February 2011 Archives

Extreme Picky Eating: The Max Diet

tater tots.jpg
My kid may be an extreme picky eater but while the number of things he'll eat is small, his food rules are complex.  Part of what makes feeding him so complicated is the fact that there are distinct cycles to his eating habits which change frequently and suddenly.  I am going to lay out (for your interest, not your criticism) all his food rules and the foods he eats to give others an idea of what it's like to feed him and, more importantly, how hard it is for him to eat.  Other parents of picky eaters may find solace in reading this account.  Either you'll realize your kid is way pickier and I've got it easier (but feel less alone) or you'll realize your kid is easier to feed and maybe find things to appreciate about your own experience by comparison.

The Rules:

Only one food on a plate at a time.
  Any condiments need to be in their own container in order to avoid touching the food before it's time to eat it.

Plates, bowls, and glasses are frequently scrutinized for cleanliness.  Any suspicious speck will contaminate the food on the plate and it will be refused.

Hand washing.
  Occasionally requests are made that we wash our hands before feeding the kid.  This always insults me and is met with a lecture about how my hands are always cleaner than his.  The truth is, he's not worried about germs, he's worried about unauthorized foods still being on my fingers such as the essence of cheese which may transfer to his food and make him lose his appetite.

Food needs to be as even and same sized as possible.  This is one of the reasons why he likes crackers and other predictably uniform foods.  Most foods are amorphous and irregular, this is repugnant to him.  Holes in toast, for example, used to be met with panic and then a flood of tears.  Now he is much more polite about refusing to eat toast that isn't "perfect".  There must be no rips, shreds, stringy bits, dark specks or anything ruining the appearance of his food.

Texture.  He mostly likes things to be crunchy and firm.  A limp carrot is an abomination.  A stale cracker is unacceptable.  mealy apples or crumbly anything is not okay.  Tater tots slightly underdone are an insult.  Texture is a very serious thing to Max and the wrong texture (such as a wet spot on a cracker) can be traumatic.   

With a few exceptions (which remains a mystery to me) sticky textures
such as jam or soft peanut butter in a piece of bread aren't tolerated because if he gets it on his hands he panics (and used to cry).  He will eat cornbread with honey on it (this is one of the exceptions) and will immediately run to the bathroom to clean his hands afterward - should there be an impediment to his getting to the bathroom he will freak out.

He does not eat at the table.
  He eats while watching movies.  I fought him from the time he was a baby in the highchair until he was about two years old trying to get him to eat at the table.  He would constantly try to get out of the chair and no food would be eaten.  I would give up and give him a snack while he watched a movie and the movie would keep him still and calm and I found he'd put food in his mouth and not examine it as closely.  This is true to this day.  I don't care what any other parent thinks of me, if it weren't for DVDs my child would not have enough distraction to eat.  It's like needing white noise to sleep (which he also needs).  I am at peace with this.

Flies or insects.
  If a fly or insect is seen in the same room in which he is eating he will lose his appetite for at least an hour, sometimes several.  For some reason ants inside the house, especially in any room he's eating in, are disturbing to him.  He doesn't mind them outside but he has nightmares that they are crawling on him in his bed. 

Food odors.  He cannot tolerate the odors of most food he doesn't himself eat.  He refuses to eat his food in the school cafeteria (a fact he didn't tell me until I found out because he got into trouble trying to eat his protein bar in the hallway).  He finds most food visually disgusting with special disgust for all pasta dishes, beans, and pizza.  He is usually neutral about people eating salads near him.  He is still very rude in dealing with his strong food odor/visual aversions though we keep working on it.

Temperature of foods matters.  If something like toast is supposed to be warm he will not eat it if it isn't the right temperature.  He doesn't eat much food that's meant to be hot except for tater tots.  I don't really blame him for not liking his tater tots cold but he's pretty dramatic about how disgusting it is.  He likes his cold beverages to be really cold, but not iced. 

"Old" water or old anything.  If it takes him too long to drink or eat something (say, longer than a half an hour) he will refuse to eat them because they've been sitting out for too long.  This drives me insane.  I do know that water grows stale but he is so sensitive to it that I have wanted to strangle his handsome little neck at constant requests for "fresh" water or new food.

Unopened bags.  He has started requesting that all Goldfish be brought to him in an unopened bag because he believes they don't taste right when they are opened by us though it seems to be fine if other crackers are put in a bowl by us. 

One left on the plate.
  One of whatever he's eating that is considered his "real" food (as opposed to snacks) must always be left on the plate.  For years he would always (ALWAYS) leave one tater tot or one carrot stick or one piece of apple.  Even if he was hungry enough to ask for more, one must remain uneaten.  He has, very lately, eased up on this.  I've asked him many times over the years why he does this and he would just tell me he had to do it.

Food Cycles.
  There is a distinct cycle to his eating that I haven't scientifically mapped but I can tell you that at one end of the cycle he'll have about fifteen different foods in rotation that he'll eat and at the other end of the cycle he'll have only two foods in rotation.  There are mini cycles within the bigger cycles.  He'll eat a few things obsessively until he gets a (literally) bad apple and then he won't be willing to try that food again for a month, sometimes more.  So what foods he'll eat are constantly changing.  This makes my head spin and my patience thin.

Brand specific.
  Don't switch brands on this kid.  He always can tell.  Have him try three vanilla ice creams without seeing the packages and he can tell you which one is the one he usually eats, which one is vanilla bean (which he hated for the specks in it), and which is the off brand you bought because they were out of the usual one. 

The Actual List of Tolerated Foods in the Max Diet:

Sugar toast.  Whole wheat toast with butter and brown sugar.

Egg toast.  (this only makes the rotation rarely).  Whole wheat toast with a fried egg and ketchup.  (this is hard to make "perfect" so comes with a high chance of being rejected.

Wheat hot dog bun with ketchup.

Cornbread with honey.  When he loves it he LOVES it and usually he will only eat  few slices before it's out of rotation for a long time.

Tater tots.

Apples.  Texture is extremely important.  The slightest bit of browning and he will stop eating them.  We've used lemon juice sometimes to help this.

Carrots.  Only likes the "baby" carrots because they're pretty uniform in shape and size.  Though he recently tried cut carrots again, unfortunately they didn't taste that great.

Grapes.  Only red grapes when they're in season.  Mostly just the red grapes we get from a friend of ours.  He'll eat bowls of those.

Cucumbers.  But only in season.  When they're good he LOVES them.

Watermelon.  Only the seedless kinds.

Strawberry "milkshakes"
made with milk, frozen strawberries, and a little sugar.

  An ever changing list of packaged crackers (organic saltines, Ritz style, Goldfish, Pop chips, and a few others that once in a while enter the rotation)

Energy/Protein bars.
  This is his main source of protein.  We only buy Luna and Cliff because they don't use corn syrup and are mostly organic.  Right now Cliff bars are NOT OKAY.  In each bar type he only likes two flavors and usually eats one flavor exclusively until he is sick of it.

Juice popsicles.  Concord grape only.

French fries.  When we go out to dinner we feed him at home and then let him order fries which are not good enough for him to eat 75% of the time.  When they're good he really likes them.

Peanut butter cracker sandwiches.  I put peanut butter (very smooth) between two natural Ritz-style crackers.  He's not eating them now but it was a great favorite for at least two months.

Peanut butter "breakfast" cookies.
  I adapted my peanut butter cookie recipe to have less sugar and wheat flour so he would eat something with protein in the mornings. 

Home baked cookies.  A few select recipes I use are approved.

Gingerbread.  He loves gingerbread. 

Ice cream.  All kinds of ice cream (except not fruity). 

Hot cocoa.  I count this as food because I make it with milk which has actual protein in it.  He doesn't like it often because he hates milk but sometimes it hits the spot.

Frozen yogurts.  But not the healthy natural ones.  He likes the tube yogurts made by Yoplait.  I hate Yoplait for having made them appealing to kids and then putting total crap in them.  Luckily, I guess, he seems almost to have permanently taken this off the acceptable foods list.

  Ten grain pancakes with a bucket of real maple syrup.

Popcorn.  Not a lot of nutritional value but at least it's something.

Potato chips.  We don't let him have these often but he loves them. 

That's 25 items total that he will eat, including desserts. 

Remember that most of the time there are only 5 to 10 of those items in rotation. 

Right now there are three:  Peppermint Luna bars, tater tots, and grape juice popsicles.

Food is emotional for most people and necessary for everyone.  I was prepared to love my child if he was born without all his limbs, to find charm in him should he be born a dwarf, and forgiving should he grow up to be a jock... but I was not prepared for a picky eater because I believed, as most parents do, that as long as I always put healthy food in front of my kid he would eat what I gave him (barring the usual disdain for broccoli and kale that many kids have).  I believed that it's parenting skill that makes good eaters, not something mental or physiological. 

Every time Max rejects the food I make for him he rejects a part of me.  He doesn't see it that way.  For eight years I've experienced his rejection of my tireless efforts to nourish his body and mind with good food.  I have compromised, worked hard at coming up with clever ways around his issues, and I have also given up a thousand times.  There have been times when I was so desperate to get him to eat anything that I let him eat crap that I don't eat myself.  No normal parent will let their kids starve.  Many parents of non-picky eaters love to say that no child will starve themselves so if you hold out and insist they eat what you want them to eat with the threat of no other options they'll cave in and bend to your awesome parental will.

My child would rather die than eat soggy toast.  I know this to be true.  How can I know?  Because I would rather starve myself to death than eat any kind of meat.  Anyway, I don't personally respect the kind of parenting that pits a parent's will against its child's with starvation as the threat.  I want a better relationship with my son than that.

Now that Max is much older he doesn't cry over his food issues, we discuss them and we work on them together.  I can't change the fact that he's picky, and neither can he, but he is more willing to try new things than he used to be and since he was diagnosed with OCD two years ago we know that many of his food issues are directly related to his OCD and this makes it easier for me to not take his food rejection personally and it helps Max to understand that his many frustrations with food aren't his fault. 

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Extreme Picky Eating: The Beginning

Max thanksgiving 2.jpg
Max's Thanksgiving Dinner

For most parents what picky eating means is that their kids don't like broccoli or spinach or papaya.  For the privilege of being able to complain that my child won't eat a few vegetables or exotic fruits I would happily amputate my foot.  You think I am being melodramatic but I assure you that missing my foot would be worth the pain in exchange for my kid eating most things besides a few vegetables or fruits that most children don't like.  To me that is not picky eating.

For some parents picky eating means their kids won't eat most vegetables or fruits and prefer a steady diet of pasta with butter, potatoes in any form, chicken, beef, cheese, milk, cereals, breads, rice, eggs, and sandwiches.  I definitely feel for parents with kids who won't eat any produce but will eat grains and meat and dairy.  I still envy them enough that if I had a ransom to give in exchange for my kid eating such a wide variety of foods, I would happily be poor but able to feed my child.  Sadly, I'm already poor and my child won't eat most of those foods.

Then there's the few of us with kids who eat 10 or less food items at any given period of time.  Think about what that would mean to you.  What if your child didn't like meat, hated nearly all dairy, choked on almost all fresh produce, disliked most cereals, bars, nuts, and grains?  What would you feed your kid?  How would your kid grow up to be healthy?  How would you deal with the fact that your child would prefer it if all food but dessert and a select few other items could simply be swallowed in gel-cap form?  How would you feel?  How capable of a parent would you consider yourself?  Would you blame your child?  Would you fight your child over food every single day?  Would you give up trying?

When my kid first started eating food as a baby he ate almost everything.  He ate pureed greens, carrots, squash, fruit, and cereals.  There were few things I put in front of him that he wasn't willing to eat.  I mashed bananas until he could eat them himself, he ate almost a banana a day until he was two years old.  He liked peanut butter and jam sandwiches, baked beans with grilled cheese sandwiches, lentil and chard soup pureed and scooped up on crackers, feta cheese, avocado, melon, pears, peaches, and he would even eat potatoes.

The change happened so gradually I can't possibly say exactly when we realized Max's palate was changing.  It wasn't overnight.  Slowly he started rejecting foods he previously liked and no power on earth could make him swallow a banana by the time he was two.  Other things were happening at the same time but the most dramatic was his powerful refusal to wear denim.  Later, when he could talk, he told me it was because it didn't feel good.  It was rough.  Anyway, slowly his diet whittled down to mostly carbohydrates and we consulted our pediatrician.

The pediatrician said it was a fairly normal stage many children go through.  Her advice was to continue to offer healthy foods at every meal and he would probably grow out of it.  He did not grow out of it.  Another year and another pediatrician visit and more advice to always offer healthy food but not to freak out if Max only wanted to eat crackers.  We already noticed other troubling trends in our child and considering these the doctor told us that we had a choice to make food a daily battle (I was making it a daily battle and crying all the time over the fact that he wouldn't eat much of what I offered) but warned that I could potentially create an eating disorder by fighting at every meal with my child. 

A child like Max.

She suggested we be careful about choosing our battles with him.  She told me that my job was to never give up offering him wholesome food.  If he chose only to eat crackers he probably wouldn't die, would most likely grow out of it, and we could give him multivitamins. 

I have never given up trying to get him to eat wholesome food.  I am an excellent cook and the biggest crime I commit in my diet is too much fat.  We eat a lot of fresh produce, whole grains, not much packaged crap, not too much salt or sugar, and we eat a truly varied diet.  To have an extreme picky eater for a child has been an enormous emotional strain on us and on our budget.  Packaged crackers aren't cheap.  Instead of growing out of the picky eating it has simply grown worse. 

I started writing about this issue on Dustpan Alley and have realized that it's time I write about it here.  Not for people with kids who will eat some things they don't like with some applied parental pressure or threats or promise of dessert, I want to write about it for those parents like us, who have struggled so hard over the basic job of feeding our child, who have shed a lot of tears, torn out a lot of hair, and thrown out a shameful quantity of rejected food. 

I get so angry listening to parents telling me how to get my kid over his picky eating.  There is a general assumption out there that if you just keep forcing your kid to try something (they say it takes twelve times) they will eventually like it.  Or that if you just refuse to feed them outside the meals you cook for yourself they will eventually just choose to eat what you put in front of them ("no child will ever choose to starve themselves").  Or that if a child doesn't like much food it's because the parents don't eat good wholesome food themselves.  Or that they aren't good cooks. 

There are a lot of assumptions out there about picky eating and most of them are made by people who don't have picky eaters for children.

I would like to address a lot of these assumptions and offer encouragement to other parents with extreme picky eaters because I need it myself and there's precious little of it out there.  I can't do it all in one post.  I will tackle it in several.  In the next post I will write out every single eating issue my kid has so that anyone who doesn't know the full scope may learn what my kid goes through and consequently what I go through trying to feed him.

I would like to offer some general advice right now:

1.  Never stop offering healthy food for your child to eat no matter how exhausting it is and how frustrated you are.

2.  Give your kid a multivitamin that includes iron.*

3.  If your kid only likes packaged food (crackers and things like that) be careful to read labels and don't allow any high fructose corn syrup, preservatives, food coloring, or other harmful ingredients into your cupboards. 

4.  Don't let other parents make you feel like a failure.  I once had a neighbor suggest that the reason my kid didn't eat healthily was because I wasn't cooking good enough food.  I have rarely had such a terrible urge to slap another woman as I did at that moment.  Her kids would eat kale raw and she assumed it was her awesomeness as a mother that made her kids like everything.  Most people will view picking eating as a failing of the parents or of the child or both.  Don't let them get under your skin.

5.  Be compassionate with your picky eater and with yourself. 

*Even finding  multi-vitamin my kid will take has been a miserable ever changing drag.  The flavors of most multi-vitamins are repugnant to him.  He finally begged for a pill to swallow but the one I found was enormous and the serving size was three a day and he could taste them going down.  I have finally found a multi-vitamin in a gel-cap which goes down more easily and he can't taste.

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