Conference moira::parenting

    Todd,  I would suggest talking to a child psychologist and possibly
    having the psychologist talk to your son and see what he/she can get
    out of the child.  Another suggestion if you are concerned about the
    nutritional part of the non eating.  They make this stuff called
    Ensure.  It is a milk type product that comes in small cans and comes
    in 3 different flavors (vanilla, strawberry and chocolate).  This stuff
    isn't bad tasting if it is cold and is like drinking a milk shake that
    is full of vitiamins and nutriants.  You can purchase is in most durg
    stores over the counter and might find it in some supermarkets.  But I
    think talking to the child psychologist is a good thought.
    
    Good luck.
    
    Liz

    re: .1,
    	Thanks for the suggestions, Liz.  Got an appointment
    	tonight with the psych..
    
    	'Ensure' hadn't even occurred to me, that's a great idea.
    	At the very least I could bolster up what he's eating.
    
    						todd

    
     this may not pertain to your four year old, but I do know from
    personal experience that kids can get some strange ideas.
    
    When I was about 5-7, I read somewhere that cheese is made from mold...
    to this day, I do not like cheese.  Silly, but I can't shake my
    repugnance for the idea.   Similarly, I read somewhere that
    some mushrooms are poisonous.  for about 5 years I wouldn't eat
    mushroom soup... fortunately, I've overcome THIS fear!  :-}
    
    JAmd

    re: .3,
    	Thanks for the thought.  Yes, we briefly considered that possibility.  
    	But he gives no indication that any belief or conscious fear is 
    	involved, and it seems to be the texture that bothers him rather
    	than the food itself.  For example, he'll eat strawberry yogurt,
    	until he gets to a piece of strawberry, at which time he stops
    	eating it and asks to have it removed.  
    
    	Also, there was a suspicious single incident
    	that my wife's mother related that coincided with the exact time
    	(as far as we can pinpoint it) that he stopped eating solid food.  
    	He was eating a hard pretzel and started gagging on it and became 
    	visibly very panicked.  We suspect that this somehow re-triggered 
    	whatever fears he might have had from the previous incident two years 
    	ago.  
    	
    -------------------------------------------------------------------------
    
    Very disappointing experience with the therapist on Friday.
    
    After nearly an hour of asking us questions about how much attention
    we give him, she threw out a few theories about sibling rivalry,
    etc., etc., and wanted to make another appointment.  At that point,
    visions of dragging the poor kid to 3 months of
    worthless insight therapy with this social worker while this
    presumably self-limiting problem played itself out flashed into 
    both our heads simultaneously and she must have noticed us roll our eyes 
    back in our heads.  
    
    I pressed her as to whether her theories were in any way
    testable or would make any difference in how the problem was treated,
    and she conceded that it probably wouldn't.  So we're looking for
    another therapist who can perhaps actually help the situation before
    he loses too much body weight or becomes nutritionally deficient.
    
    
    								todd

    Boy Todd, looks like you really hit a dead end with the first
    Therapist.  I hope you find a good one this time around.  Did your pedi
    reccommend the first one or did you find her yourself.  Maybe your pedi
    could reccommend one that specializes in childhood eating disorders. 
    Or even look in the yellowpages of your local phone book.  Meanwhile I
    would suggest having your child eat/drink what he likes best.  Milk
    shakes, the Ensure and if he will eat peanut butter sandwiches they
    have alot of protine in them.  
    
    
    Good Luck.
    
    Liz

    Todd,
    
    Geographicly, where are you located?  Is there a large University
    teaching hospital available to you?  Most have not only individual
    psycologists, but a whole department specializing in eating disorders.
    I wonder what would happen if you simply ignored the behavior?, would
    it resolve itself?  I suggest this in the sense of reinforcement of
    positvie rather than negative (which is what this really amount to)
    behavior.  I wonder at what age bulemia and other eating disorders can
    start, he may have a real eating disorder brewing!  You said he stopped
    eating yogurt when he found a strawberry.  He wouldn't be the first
    person who can't stand anything with LUMPS!  My husband is a prime
    example!  For some reason, in my observations, it is a *male* thing. 
    Haven't met a girl or woman who objects to Lumpy things.  (no attacks
    needed, this is just an observation).
    
    In the meantime how about high protien things like chicken soup, egg
    nogs, and I guess I just object to giving him sweet things like frappes
    and ice cream drinks as a substitute for good wholesome food.  What
    about soft things like pasta, mac&cheese, scrambled eggs, egg salad?
    and first I'd ask the pedi to take a look at him physically, to rule
    out not sore throat.  after all it is mid summer and there are some
    nasy throat bugs running around.  My husband is still hoarse almost 2
    weeks after it started witha simple sore throat, strep.
    
    Can you reason with him, tell him he's going to end up sick and in the
    hospital *again* if he won't start eating?  Can you try and ask HIM why
    he doesn't like to eat.  What made *him* stop eating, and what can
    *you* do to help him start eating again.  
    
    I guess AJ is very keen on cause and effect, and these things have been
    tried, and worked in our situation a couple times.
    
    Don't let it get to you, I swear kids pick up on negative feelings much
    quicker than positive feelings.
    
    Lyn

    re: .6,
    	I'm in Philadelphia, Pa..  Someone kindly suggested in mail
    	a pediatric gastroenterologist in Boston, who might be able
    	to provide a local referral (then, the trick is getting
    	our primary pediatrician to refer that specialist).
    
    	The deal with the referral is that we have U.S. Healthcare
    	and the primary pediatrician has to refer the specialist in order 
    	to have a prayer of being able to afford the treatment.  We went
    	to the place that he referred for this reason.
    
    	Our current strategy is actually to ignore the behavior, or tread
    	lightly around it, but to make his previously favorite foods available 
    	all around him and to eat them ourselves, to hopefully give him the 
    	idea.  He seems interested in them but won't actually put them
    	in his mouth.  He's now mostly eating liquids that we fortify for
    	him.  We are mostly low key right now, though sometimes our
    	patience wears a little thin.
    
    	I don't think I mentioned it, but he did spend time with 
    	a pediatrician, who decided that there wasn't any obvious
    	sore throat, dental problem, etc., and most likely behavioral
    	again.  Of course that doesn't rule our something physical but
    	more difficult to find.
    
>    Can you reason with him, tell him he's going to end up sick and in the
>    hospital *again* if he won't start eating?  Can you try and ask HIM why
>    he doesn't like to eat.  What made *him* stop eating, and what can
>    *you* do to help him start eating again.  
    
    	Yes, we can reason with him to some extent, and my wife mentioned
    the hospital.  That scared the hell out of him, had him begging us for
    several minutes not to take him to the hospital, but didn't resolve
    the problem.   His response is that he is 'afraid' to eat, but he
    never gets more specific than that.  Never mentions a specific pain
    or fear, just generally afraid to eat.  
    
    Thanks for all the suggestions.  Having failed with the peds referral, 
    we'll probably try your idea of a teaching hospital.
    
    						kind regards,
    
    						todd

    It definitely sounds like the choking incident might be related. Who
    wouldn't be afraid to eat after that (and 4 yr. olds have VERY good
    imaginations)? Anyway, I have a daughter who is very sensitive to 
    food texture (if the applesauce is too thick, I have to use a food
    processor), so I can relate to a certain extent. What I might try if I
    was in your situation is to go back to 'baby food' consistency of his
    food, if you're concerned about his nutrition. Then you might be
    able to gradually ramp up from smooth to chunkier foods. Sounds a
    little weird, but it might work. I agree with 'ignoring' it as a way to
    keep the pressure off him; on the other hand, he might need someone to
    recognize his fear (it's real to him) and give him a process for
    overcoming it. Maybe this suggestion would do that?  

    	Hmmm, does your child by any chance watch Rescue 911? Although it
    is a great teaching aid, I could imagine that some very sensitive
    children (and adults) could get very frightened from it.

    	On a fairly recent episode they had a choking story, some old woman
    choked on a chicken bone and her grandchildren saved her. All said that
    if the children had not been there, that she would have *died*. I could
    see a young child internalizing that to be *I* could choke and die.


    	From that very show I have sworn to :

    	never put our kids on a school bus
    	never let our kids near water
    	never let our kids walk by a plate glass window
    	never let our kids eat solid foods
    	never let our kids......

    	(you get the picture)

    	Some of the scenes in that show can truly cause fear and alarm
    (Although I think the benefit of that show outweighs the risks).

    			Wendy

That's not weird at all, Lisa.  I think you are right.

Since you (the parents) are ruling out physical problems that would cause this
then it seems to be a behavioral psychology problem, and therefore requires a
behavioral psychology solution.  I, too, was going to suggest gradually
increasing the texture of the foods.  You might actually use real baby food,
though if it upset his pride then you would have to make your own smooth or
relatively smooth food. 

This type of solution is how to address phobias in general - you *gradually*
take them from a relatively "safe" environment to one which causes them to
fear.  By doing it slowly, over time, each step is not too scary for them to
handle.  Eventually they have overcome the fear, and their behavior is in line
with that of other people.  In this case, he would gradually eat more and more
textured foods until he ate like other 4 year olds (which isn't to say that 
4 year olds eat "normally").  :-) 

       Carol

Todd,

Does your son attend a day care, or is he around other children his own age
at mealtime?  My daughter is usually a very picky eater, but eats much better
at daycare.  The other kids sitting and eating seems to be what she needs.  She
does what they do.  You might try to invite a couple of friends over his age 
for a small picnic.  Maybe seeing the others eating, without problems, will
encourage him to try.

just a thought

Michael

    Not to be repititous, but if you can get your son to say he is "afraid"
    then I would try to push just a little more to try with "WHY are you
    afraid, WHAT are you afraid of?"  WHAT made you afraid. 
    
    Fear is a real thing, to kids and adults, but the main thing your son
    needs now is to know that he is loved, and that would seem aparent from
    your comments!
    
    Try again to reason with him, I find difficult things to talk about are
    sometimes easier when we just sit, cuddle and talk softly.  Drag out
    that old comfortable rocking chair and just sit and talk.
    
    Lyn

    These suggestions are very helpful.  Thank you all so much.
    We haven't tried baby food or making baby food out of his previous
    favorites.  That seems worth a try.  Can't wait to taste pureed peanut 
    butter and jelly soup with him.  Yum. :-)
    
>Does your son attend a day care, or is he around other children his own age
>at mealtime?  My daughter is usually a very picky eater, but eats much better
>at daycare.  The other kids sitting and eating seems to be what she needs.  She
>does what they do.  You might try to invite a couple of friends over his age 
>for a small picnic.  Maybe seeing the others eating, without problems, will
>encourage him to try.
    
    That's an excellent idea.
    This actually does work for his 2 yr old brother Nicholas, who eats
    much better at daycare than he does at home.  So far though, 4 yr old Ian 
    has been just as problematic with his diet at daycare as he is at 
    home.
    
    Thanks again very much for the concern and the helpful ideas.
    Thanks also for the doctor recommendations I received in mail.
    
    							kind regards,
    
    							todd

    There are some allergies (not necessarily to food) that can cause the
    soft tissue of the throat to swell so that swallowing is difficult.
    The swelling can't be seen in a routine examination as it is too far
    down the throat so unless the cause of the allergy is found, an 
    individual could have this condition for life and be prone to choking 
    and worse - be unable to breathe.  If a doctor can't find out what is
    causing the swelling, the course of action I am aware of is to have 
    the person take antihistamines if the condition persists. This will
    reduce the swelling and provide some comfort.
    Has your child been exposed to a different environment or have you
    started using any different cleaning chemicals or paints at home?
    *Is the above scenerio a possibility?
    

    re: .14,
    	Hmmm ... I never heard of that.  He doesn't seem to have any
    	trouble swallowing liquids or with breathing.  I'll bring it
    	up with the next specialist we see.  Thanks.
    
    Someone made an interesting suggestion in mail about his problem,
    that I use a stuffed animal that "won't eat" as a surrogate and have
    Ian try to find out what's wrong with his furry friend, maybe giving
    a clue to his own problem in the process.  Makes a lot of sense.
    
    							todd

    Todd,
    
    The allergy is a very real thing.  A friend of mine was, literally,
    deathly allergic to nuts in ANY form.  If he consumed so much as a tad
    of peanut oil, his throat would swell and constrict, until it would
    eventually suffocate him.  Not to suggest that this is your sons'
    problem, but there are some very real, very dangerous allergies that
    might not be apparant in a routine exam.
    
    I too was going to suggest the 911 theory, with a different twist.  If
    he's afraid of choking, perhaps he's old enough to learn how to deal
    with choking himself.  They do teach the Heimlich and how to perform it
    "on yourself".  I think (though I could be wrong), that by letting him
    live with his symptoms, you are only feeding his fear.  "Well gee, if
    mom and dad don't even make me eat this cuz I'm afraid, then maybe I
    SHOULD be afraid!".  If he's afraid of choking, help him deal with
    CHOKING.  The issue isn't really the food - it's his fear of being able
    to breathe.  Perhaps all of you can take a choking course together -
    may give him comfort knowing that people around him can deal with it if
    they need to.  
    
    And ... when Jason was 4, he pretty much decided he wasn't going to
    eat.  Anything.  No amount of asking/pleading/begging or anything was
    going to get him to try it.  Until one day I sat down with him and told
    him, quite sternly, that if he didn't eat something (I forget what it
    was - something I knew he liked) that day, then we would have to take
    him to the hospital that night because he hadn't eaten in so long, he
    was going to get very sick.  I explained to him how an IV works, and if
    he didn't want to eat, well okay, but they'd have to feed him through a
    needle in his arm.  Sounds a bit drastic, but I was REALLY at my wits
    end with this child and trying to get him to EAT!!  He was clearly
    hungry, and being skinny didn't have any weight he could afford to
    lose.  Well don't you know that afternoon he ate a big lunch, then a
    big supper, and the next morning was asking me what kind of food would
    be better for him so that he could stay strong and get bigger etc.  I
    felt like a WITCH saying those things to him, but it was to the point
    where he was just NOT healthy from his lack of food - and it was just
    something he didn't want to have to deal with.  
    
    It seems a little early to use the "hospital" as an alternative for
    him, especially since he's clearly scared to death of it - as
    suggested, I would definitely try to get him to voice SPECIFICALLY
    what's wrong.  Maybe you can read books about choking, and point out
    specific foods that are easier to choke on than others (hard candy,
    pretzels, carrots etc).  Even if he decides to boycott those foods,
    you're better off than you are now.  Show him how, even if *YOU* don't
    chew it, creamed corn (or whatever) just slides down, and you can't
    choke on it.  AND, don't leave out the importance of the act of CHEWING
    itself.  Your teeth NEED to chew to stay healthy - feeding baby food
    or only a soft diet to an older child, for an extended period of time,
    is doing nothing to help their dental situation. 
    
    Perhaps it may help to take him food shopping and let him pick out a
    few things that are "just for Ian".  Things that he's sure he'll eat,
    things that he wants to try to eat.  I wouldn't present it as an option
    to him that he just doesn't eat solid food.  He won't thrive well on
    soft foods, and it may help to make him very aware of this.  "If you
    want to be big like Hulk Hogan, you have to eat steak!" ... or however
    you put it - placing the emphasis on food value and nutrition may mean 
    more to him than "Ian, you HAVE to eat that bread!"  
    
    As for your counselor, hopefully you can tell your pedi that you were
    very dissatisfied, and they can make another referral.  I know that
    with our HMO, they will allow a second opinion, and will pay for it if
    the second opinion differs from the first.  If it doesn't, you're
    stuck, but one visit isn't THAT much money.  Check what your insurance
    options are - there are a lot of bad counselors around - just because
    one is unwilling or unable to help, doesn't mean that there isn't any
    help available!!  Perhaps your local "family crisis" center (usually in
    the front of the phone book) has a recommendation?  Or there's always
    your own research and the local library.  Where it's happened once
    before, I'd expect it'll happen again when he's older - you can't just
    expect the Drs to be as concerned about your son as you are, and you
    are his best advocate.  Don't accept "I don't know" or them brushing
    it off as "behavioral".  If it's behavioral, then insist on help
    modifying his behavior.  Ian needs some sort of help - it's awful that
    the medical profession isn't doing it, but it would be a tragedy if you
    didn't insist that something happen for him.
    
    Good Luck!!  And you thought the hard part would be getting them to
    pick up their toys and stop fighting with each other (-:   Kids! (-:
    

    -1 reminds me that I've had a rather severe allergic reaction to
    certain dietetic hard candies.  It may be the sweetener or the
    artificial color or flavor.  My throat constricted and I could not
    breath.  Luckily it cleared up quickly but it was frightening.
    
    Anytime I eat hard candy now, I warn my companions that I may react
    this way.
    
    My daughter had a similar reaction to a diarrhea medicine.  (Sorry,
    can't remember the name.)  It was prescribed by a general practicioner. 
    Her new pediatrician said he NEVER gives this to kids.  I am happy with
    the pedi, needless to say.
    
    Maybe Ian had such a reaction once.  You might not even have known it
    was happening if he was wandering around at a picnic or such, and you
    didn't see it.
    
    It would be safe to stay away from artificial sweeteners, colors, and
    flavors.  It's a good practice, anyway.
    
    Laura
    

    
    
    	When I was younger, if I ate certain fruits and raw vegetables, I
    got that constricted-throat feeling.  My throat never closed up, but
    it's a very uncomfortable feeling.  To this day, I can't eat raw
    carrots, and if I haven't had a plumb or nectarine from the end of one
    season to the beginning of the next, I can get that feeling.  SO...
    since it's fresh-plumb-peach-nectarine season, maybe something like
    this has happened with your son.
    
    	I also remember a few choking incidents when I was very young.  To
    this day, someone choking makes me panic.  Never caused me not to eat,
    but I am probably over-paranoid with my own daughter.
                                   
    	Justine

    It's  not impossible to choke on smooth foods like creamed corn.
    I choke easily, and have choked when just swallowing saliva (something
    people do automatically all day long, otherwise we'd drool like
    babies).  In my case it seems to be related to trying to do too 
    many things at once--some hand task plus talk, plus swallow.
    
    		-John Bishop

    Some people get a sort of mucus overload occasionally while eating.  I
    think it is related to eating too fast on an empty stomach, maybe some
    anxiety too.  I rather doubt Ian has had it, because you would have
    noticed.  Just a thought.
    
    Laura

    Advice # 21:  
    
    Daily strenuous exercise will create an appetite that won't be picky.
    Swimming is especially great for creating a starving child that begs
    for food.

    To the basenoter:  Is there any update to provide?  
    
    You have been in our thougths a lot lately.
    
    Lyn

    Update :
    
    	No change so far.  Maybe promising signs of interest as he
    	puts hard candies into his mouth now sometimes, tentatively.
    
    	But still eating strawberry yogurt (without the strawberry
    	pieces) and whipped concoctions we prepare for him as his staple.
    
    	Very tenacious problem.   Our patience is wearing thin.
    
    re: appetite and exercise,
    
    	Thanks for the suggestion, but it seems to be more than pickiness.
    	He has been swimming nearly every day at our in-laws, 
    	and sometimes has a ravenous appetite, but still avoids the
    	solid food for some reason.
    							todd

    We finally had a breakthrough with this non-eating problem two days ago.
    
    Ian (the 4 yr old) has been wanting us to buy him a present at a 
    particular store for some time now, and we were driving along near that 
    area when my wife decided to try bribery using the store as leverage.
    We had tried bribery numerous times before, so we had no great
    expectations of success.
    
    To boost the leverage, she said that he could have 'anything in the store'
    if he'd have 'one bite' of a peanut butter and jelly sandwhich.
    I know that sounds a bit much, but if you had any idea of how difficult
    this problem has been ... anyway ...
    
    He thought about it for a minute or so, and then broke down and cried
    inconsolably for several minutes, going through some kind of very sincere 
    internal turmoil (not seeming to be just the usual 'gimme gimme' tantrum) 
    and then came out of it sobbing meekly that he wanted to go right home and 
    eat something.
    
    He had half a sandwhich, after which we paid off on the promise,
    and he's been gradually eating more since then, though still not 
    quite back to normal.   
    
    							todd

    re: .24 
    
    So, what did he pick as his reward?
    
    
    Best of luck.

>    So, what did he pick as his reward?
    
    	A large plastic Tyrannosaurus Rex.
    
    	Which reminds me of an interesting thing about this problem.
    	
    	For the past week he had been asking me to read him a particular
    	story from a book of dinosaur stories.  This particular story was
    	about an aging meat eater who had gotten so weak from hunger
    	that she couldn't hunt anymore.  She makes a few abortive
    	and pitiful attempts to catch and scavenge, and then, so weak from
    	hunger that she can no longer defend herself, she gets 
    	eaten by another of her same species in an explicit, brutal
    	carnage.  
    
    	I obviously started out taming the story down greatly so it
    	wouldn't upset him, but his interest increasingly grew in the
    	story and he kept asking for it, so I gradually let more of the
    	gory details of the story and its message through.  I suspect
    	that it may have helped relay a message to him that helped the
    	bribe push him over his still mysterious fear.   He didn't
    	visibly ever respond with fear to the story or have any nightmares
    	over it that we know of, but he may have understood it in a way
    	that no amount of my reasoning with him or cajoling alone could have 
    	done.  That, plus the bribe, may have done the trick.
    
    	I'm just guessing ... the 4 yr old mind is a complete mystery to
    	me.
    
    								todd
    	

    Todd,
    
    Congratulations on the breakthrough!!  I can only hope it keeps on.
    
    Lyn

    Did he give you any idea about why he cried so hard while thinking it
    over?  I suppose that would be too much to expect if he's still having
    a hard time with eating.  Maybe once this passes and he's back eating
    normally he'll give you some idea about what was wrong......
    
    Glad things are better!
    
    k.

<            <<< Note 558.24 by DWOVAX::STARK "Nature finds a way" >>>

CONGRATULATIONS!!!!!!!!!!!!!

      Carol                          

    Thanks for the kind words.  If he gives us a clue as to what was (or
    is) going on, I'll share it here.   Might have something or other to
    do with the new baby coming in the next couple of weeks.  He has also
    shown some regressive behavior in other ways, like wetting the bed
    (which he hadn't done for almost 2 years).  
    
    He's still only eating one thing,
    peanut butter and jelly sandwhiches.  But at least this tells us we
    can probably rule out many of the medical problems, and focus on the
    behavioral issues, since he eats this without any pain or difficulty.  
    
    Quite a relief, after all those weeks.  
    								todd

    CONGRATULATIONS TODD!!!!!!
    
    I have very happy to hear of your breakthrough with your son's eating
    habit.  I hope this doesn't reoccur when the baby's born.  Maybe when
    the new baby comes and you let him help you out with the baby, etc he
    might start eating more.
    
    
    Again, Congratulations.
    
    Liz

    Wow, Todd!  Let me add my CONGRATULATIONS!
    
    And hey, truth sure is stranger than fiction.  I got goose bumps
    reading your account of his oft-requested starving-dinosaur story.  And
    what a courageous kiddo to eat a *HALF* a sandwich when you were only
    asking him to have one bite.
    
    Leslie

    Todd,

    	Wonderful news. What gentle perseverance on your part and what
    great courage on the part of your son.

    				Wendy

    re: courage,
    
    	Yes, we were *very* impressed, but not entirely surprised.  He has
    	frequently shown such signs of strong character.  Probably gets it
    	from his mother.  :-)
    
    	We're a little concerned about his response to the new baby.
    	We've spoken to him about it, and he's decided he wants it to
    	be a girl and even picked out some names.  He seems excited about
    	it.  
    
    	My wife Sue and I decided to have he and his 2 yr old brother
    	in daycare full time for a couple of weeks while Sue takes care of
    	the baby and gets back on her feet.  We're afraid that they may
    	take this as a sign of rejection, no matter how we explain and deal
    	with it.  Any thoughts ?
    	
    								todd

If it's economically feasible, you might wish to consider having them in
daycare fulltime well before the baby arrives.  (And of course, it's so easy
to count backwards from the day of arrival :-)

I've no direct experience, but everything I've read recommends that you make
any big changes 2-3 months before the new arrival is due, or that you wait
2-3 months afterwards.  Postponing clearly wouldn't help you much...

Good luck!

- Deb

    Please continue any discussion about siblings adjusting to a new baby
    to one of the two following notes:
    
       250  SCAACT::RESENDE       4-AUG-1992    17  Child doesn't want
    							another baby
       436   GLOSS::KAPLAN        2-FEB-1993    16  Preparing Toddler for
    							New Baby
    
    Laura
    co-mod

    Although Ian had thankfully expanded his dietary repetoire
    to include that childhood gustatory delight PBJ, we thought it
    best to keep our previous child psychiatrist appointment.
    
    Ian was all over the place during the appointment, from start to
    finish, and nothing we said or did even slowed him down.  We finally
    resorted to physical restraint, and he had a tantrum and began trying
    to bite us.  Our embarrased claims of 'he never does this at 
    home,' weren't likely very convincing.  
    
    The doctor concluded from his observations and from what we told him
    that Ian probably was going through some fairly common regressive
    behavior, of which the eating problem was likely just one aspect.
    He suggested that we not do anything further about the eating thing,
    but try to 'model' correct eating in front of him.  His general
    feeling, though he didn't say so in so many words, seemed to be 
    that parents often over-react to eating problems and reinforce
    the problem more than resolve it.  He also suggested that we
    should make allowances for regressive behavior, not discouraging it,
    but setting limits for it within acceptable bounds.  I'm not sure how
    exactly to carry that out.
    
    He also had some comments about my handling of Ian, that I didn't
    remain firm, but softened up too much when imposing verbal limits.
    He didn't connect that to the eating problem, though, just as a
    constructive criticism in general.
    
    							kind regards,
    
    							todd

It sounds to me that you've got a good
psychiatrist.  Reasonable, non-alarmist,
and what he had to say makes sense to me.

Ian's behavior at his office sounds like
that of a toddler who doesn't have many
words yet.  Having recently been in this
phase with Elise, here's what I remember
on handling such problems:

Remind his to use his words to describe
what he wants. Refuse to understand screams
and grunts, make him verbalize. (He's 4,
he can do it).

Wait out tantrums.  Don't give in, don't
bribe.  If you have trouble ignoring him, 
then sit quietly near him (out of range)
and every once in a while say something
soothing, like, I'm here when you are
ready to talk.  Don't get angry, it just
makes things worse.

Serve something he will eat at every meal,
but a small amount.  Also serve
other tempting things (only healthy choices).
Do not discuss his food choices or
anything about his eating.  Discussion of
manners is very appropriate.


Good luck,  It sounds to me like things
are improving...

Pat

    Pat,
    Thanks very much for the thoughts.
    
    Yes, he's a good shrink.  I was very pleased with him,
    which is rare for me to say about a doctor, especially 
    a psychiatrist.
    
>Ian's behavior at his office sounds like
>that of a toddler who doesn't have many
>words yet.  Having recently been in this
>phase with Elise, here's what I remember
    
    His speech patterns have indeed been regressing,
    but that's largely situational.  He is quite eloquent
    and has a relatively impressive vocabulary for a 4 
    year old in most situations.  He has the intellectual capacity
    already to get his needs met through verbal interaction.  So, I tend to 
    think the cause and effect is possibly reversed from Elise,
    that his erudition sometimes suffers from his regression,
    rather than his social interactions suffering from slowly developing
    speech habits.  His younger brother, on the other hand, is almost 3
    and has almost no words, so Nicky *is* in that boat with Elise,
    and your advice is probably going to come in useful with him.
    
>Wait out tantrums.  Don't give in, don't
>bribe.  If you have trouble ignoring him, 
>then sit quietly near him (out of range)
    
    That's excellent, thanks.  It took me a while, but that was finally
    the approach I settled on myself.  It does seem to be the best
    in most cases.  It doesn't neglect him entirely, yet doesn't
    reinforce his use of the tantrum to get attention.
    
>Don't get angry, it just
>makes things worse.
    
    That's funny, I probably have the opposite problem.  The child psychiatrist 
    said that I should try getting angry sometime, since I almost never do.  
    :-)    I'm very much the type that lets things go on and refuses to react
    except with verbal patterns.  I become sarcastic, or use other means of
    passively expressing anger, but I don't change my outward behavior
    very much.  Of course, this is an inappropriate way to handle a
    4 yr old, since he doesn't catch the same subtleties that an adult
    would.  I think I have to learn to *look* angry when I'm angry
    (meaning when something is important or urgent, rather than just that
    I lost my temper).  I get the feeling that my kids don't ever get a 
    sense of urgency from me, because of my habitual approach.
    
    						kind regards,
    
    						todd

    re: 4 yr old tantrums , etc
    
    I know this is not about eating habits,but....
    
    Avanti (4 yrs) went thru the phase of "not using works" but simply
    crying when something happens that she does not want to happen (not
    necessarily unpleasant) or she does not get her way. This happened soon
    after Neel was born so we knew that it was related to the arrival of
    Neel with whom she has to share Mommy, Daddy and their attention.
    
    At her preschool/daycare the teachers worked with her by reminding her
    to use her words. We did and do the same at home and if she feels like
    crying (tantrum related) then she has to find a spot to sit and workout
    her feelings and calm herself down. This has helped her a lot in
    addition to my putting aside time for her exclusively each night. She
    has learned to use words instead of displays of tantrums.
    
    Shaila

    Last week AJ went through a six day bout with a wonderful summer
    stomach flu.  (Which he so generously shared with me earlier this week,
    Thanks!)  As he recovered I kept remembering this string.  I would
    offer him food, he would aparently remember that food had very recently
    made him ill, vomit, have stomach cramps, the runs etc.  I would always
    get a "no thank you I'm just not hungry", or I'd get after two bites
    "I'm just not hungry anymore".  I just gave him MY generic answer of
    "No I don't think so, you WILL eat"  fortunate for us, he did end up
    eating, and sometimes we would reward him with some frozen yogurt. 
    (which he equates to ice cream)  I did have fears of him not eating,
    and loosing weight.
    
    Only a couple times did we have to resort to threats of, "well if you
    are *really* feelling that badly I had better call the doctor right
    away, and see what she has to say".  I reserve these threats as a last
    resort.  His build is such that I can still count his ribs! very tall
    and thin, with broad muscular shoulders.
    
    I am keeping some of your thought in the back of my mind, for future
    reference.
    
    Lyn

    Gosh Lyn,
    
    Some stuff sounds just like what we do with Avanti. She goes into "My
    tummy hurts" routine if she does not want to drink milk ( the major
    peeve ..of course Mommy does not like milk either but eats yogurt ) and
    we have to say "no you will finish that milk" or "if your tummy hurts
    that badly then we need to call the doctor" soon after which the milk
    is gone within seconds. AT first I thought that she really had a
    tummy-ache but asking for "fruit snacks" soon after made me think. we
    do not allow any candy in our house except occasionally - only fruit
    snacks are allowed - that too on occassion.
    
    SHaila

Todd,

Just to clarify a little - I didn't mean to
imply that Ian's language abilities were
suffering or missing, just that there is a
certain superficial similarity to toddler 
behavior.  I thought a refresher in
toddler management might be useful.

You are absolutely correct about the anger.
I was thinking toddler - you're dealing
with a kid who has the verbal skills to
reason.

Good luck,

Pat

    Thanks, Pat.
    
>I was thinking toddler - you're dealing
>with a kid who has the verbal skills to
>reason.
    
    Yeh, but then again a four year old's version of reasoning
    is a little different from an adult's.
    
    Yesterday, he noticed that another child was missing from
    daycare, and mentioned that the child (a 3 yr old boy) must be home
    resting after having a baby.  He obviously absorbed some of our
    talk with him about his mother's pregnancy, but not quite in the
    form we thought we had explained to him.
    
    						kind regards,
    
    						todd

    Four is a *very* hard age, in my experience, and having another baby
    then only makes it worse.  I had my third when my second one was 4, and it 
    was *horrible*.  James (number 2) pulled every stunt a rotten 4-year-old
    can.  Once at the doctor's he threw a textbook tantrum-- on his stomach
    on the floor, kicking and screaming to beat the band (all the parents
    in the waiting room stared at me like "What did you do to that poor
    child???").  The doctor looked down at him, smiled, and said, "Yup-- 
    that's four!"  I said, "Want him?"  He said, "No way-- I've already
    gone through 4 twice!!!"  
    
    As I understand it, "they" say the children are worried about where
    they'll fit in once the new baby arrives.  So I kept emphasizing the
    fact that there was plenty of love in our family for everyone, and I
    used positive reinforcement when the older two behaved well (like
    "big boys").  I also played up the fact that James would now get to be 
    a big brother (although the basenoter already has two).
    
    Good luck.  Four stinks (IMHO).  Testing, testing...  It's the open 
    defiance that's really getting me now.  Yes, the "baby" is 4.  Argh!!!
    
    Good luck.  I've found that by 4 1/2 they start acting human again...
    
    
    Pam
      

    Several years ago my husband and I went to a class called...
    
    "Is there life after four, and if so, is it worth living?"
    
    Honest, this was the name of the one night class and it
    truly helped us understand our, then 3� year old, daughter.
    
    Jodi-

    I have a 4 1/2 year old daughter. She has had several experiences with
    choking. She choked on New Years Day at a restaurant and it caused
    quite a commotion. Then she choked on chicken, 2 weeks ago. We tried 
    not to make a big deal out of it and she seemed fine. 
    
    Then last Sunday she choked on the forbidden food (popcorn that my son 
    shared with her). Last Monday, she announced that she would not eat 
    anything that had to be chewed and swallowed.  She would only eat
    ice cream, pudding, tomato soup etc.
    
    I brought her to the pedi on Wednesday and she checked for enlarged
    tonsils etc. The pedi reassured her that she could eat anything and
    that she just needed to slow down, chew and swallow.
    
    No luck! She still is not eating much. I did get a 1/4 of a cup of 
    stew into her. It took her 2 hours to chew/swallow and take a sip of
    water after each swallow. She has already lost 2 lbs.
    
    Any suggestions, does anyone know a child that has had this problem?
    
    

    My son, also 4 1/2, has been going through something quite similar. 
    Everytime he eats something that causes him to choke, he won't eat it
    any more.  For instance, pepperoni used to be one of his favorite
    things to eat.  Everytime we went to the grocery store, I had to buy
    pepperoni for him.  One time he choked on it, and now he won't touch
    it.  I have a very difficult time getting him to eat much of anything
    other than yogurt or any other food that's soft or liquid.  I've even
    noticed lately that he's not drinking what I give him with his meals
    until long after he's done eating and that's only when I say something
    to him about not drinking his drink.  He's very skinny (he's 44 inches
    tall and only 32 - 34 lbs.) and he always has dark circles under his
    eyes.  I'm afraid he may be anemic.  I looked in his throat over the
    weekend due to the fact that he had a cold and his tonsils did seam a
    bit large to me.  I don't think they do anything about enlarged tonsils
    anymore though.  Anyway, maybe it's just a phase that kids go through. 
    Hopefully it'll pass.  If it doesn't soon, I'll be taking him to see
    the pediatrician.
    
    Lori B.

    
    
    Well, we are now going into the third week of Erin's not eating
    anything that has to be chewed/swallowed or has lumps i.e. applesauce.
    
    When I first called the doctor's office the beginning of the second
    week of this ordeal - the nurse said. "try some icecream, yougurt,
    mashed potatoes, peas", I admit, it was the icecream and sweet stuff
    she would eat. I talked to my doctor again this week and she said 
    make her eat!!!! Easier said then done. We have now progressed to the
    baby food level - she will eat the jell like apples and peaches. I
    mentioned baby food to her before and she refused. I was able to sneak
    the baby food into a china plate w/matching tea cup (of course this was
    at a tea party) without her seeing.
    
    I finally made it clear to her that if she ate soup, applesauce etc.
    then we would let her have a treat. We made some progress last night
    she ate cream of broccoli soup. I guess it is going to be a long
    gradual haul with this. I am also giving her pediasure (kids ensure)
    for a snack once a day.
    
    It so sad to see her thin again. She was just reaching the 10% range
    for her age...
    
    Anyone else going through this????
    
    Harriet
    that it was from a baby food jar.

	Harriet,

	How is Erin doing now?
        Eating a lot more I hope.

	Karen T.

    
    FYI; Harriet left the company back in March.  Actually, she was a DEC
    tag and resigned from that program.