4 Year Old Won't Eat

[Lfrost]

So a few days ago my son seems to have lost his appetite. He has been gluten free for almost 4 weeks now, but I am having to basically force him to eat. Before going gluten free he ate like a bird, but at least he always ate a waffle for breakfast and a pb&j for lunch, then he would pick at his dinner.

Now he's not eating much of anything. I am at the point where I will let him eat ANYTHING (that doesn't contain his allergies) if he would just eat! He was on a huge banana kick a couple of weeks ago (eating up to 3 a day) but he won't eat them now. He loves watermelon, but won't eat it. Today he told me he was hungry and I asked what he would like, I made it for him and then he changed his mind--said he wasn't hungry. At most he is eating two or three bites of his meals and that is only after we tell him he has to eat it in order to get up. He will eat a fruit snack here and there or some popcorn, but I am getting worried since it has been going on for a few days now.

My parents say not to worry, he will eat when he gets hungry, but I am concerned.

[rosetapper23]

Although your son's situation sounds more serious than my own children's occasional refusal to eat, my remedy was to tell each child that if they didn't want to eat what I had prepared, they had to make their own meal. This usually played out quite well, because they enjoyed being "big" and were allowed to be creative in preparing their meals. However, it became old when they discovered that actually a bit of work was involved....so, in the end, they would always accept what I prepared and would eat it.

Have you tried asking your son to put together something he'd like to eat? Perhaps you could provide some banana slices, fruit bits, salad fixings, etc., and let him creatively prepare a meal for himself. A little chocolate or maple syrup might entice him, too.

[Lfrost]

That is a great idea. He does love to help me cook, but I am worried that it is something more. He told me he wanted pancakes for dinner (gluten free) and I made them for him (he usually loves them) he did take two bites and when I told him he had to eat more he told me food makes him sick. He hasn't been acting sick though, still runs around, plays at the park, etc.

I am not sure what is going on. I don't know if we are missing more allergies that the doctor didn't test for? Do allergies cause a loss of appetite? We are already avoiding wheat, egg, soy, peanut, fish, and milk. I also don't know if he just finds the gluten free food bland? Actually that can't be it because he is refusing favorite foods and fruits, etc.

[Juliebove]

It could be a combination of things. When my daughter was that age, her food intolerances had not yet been diagnosed. She would do something weird. She would throw her fork down on her dinner plate and scream that she was hungry and wanted a snack! I could never figure out what that meant. I do know that she did love and still does love pre-packaged snacks. So perhaps she preferred those to what I made for dinner?

There were a few things I did. One was to have her pick out food from the grocery store. We would try new things and she would help me cook. This didn't always work.

The other thing we did was buy a bunch of plastic containers of her choice. I could then keep snack like things in those in the fridge. Like cheese, meat, eggs...

[Mom2J112903]

Has any other GI testing been done? Even a UGI with SBFT would be something to think about. An UGI with SBFT is a radiological test where the child drinks barium, they watch how the barium moves down the esphagus then they take x-rays until the barium reaches the end of the small bowel at regular intervals. This is a simple test which will show if there is any dysmotility thru the GI system. If food can not empty out of the stomach or move thru the intestines, it WILL hurt and it WILL cause a lack of appetite. We have been down the GI road for nearly 9yrs and I have learned to never "settle" on an answer if symptoms still persist to the point the child isn't thriving.

[Lfrost]

Has any other GI testing been done? Even a UGI with SBFT would be something to think about. An UGI with SBFT is a radiological test where the child drinks barium, they watch how the barium moves down the esphagus then they take x-rays until the barium reaches the end of the small bowel at regular intervals. This is a simple test which will show if there is any dysmotility thru the GI system. If food can not empty out of the stomach or move thru the intestines, it WILL hurt and it WILL cause a lack of appetite. We have been down the GI road for nearly 9yrs and I have learned to never "settle" on an answer if symptoms still persist to the point the child isn't thriving.

Honestly I have asked NUMEROUS times for a referral to a GI, but my son's doctor won't give us one. I kinda blew up on the doctor the last time which got him to at least do allergy testing and the celiac panel (he wasn't even going to do those). We are currently doing a gluten free challenge and my son's next appointment is on the 11th. If the doctor doesn't give us a referral then, then we are going to hunt out a new doctor.

[Mom2J112903]

I have went thru 8 pediatricians for one reason or another, but MAINLY because they refuse refferals! You are a PEDIATRICIAN for Pete's sake, NOT a specialist that should ALWAYS be brought in if you are dealing with a symptom that is NOT a "typical" childhood thing. To get a refferal to our GI doc (we moved and had to get a new one) it took my son being in the ER twice in 5 days because of GI pain. He has a g-tube now because of his GI disorders/malfunctions and yet the last ped said that there wasn't anything wrong with it. I have had peds tell me that it is ok he hasn't ate or drank much less peed in 24hrs time because he was up playing around still. Yeah, only took nearly 2L of fluid to get him peeing after our GI admitted him. The VERY first one we saw, we saw only twice-once for his newborn check up then again a few days later when he vomited so much it was leaking out of his bassinet....ped said that was typical for a newborn. So yeah, 8 is a lot but I will NOT let a ped be my son's ONLY md and that is what many of them want to be.

[Lfrost]

To make matters worse, my son's Dr. isn't even a ped. He is a family practitioner. My son has had chronic constipation since birth and started vomiting daily for an entire month and my doctor said he was fine 'it must be a virus'. That is when I actually blew up on the doctor and got my testing ordered.

My daughters have a different Dr. (because they wanted a girl) she is AMAZING! She listens, she refers, she remembers, etc. So, I am currently wondering if I should move my son over to her because she is so great, or if I should take my chances finding an actual Ped. that I don't know personally.

[Mom2J112903]

Hirschprungs or Gastric/Intestinal Dysmotilty, have they ever mentioned those?

[Kelleybean]

Any possibility that it's not physical - that it's "behavioral"? I put the behavioral in quotes because I'm not trying to say that he's doing it to be stubborn or anything like that. But that the new foods may taste differently to him and he's sensitive to texture, for example. I was wondering if an OT with a speciality in feeding programs might be helpful. There could also be other allergies going on, and he's instinctively trying to avoid anything that makes him feel bad?

[Lfrost]

Nope, just said he 'had a virus'. The allergy tests did come back with low IgE allergies to wheat, egg, milk, peanuts, soy, and fish. When we went gluten free and he had a slip up of eating wheat, he immediately got a rash across his chin, then when he ate peanut butter, he got a rash across his leg and his whole body itched.

He has done well gluten free and had a complete turn around behaviorally, but just this last week he is refusing to eat and has been whining more. We haven't added any new foods in, so I am wondering if we might be missing something more. His rash reactions didn't start until we took his allergen foods away and then reintroduced them. So I am wondering if he has become hypersensitive to something else now, but I am fishing in the dark and since he isn't eating, it is hard to do any food challenges.

I will check in on these other possibilities. The bad thing is that if I suggest something to the doctor that I found online, he almost seems offended and pushes harder that that can't be it (maybe to save face?, who knows).

[Lfrost]

Any possibility that it's not physical - that it's "behavioral"? I put the behavioral in quotes because I'm not trying to say that he's doing it to be stubborn or anything like that. But that the new foods may taste differently to him and he's sensitive to texture, for example. I was wondering if an OT with a speciality in feeding programs might be helpful. There could also be other allergies going on, and he's instinctively trying to avoid anything that makes him feel bad?

I was wondering if it might be behavioral and that is why we have been making him sit at the table and eat at least 3 bites or he goes to time out. It takes forever to get him to do it, and last night is when he told me that it makes him sick.

As a side note, the constipation is back (black, constipated smelling skid marks in his underwear) and he says his poop is stuck. I don't know if this is from not eating so there is nothing to push out or if it is a reaction.

[Kelleybean]

This strategy may not work for you since you say that he won't eat ANYTHING. But when we give something unpreferred to our son, we always have something at the same time that is highly preferred. One bite of the unpreferred item, then he gets a bite of the favorite. Works really well for him. My other thought is could he be in a cycle? Ate something that made him feel bad, so he built an aversion to eating b/c he's afraid he'll feel bad again. I'm wondering if addressing it both ways might help - physical and behavioral.

[tarnalberry]

I would absolutely switch docs to the other one, immediately.

[Lfrost]

Yea! I just talked to a coworker and he informed me that with our insurance we do not need a referral for an allergist, so I will be making an appointment on Monday. This is an allergist that my coworker has and loves and who also sees children.

That makes me wonder if I even need a referral for a GI then. Looks like I will be calling around on Monday! . Also, might an allergist give a referral to a GI? I am still going to switch my son's doctor, but just wondering.

And, on a very positive note, my son helped pick out and cook lunch...a bunless hot dog and some pineapple. He ate a few bites around noon, but we left it out for him. We have a local fair in town and he really wants to ride the roller coaster again so we told him he had to finish his lunch. It took a few hours, but by 3 he finished his lunch!

[Mom2J112903]

If he is constipated, he isn't going to want to eat since he is "full" already. He may even vomit if he is constipated to the point things are at a stand-still.

[MoMof2Boyz]

If he is constipated, he isn't going to want to eat since he is "full" already. He may even vomit if he is constipated to the point things are at a stand-still.

I was going to say the same thing. When my kids get constipated they won't hardly eat anything. I can't remember if you said you were giving him anything for the constipation? might try some miralax just to help get things moving. Good luck with the allergist and definitely switch doctors.

[Lfrost]

I think the bowels are starting to move. He has been having accidents in his unders today (big set back, he was just starting to go on his own)

Here is the interesting thing, his poo today has that very distinct constipated smell, but the poo that comes out is a normal brown color and the consistancy of tar (except the first poo of the day, that was a 'rabbit turd'). When we put him on the pot, he says he can't go, "it is stuck". Then a little while later he has another small accident in his unders. He has done this about 4 times already today. I am glad things are moving, but not sure how to help him.

Why would it smell constipated, but be a tar consistancy? Would you still go with the Miralax? I do have some.

[MoMof2Boyz]

I think the bowels are starting to move. He has been having accidents in his unders today (big set back, he was just starting to go on his own)

Here is the interesting thing, his poo today has that very distinct constipated smell, but the poo that comes out is a normal brown color and the consistancy of tar (except the first poo of the day, that was a 'rabbit turd'). When we put him on the pot, he says he can't go, "it is stuck". Then a little while later he has another small accident in his unders. He has done this about 4 times already today. I am glad things are moving, but not sure how to help him.

Why would it smell constipated, but be a tar consistancy? Would you still go with the Miralax? I do have some.

I think I'd go with the miralax, maybe half the dose, it will get things moving more, so if he has accidents, it's not his fault, he might have a lot poop stuck in his colon and the poop that does start to come out will be more liquidy and he might not be able to make it to the bathroom on time. I don't k now why it'd have the constipated smell but the tar consistancy(I think poop smells awful anyway but maybe someone else can chime in.

[Mom2J112903]

I think the bowels are starting to move. He has been having accidents in his unders today (big set back, he was just starting to go on his own)

Here is the interesting thing, his poo today has that very distinct constipated smell, but the poo that comes out is a normal brown color and the consistancy of tar (except the first poo of the day, that was a 'rabbit turd'). When we put him on the pot, he says he can't go, "it is stuck". Then a little while later he has another small accident in his unders. He has done this about 4 times already today. I am glad things are moving, but not sure how to help him.

Why would it smell constipated, but be a tar consistancy? Would you still go with the Miralax? I do have some.

What is happening is that *some* of the stool is moving but not *all*. So think of a stick jammed in between two rocks. It starts raning and there is a a TON of water behind it but only *some* can move. This is what happens with the stool when a person is moderatly to severely constipated.

Miralax is your friend, you can NOT overdose on it and you can always back off once you get "cleaned out". Do NOT let him eat though until he is cleaned out as that only adds MORE stool to the problem. Our at home clean out (my son has severe intestinal dysmotility) is 1 cap of Miralax per hour during waking hours. No more than 48hrs though and NO solid food. You can back off and go back to a "regular" diet once you see "Mt Dew" colored stool. Now every GI has their own way of doing an at home clean out but honestly Miralax is going to be the cheapest and easiest on both you and your son.

When my son was eating a "regular" diet he was on 6 caps of Miralax a day plus 2 doses of Lactulose and we *still* had problems. Now on an elemental formula via g-tube, he gets 3 of Miralax (some days only 2) and his 2 doses of Lactulose. Yes, his entire GI tract is dysfunctional and we NEED our GI to keep my son healthy. So for us getting a Celiac dx was only the beginning because he had symptoms that did not go away, even on a gluten-free diet.

[Lfrost]

Thank you! We will do the miralax today!

[Lfrost]

Miralax is your friend, you can NOT overdose on it and you can always back off once you get "cleaned out". Do NOT let him eat though until he is cleaned out as that only adds MORE stool to the problem. Our at home clean out (my son has severe intestinal dysmotility) is 1 cap of Miralax per hour during waking hours. No more than 48hrs though and NO solid food. You can back off and go back to a "regular" diet once you see "Mt Dew" colored stool. Now every GI has their own way of doing an at home clean out but honestly Miralax is going to be the cheapest and easiest on both you and your son.

Do you know about how long into the clean out it takes before a BM? I know he probably won't make it to the bathroom, but would like to encourage him to sit on the pot He keeps assuring us he does not need to go.

Also, I know you say not to let him eat, but would applesauce be ok? Applesauce is what we usually 'disguise' his Miralax in since sometimes he won't finish his drinks in a timely manner!

[Mom2J112903]

Anything that he eats/drinks needs to be clear liquids per our GI and any other GI that I have read from other parents dealing with dysmotility of the intestines. I can't say how long it will take for the bowels to start moving because my son is not typical in that dept. I am guessing though maybe 6-8hrs?

[Lfrost]

Ladies and gentlemen, we have movement! We also have a hungry boy asking for food!

Thank you all for the great support and help!

[Mom2J112903]

Who would have ever thought poop would bring such joy?