(These are the remains of one of Max’s breakfast “cookies”. I often find little piles of rejected bits on Max’s plate. This is a vast improvement on when he used to simply reject an entire plate of food if there was one bit of what he considered disturbing wrongness on it.)
This past week Max met his new pediatrician in an appointment to discuss options for dealing with his bloody noses which have returned in force. During that appointment she told us that he’s a little tall for his age and a little heavy for his age. Due to his being in the 95 percentile for his weight she told us she has to discuss diet and exercise. I told her that diet is difficult with Max because he’s an extreme picky eater. She asked what he eats and on being told she launched into a lecture about how a diet made up completely of empty carbs is really unhealthy. As if I didn’t know. I then explained that his eating habits are related to his OCD which makes eating very problematic for him. This did not, apparently, register with her as an important fact to consider.
She went on to ask me if I have read the labels on cheese puffs – a nutrition-less “food” – and I assured her that I am an avid label reader and am aware of everything that is in (or isn’t in) the food my kid eats. I reiterated that there are few foods Max will eat and that at the end of the day it’s important that he eat something rather than nothing. She told me she wanted to make an appointment for me with the nutritionist.
And that’s when I got angry. But I held it in and told her I knew exactly what my son SHOULD be eating to be healthy – that it wasn’t a question of knowing what a healthy diet is but a question of what my son is willing to eat. She turned to him and asked him if he understands that the way he eats is going to lead to many diet-related health problems like diabetes and heart disease.
Right then and there I knew I was going to get a new pediatrician for Max. Trying to scare a kid with OCD into eating food that tastes like goat pellets by telling him the alternative is horrible sickness – is ineffective. Shaming a parent of such a kid is not going to make the kid eat better either. The worst thing is that I believe she assumed that I must eat the same way I feed my kid because I’m obese. I LOOK like a person who doesn’t know what a healthy diet is. I LOOK like a person who lives off of diet soda and Doritos.
My concerns about my son’s physical health are constant and upsetting to me but one thing I know for sure: badgering Max to eat differently or forcing food down his throat that makes him want to throw up is not good for his mental and emotional health. Food is as stressful a topic for him as it is for me. I want his physical health to be better but I have to constantly balance that against his over-all well being and the quality of my relationship with him.
We’ve been very fortunate in most of Max’s pediatricians over the years in that they understood that a picky eater like Max isn’t being picky to be difficult – they have understood that it’s not an ideal situation and their advice has been useful and their approach has been both reasonable and encouraging. Not one of them ever assumed that my kid’s extreme dietary restrictions were a result of my ignorance of what a healthy diet is. All of them had encountered kids like Max before and knew what I was dealing with.
Best advice:
Don’t make a battle out of food with an extreme picky eater like Max.
With your average kid who is reluctant to eat vegetables it may be effective to simply keep reintroducing them to foods you want them to eat and with the idea that eventually they will accept them. Or that famous tactic of making your kid sit at a table for hours until they finally eat that piece of carrot. Or the other one where if they don’t eat what you expect them to eat they don’t eat at all – in the belief that no child will ever starve themselves to death. With average kids these tactics may work and aren’t likely to cause bigger problems. Kids like Max are at risk of developing eating disorders by making food a constant battle ground. So if your kid has major sensory issues that are limiting what he/she is willing to eat – understand that they may be incapable of overcoming their food aversions.
Give your extreme picky eater multi-vitamins –
Even this has been majorly challenging because most vitamins have a flavor and even non-picky adults recognize that vitamin-flavored things are usually not pleasant. Chewables for kids can taste good or NOT. Max would accept chewables for a while and then they would start to taste bad to him. Some never passed muster in the first place. Eventually he begged me to get him vitamins he could swallow. I prefer natural vitamins but these are HUGE (even the ones for kids) and taste NASTY. Even to me. Max thought I was trying to kill him with the horse vitamins. After trying to find flavorless swallowables I finally went back to chewables and made him try the ones from Trader Joe’s – he’s been taking these without complaint for the past few months. Fingers crossed he continues to take them without complaint.
Never give up offering healthy food options to your picky eater –
It’s exhausting trying to get a picky eater to try new things or old things they used to like. I give up from time to time. But I always pick up the challenge again because I love my kid and I really do want him to be healthier. I eat healthy food myself so we always have lots of produce and whole grain breads and nuts around the house. I always offer him healthy options and try to get him to try new things. Continue to be an example of how to eat healthily for your child and know that that example is meaningful even if it isn’t going to make them eat brown rice any time soon. They’ll KNOW what a healthy diet is and that will help them later on.
For the last few months I’ve had no energy to engage in the constant struggle of getting Max to eat produce and during the move and settling in period his diet has definitely reached a low level. Even before this upsetting visit to the pediatrician I was working on a plan for a renewed effort at improving his diet. I have decided to channel my anger and the shame this doc made me feel into new food ideas for Max. I’m going to jot them down here for my own sake – so I can keep track of them and not forget any of them.
Some diet guidelines to enforce (setting small boundaries and rules has worked for him in the past and it’s time to re-establish them):
Take his multi-vitamins every day.
Drink plenty of water – I don’t care if it’s mineral water or plain.
Take at least a couple of bites of something in the morning before gym class.
Eat one fruit or vegetable item a day (half an apple, half a cucumber, several baby carrots, or a handful of grapes).
Something with whole grains in it (cornbread made with whole wheat, breakfast “cookie”, slice of whole wheat bread with either ketchup or brown sugar on it – don’t care, or whole wheat crackers, or home made granola bar).
Potato chips only on weekends.
Soda only on weekends.
On to some new food ideas:
Grape and apple slushie:
he won’t drink most smoothies. He asked how come he couldn’t have a grape or apple smoothie. I explained the challenge there with regard to texture (when he says grape in this context he means concords which have seeds) and apples aren’t often a smoothie ingredient. My idea is to freeze natural unfiltered concord grape juice into ice cube trays then blend them with half an apple. The result will hopefully be a purple grape tasting icy drink that has some fresh apple in it.
Quick breads baked in square muffin pans:
he likes cornbread but won’t eat it when it isn’t fresh (it gets too dry and crumbly by the next day) and this is a problem for me. He might eat it more often if I could freeze individual portions. The problem is that he doesn’t like muffins (the puffed top not matching the shape of the bottom is the problem) and usually I make cornbread in a pie dish and do triangular slices – these are too fragile for freezing. Even if I did them in a square pan and cut them in squares – the slices will be too fragile for my purposes. I think individual square servings of quick breads might work well. I could do cornbread and gingerbread this way. I also want to get him to try a zucchini bread.
Granola bars using brown rice syrup –
He’s liked granola bars a few times in the past but the commercial ones often have high fructose corn syrup in them. When I made some at home using honey the honey flavor was too strong. Someone suggested using agave syrup or brown rice syrup – I am not a fan of agave syrup but one granola bar he liked for a while used brown rice syrup and so I want to experiment with that.
Veggie burgers –
Recently he ate a few garden burgers (the original one) but near the end of the third one he encountered a lump of something that was unpleasant and hasn’t wanted to eat them since. My mom and I also experienced this gristle-like lump in ours around the same time. Very strange. I found a recipe for veggie burgers in a Cook’s Illustrated issue that seems very promising. The only issue with veggie burgers at home is shaping them. Max won’t eat funky shaped things. My friend Chelsea told me about hamburger presses and I’m going to get one and try that.
Potatoes –
I have wanted to try making tater tots at home so that I can use organic potatoes but all tater tots really require frying. I would like to find some potato finger foods that Max would like that are baked instead of fried. My thought here is doing a kind of hash brown but in small silver dollar sized pieces. With the slightly flattened shape I can get both sides to be golden brown in the oven without frying. I also want to see if I can get him to eat and enjoy oven baked fries.
Corn dog type thing that’s got a different kind of filling –
Except corn dogs require frying. I just keep thinking of a finger food that’s got and outside grain type covering with shredded potatoes and carrots (or something like that) inside. Something he could dip in ketchup or ranch. This is not a fully formed idea yet – just jotting down the basic idea. I was thinking of things like bite-sized bagel dogs but with whole wheat bagel dough and a filling that’s a mix of things that wouldn’t be too strongly flavored or weirdly textured – again – potatoes come to mind. Yes, I know, more carbs. I’m working with what I can. I’ll take an all carb diet consisting of organic and home made food to an all carb diet that comes in packages. If I could get something like this to work out – I could start playing with adding ingredients in small amounts to add nutrients.
Peanut butter balls –
He likes peanut butter flavor. He desperately needs more protein. I’m thinking lightly sweetened peanut butter dipped in a thin layer of chocolate (he like a little chocolate but not a lot). Maybe I could mix a little bit of bran into them that he wouldn’t notice. If I could get him to eat a peanut butter ball before school that would at least be a little bit of protein to start the day off with. He’s eating peanut butter breakfast “cookies” again right now but will tire of them before too long.
That’s all I have right now. Perhaps as I try some of these things I’ll report back how they worked out.
The last thing I want to mention in this new picky eating post is that I have appreciated the comments I’ve gotten from other parents of picky eaters like Max. Recently a mom and daughter commented on my old picky eating post and it was really wonderful to hear from a picky eater who grew up and started broadening her eating horizons. She reports that she is perfectly healthy and isn’t as picky as she used to be. Thank you for sharing your stories! It really does make me feel better and also hopeful that I can get Max to adulthood without him developing terrible diet related health problems.
Extreme Picky Eating: The Beginning
Extreme Picky Eating: The Max Diet