite them to sneak a taste.

NPR article http://www.npr.org/sections/thesalt/2017/03/12/518869833/save-hide-and-seek-for-the-playground-why-kids-should-see-their-veggies ("nobody has come up with anything that works better than mere exposure." She's referring to research (including her own) showing that the surest way to get kids to eat a given veggie, or any food for that matter, is to offer it a lot, or somewhere in the window of 8-15 times.) If neurotypical kids need 8-15 exposures - kids with sensory food aversion might need like 50.

After attending like 30 pizza parties where all the other kids where happy as can be about pizza - my kid had this look of desire on his face. I asked him (very privately) if he wanted me to cut him the tiniest taste. he said yes and enjoyed it. The sale as it were was not done by mommy, but by seeing all the kids like the food over and over and over without being forced to try it. Finally, he wanted in on the fun also.