Toddler not eating

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Toddler not eating

Postby Suemaruk » Thu 04 Apr, 2013 5:32 pm

Hello I have a 15 month old baby who is not eating much of anything at all. I was advised by the clinic to stop giving her milk in the nights as she was waking for 2 bottles a night so last week I started this but it hasn't made a difference. Today all she has eaten is a handful of grapes and a rice cracker. since she has learn to shake her head for no she does it before she has even seen what I am giving her, I have tried walking away and watching her form afar and i have tried spoon feeding her or giving her a spoon or fork or finger foods but it doesn't make any difference. last week she ate some spaghetti but I made it again this week and she wont even look at it. I had her checked at the doctors and apart from having glue ear she is well. We play well and go to the park for fresh air everyday so I feel she should be hungry for more than a cracker and a bit of fruit.
She is still waking for the bottles in the night but since last week I am offering water instead to help her eating in the day and also to protect her teeth as per the advice at the clinic. When she wakes I comfort her but sometimes she is awake unsettled for over 3 hours so then ends up in with me on those nights so that I can get some sleep although this is not every night. Am I doing the right thing when she wakes or should I be doing something different? We have done it for 6 nights now.
Please help I am getting really worried about her.Thank you so much in advance
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Re: Toddler not eating

Postby NgalaOnline » Sat 06 Apr, 2013 12:31 pm

Hi Suemaruk

Thank you for your post. It is common for parents to be concerned by their toddler's eating, and for parents to find that their toddler is not consuming a lot of food in the second and third years of life. This can be quite upsetting for parents but is often normal. When looking at a toddler's food intake (amount and also variety) it is generally best to look at the intake over a period such as a week rather than a day because it is quite common for toddlers to have days where they eat very little, then other days where they "catch up" and seem to eat more. You may find it reassuring to document what your child is eating over a week or so.

One common issue with toddler nutrition is that toddlers can get into the habit of filling up on liquids and then having a diminished appetite for solids. The advice given by your child health nurse to eliminate night time bottles is a good idea. In the second year of life children's growth rate does decrease, and it is normal for toddlers to only put on 1-2 kg in the entire second year, compared to the first year of life when babies typically triple their weight within a year. This means it is common for toddlers to have a small appetite in the second year, and for this appetite to easily be filled with fluids. Milk, however, no longer provides complete and adequate nutrition for a toddler so it is important for the amount of milk being consumed to reduce to no more than 600ml in 24 hours (and it can be less than this if other sources of dairy such as cheese or yoghurt are being consumed). Consuming more than 600mls of milk in a 24 hour period is linked with iron deficiency anaemia for many toddlers, as cow's milk inhibits the absorption of iron and often the milk is displacing the role of solid foods in the toddler's diet. Juice is best avoided or limited in toddlerhood, and some parents find it necessary to offer food before water if their toddler typically fills up on water at meal times. The best way to prevent overconsumption of fluids is to cease the use of bottles when a child turns 12 months, and begin using a sippy cup instead. This also benefits children's dental health and ear health, as bottles tend to distribute milk around the teeth in a way that promotes dental decay (especially if bottles of milk are consumed overnight when saliva production is reduced) whereas sippy cups do not distribute fluids around the teeth in the same manner. Drinking bottles whilst lying flat has also been shown to be linked to an increase in ear infections due to the milk flowing into the Eustachian tube of the ears, so for many reasons your plan to stop night time bottle feeding is a good idea.

Research suggests that the most successful method of getting children to accept new foods is to continually re-expose the child to the same food in a very neutral manner, without strong praise, encouragement or any punishment in response to their eating or not eating of the food. It is common for food refusal to cause parents a lot of anxiety, but research shows that a child is more likely to eat when there is very little focus or attention given to the child's eating or lack of eating. It is best to present the food to your child, and if she does not eat it within a reasonable time frame (such as 10 or 20 minutes) simply take the food away again without much attention given to the issue, but then do try exposing the child to the same foods again another day without any comment over the fact that the child refused this food last time. Putting the food next to a food that the child likes and also role modeling eating (such as having the child eating meals at a table with their parents and peers whenever possible, seeing other people eating these foods) are also good ideas. Research shows that toddlers experience "food neophobia" which means that they have a genuine phobia or fear of foods that they are not familiar with. Many children will require being presented with the same food an average of 20 times before they will try this new food in any way or even touch it. It is very common for children to need to touch and taste new foods a number of times before they will actually eat the food. Self-finger feeding often seems to be best for toddlers who are not very interested in eating. Studies show that encouragement or praise about eating the food, or punishment for not eating (such as making the child sit at the table for a long period until she eats some) increases the child's anxiety and suspicion about the food and decreases the likelihood that they will try the new food. Often a toddler's refusal to eat foods is related to texture and appearance rather than taste. For instance, many toddlers are averse to soggier foods but like crunchy foods or vice versa. Many parents may find that their child would not touch cooked vegetables but will happily eat them raw or grated.

It can be helpful to use a diary to record what your child is actually eating over a period such as a week. Many parents find this method helpful in showing them that, even if consumed in only small amounts such as a few bites here and there, their child is eating enough variety over a week. If this is what you find, and your child is continuing to grow well, appear well and energetic, and have soft bowel motions and pale urine then it is likely that there is not a cause for concern. You may then like to continue with the methods listed above of continuing to repetitively offer simple, healthy foods without pressure on her to eat them.

It does sound as though you are doing a good job with changing her previous night time sleep association of feeding to sleep with a bottle. It is common for this to be a difficult transition, involving some nights of lengthy settling periods and reduced sleeps for all. It is fantastic that you are continuing to persevere through this process, and that your daughter is getting used to only having water at night. It is common for there to be some "good nights" and "bad nights" and for this process to sometimes take a week or more. Most people find, however, that if they are able to be consistent with their approach they are usually able to make significant changes to their baby's night time sleep. It is understandable that you would be tired after settling for three hours in the middle of the night and that there may be occasions where it is very difficult to persist with settling her in her cot, however whenever possible it is best to try to keep your baby in her cot to prevent her being brought into your bed developing into a new sleep association. The Ngala helpline is avaiable 7 days a week, so if you would like some more help and support regarding the sleeping, please feel free to ring the helpline to discuss how it is going. I hope this information is helpful.
This information is general in nature and should not be used as a substitute for the personalized assistance that can be received from the Ngala Helpline by telephone.

For families residing in Western Australia you can also contact the
Ngala Helpline
Telephone 9368 9368 or 1800 111 546 for country access
Available 7 days a week, 8am to 8pm
or request a callback online

For helplines in other Australian states please follow this link
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