please post the granny's mac and cheese recipe. We are trying to avoid a feeding tube for my little one. My 5 year old is finally up to 31.5 pounds after 5 months of pushing calories (she gained over 3.5 pounds). We've done the heavy whipping cream/whole milk/Carnation inst Breakfast/chocolate syrup to get in around 700 cals everyday. It is so hard. She says she is full and just stops eating. She loves mac and cheese usually.

Periactin will stimulate her appetite.

I think you are doing great to get the high fat foods into her..but if you want her to gain weight then make sure she eats simple carbs at the same time. Full fat yogurt and pretzel chips etc.

Remember that the high protein and high fat diets...are basically Paleolithic or Atkins. People lose body fat on these diets. Since you want the opposite then do fatty and starchy together! If you want my grannies macaroni and cheese recipe I will post it.

Nutritionists bought into the low fat diets for weight loss but it's more complicated than that. Think Comfort food and she will gain and grow.

Signed someone who is trying to lose via low carb to overcome her Southern upbringing.

I feed my thin, ADHD-medicated daughter whenever she gets hungry. Sometimes it's not until 9pm, when she'll down 3 greek yogurts (protein-rich snacks are key here). I stopped trying to force food on her when she isn't hungry and now just depend on those hungry times (generally breakfast and just before bed).

Anonymous wrote:OP here. She is under 5th percentile for height and under the 1st percentile for weight! Medical opinion is divided... her pediatrician takes the view that there's nothing much to worry about, but she did send us to an endocrinologist to rule out any growth hormone problems. The endocrinologist found nothing wrong with her medically but was very freaked by her low BMI and says she must have an eating disorder. We (and her pediatrician) think that this is just silly -- she is not anorexic or bulimic, she's just a picky kid who has had a very minimal appetite her whole life.

That being said, the endocrinologist completely terrified us by saying that she is at risk for delayed puberty, no menses, etc. etc. The pediatrician, meanwhile, remains fairly nonchalant. I don't want to GIVE the poor kid an eating disorder by turning food into a huge issue-- but I also on't want to do her a disservice by ignoring something that could genuinely cause her problems....

argh

my DD has been in the last 10-20 percentile since she was born. now she is 8 and a half and in the last two years she has not grown much. she eats everything, but she does not eat much. she has ADHD (no medication) and when she is busy playing or doing other things she forgets to eat. she would routinely come back from school with her lunch box full because she had spend her lunch time chatting with her friends, I really wonder sometimes how she survives on just air. we started giving her a bigger breakfast (scramble eggs), but she is really small. I was not too concerned because I am short (5') and I was also tiny as a child with lots of energy on little food (until I was about 14, then I started eating more) now she wears size 6 yr old, and when she visited her sister's pre-K class she was not really standing out that much. last summer she fell off the growing chart, so we took her to the endocrinologist. he visited and found nothing wrong. he had her have an X-ray of her hand to so the growing age of her bones, and determined that her bones had grown as if she was 6 and a half. thus she has room to grow, and we are not very worried (although we revisited the thing in 6 months to verify that she is fine). now when people ask her how old she is, she sometime says that she is 8 and that she is a "late bloomer". I agree wiht you that making food a problem may not be a good solution because you don't want to create a worse problem

I have no advice on getting her to eat more food, but one way that has worked for us to sneak in fat and calories is to mix in some heavy cream with the Boost. It works.

there can be harm in having a child that age with this type of issue evaluated. it can highlight that it is an issue. I think you should work with what you have and further evaluation can be done if a medical issue starts. the evaluation would be tough on a kid that age. I'm sure she already feels uncomfortable about it.

she doesn't need another label of something being wrong with her eating. I'd suggest the evaluation if I thought it would actually help her, it likely won't.
you are on the ground as they say with her, try to work through it.

My brother and FIL have this issue. They have both been about 5'9" and 115 lbs most of their adult life. They just have little interest in food but are perfectly healthy although underweight.

My FIL was sent by the army to the old Walter Reed Army medical center during WWII to be studied b/c of his weight. They did not find anything wrong. He's perfectly healthy and had no problems doing 6 mile marches with 50 lbs+ backpack worth of gear.

My brother does Cross Fit and does ultra marathons and marathons as an adult. Usually places in the top three for his age group.

If there are no health issues, I'd let it go. There is inherently nothing wrong with being underweight and there are many studies that show that underweight animals including humans live longer and have fewer health problems than avg weight and over weight animals.

I'm so sorry, OP.

My son is 8, with the same percentiles for height and weight as your daughter, and has a tiny appetite. He is not on meds for his ADD, and we are afraid to even start them because of all this!

The ped is old-school and is not worried at all. We have not pursued GI issues.

He can eat whatever he wants. I enrolled him in gym classes twice a week because he's not into sports and I notice now it has at least helped him develop some muscle. When he comes back from gym are the only times he positively gorges - that is, eats a full meal.

His 3 year old sister eats more than he does

It can't hurt to have her evaluated. Might be more behavioral - not necessarily eating disorder behavioral, but ocd or even the hyper-limited behaviors associated with some forms of ADD. My neighbor's DS hardly eats anything, mostly yogurt and a few other mild foods. The food issues seem to be related so some type of broad behavioral issue.

I wouldn't push the GI or therapist. you are right you may create more of an issue and if they do suggest anything it will become more of an excuse not to eat and why etc.

it sounds like there is a sense of her being picky, her choosing to limit what foods she likes/doesn't. I would continue to try to offer things she will eat, keep the communication open and try not to make a big deal of it.

You are doing the right thing by adding in some calories. I'd caution you though about those boost type drinks, try to do something homemade just because it sets her up for continuing to eat and make real food which is a big deal.

I wish I had advice for you OP. My brother has weird food aversions and is an incredibly picky eater. Incredibly picky. Pizza from only one place, absolutely no seasonings, no fruits or veggie, pasta with butter but he will pick off any parsley flakes. Certain textures make him gag, etc. He does eat enough as as he got older ate only from bad places (burgers from fast food places, pizza from Dominos, etc) and gained a lot of weight. He's slowly losing weight now by calorie counting, but he is still an incredibly picky eater with a lot of food aversions.

I'd suggest a feeding clinic. My mom now wishes that they existed when my brother was younger because it would have saved him from the way he eats now.

For something like this, I wouldn't go along with what the pediatrician says. They know a little about a lot, like all general practitioners. That's why we have specialists because they are more trained to pick up on smaller issues. Your ped probably isn't concerned because she's still on the growth chart and she's not malnourished.

OP here. I guess when I say i don't think it's an eating disorder I may be using that term in too restrictive a sense: I don't think she is anorexic or bulemic; I don't think she considers herself "too fat" or is fearful of weight gain or is even subconsciously trying to stave off puberty. On the contrary, she worries that she is too small and she very much wants to grow, for what it is worth. That said I recognize that there may be other kinds of eating disorders linked to anxiety, obsessiveness, etc. And I also worry about some kind of undiagnosed GI thing. I am wondering if I should take her a) to a therapist or b) to a pediatric GI for a check-up to rule out any medical causes.

I am not big, but not tiny (5' 4 and 135), though I was quite small as a child (not this small though). Her dad has always been tall and thin. Definitely no one in her family is large or overweight -- no one is super thin, but every one is probably on lower end of the normal weight range. We already give her boost in the morning, milkshales mixed wiht boost at night, and extra butter and cheese on everything I can sneak it into.

I guess I am torn between, on the one hand, fearing that I am not "doing enough" to address an issue that could be addressed through some combination of medical intervention, therapy and behavioral changes, versus fearing on the other hand that even having her do a GI checkup or speak to a therapist could end up creating an issue where there really is none (or where this is a small issue that will probably resolve itself over time IF i can refrain from going crazy over it). As I said, her pediatrician does not seem very concerned, so maybe I'm overreacting.

you are describing me as a kid. if it is pizza from one place get extra and freeze it. I can't really describe it, but I only eat limited foods and the certain places thing and brands I can totally relate to. I think it is sort of a control OCD kind of thing. think "safe" foods. I could only eat one type of chicken nugget when I was 13 and then none b/c that one wasn't okay anymore. everything else was just yuck and I literally was sick at the thought of eating it. I wasn't trying to lose weight, but I just couldn't eat it.

I replaced some safe foods with other safe foods and grew my list as I got older. I developed a true eating disorder around counting calories and body image etc. a couple years later, but the roots were the weird restricted eating as a kid/preteen. I had a roomate very similar, wouldn't eat, but it wasn't typical anorexia, she just didn't like food.

stock up on things she will eat and just try to not worry about what she is eating or how limited it is, but just make sure she eats.

What do you and dh look like? Are you both short/thin?

Have you tried eliminating gluten? I know it would probably cut out some of the foods she loves , but it may be malabsorption due to leaky gut.