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My 15 month old baby does not eat. At most, she has 100ml of Pediasure per day, a teaspoon of cheddar cheese, half a slice of bread and perhaps 10 teaspoons of cereal or porridge. I have tried many, many different kinds of food but she just takes one look and shakes her head. She wouldn’t even try them! She is completely underweight at 7.2kg and I am at my wits end. She keeps eating the same thing every day and very small portions. She is breast fed on demand at other times. What should I do? I saw a nutritionist who has given me MPC oil? and some multivitamins but they haven’t really worked enough. HELP!

Thank you.

Asked by Mamapumpkin - Posted 7 years, 11 months, 4 weeks, 1 Day, 12 hours, 50 minutes ago.

Thank you for your email.

Its always a challenge to feed children heading to the terrible two’s.

Firstly, Its important that your paediatrician do a through clinical check to ensure that there is nothing physically wrong with her.

Its equally important to determine her pattern of growth from birth to now. This is to determine if she was always small (genetic/ nutritional cause) or only recently fallen off her growth charts.

Continued growth failure usually will require some blood tests to determine any other illnesses that are not apparent on clinical examination.

What you must understand is that you cant force children to eat. They will determine when and how much they will eat at one time. You can determine what’s on her plate.

When you are feeling at the end of your tether with a fussy eater, take a deep breath, relax and remember this is a normal phase in your toddler’s development which will resolve with time.

By being anxious you can often make the problem worse, particularly if you are expecting your toddler to eat more than she needs. If allowed to do so, toddlers will eat just enough calories for their own requirements, so you should always respect your toddler’s decision that she has had enough to eat. You need to resist trying to persuade her to eat more. All this is of course, easier said than done. Remember that it is your responsibility to offer your toddler nutritious food but always allow her to choose how much she will eat.

How can you tell if your toddler is full?
It may seem obvious but your toddler is telling you that she has had enough to eat of a particular food, course or meal, if she is:

• keeping her mouth shut when offered food

• saying no

• turning her head away from the food being offered

• pushing away a spoon, bowl or plate containing food

• holding food in her mouth and refusing to swallow it

• spitting food out repeatedly

• leaning out of her highchair or trying to climb out

• crying, shouting or screaming

• gagging or retching

What is the best way to cope with my faddy eater?
Most toddlers go through a phase of only eating a very narrow range of foods. This is a normal part of toddler development called food neophobia - being frightened of new foods. Your toddler needs time to learn that these foods are safe to eat and enjoyable. She will learn this by watching you and others eating those foods. Eventually she will widen the variety of foods she eats but some take much longer than others to do this. To help her on her way, and to keep your sanity, follow these tips:

Eat with your child as often as possible. Toddlers learn to eat foods they are unfamiliar with by watching and copying their parents and other children eating them.

Make positive comments about the food you are eating. Parents are strong role models and if you make positive comments about foods, your toddler will be more willing to try them.

Arrange for your toddler to eat with other toddlers as often as possible. Invite a friend from playgroup over for tea. Your toddler may eat better when she is with her own age group.

Develop a daily routine of three meals and two to three snacks around your toddler’s daytime sleep pattern and try to stick to it. Toddlers thrive on routine and knowing what to expect. She won’t eat well if she becomes over-hungry, and toddlers who are tired will be too miserable to eat. Don’t expect her to eat a large meal just before going to bed. Give her a small snack or drink and save her proper meal until later, after she has woken up.

Offer two courses at mealtimes: a savoury course followed by a sweet course. Toddlers often get bored with too much of one taste and will be ready to try something new. Two courses also give your toddler two opportunities to take in the calories and nutrients needed and means there is a wider variety of foods at each meal.

Limit mealtimes to about 20 - 30 minutes and accept that after this your toddler is unlikely to eat much more. It is better to wait for the next snack or meal and offer some nutritious foods then, rather than extending a meal trying to persuade your toddler to eat more. Most toddlers eat whatever they are going to in the first 20 minutes.

Praise your toddler when she eats well because toddlers respond positively to praise. If you only give her attention when she is not eating, she may refuse food just to get some attention from you. Toddlers like attention, even if it is negative. If she doesn’t eat well, take the uneaten food away without commenting and accept that she has had enough.

Give small portions. Toddlers can be overwhelmed by large portions and lose their appetite. If the small portion is finished, praise your toddler and offer her some more.

Offer finger foods as often as possible and allow your toddler to make a mess at mealtimes. Toddlers enjoy having the control of feeding themselves with finger foods.

Eat in a calm relaxed environment away from distractions such as the TV, games and toys. Toddlers can concentrate on one thing at a time so distractions make it more difficult for them to concentrate on eating.

Be aware that if you are eating out, your toddler may not be prepared to try any of the food on offer, as it may all be unfamiliar to her. Take something that she will eat with you to tide her over until her next meal or snack.

Involve older toddlers in food shopping and preparing for the meal such as putting things on the table. This will encourage a positive attitude to food and mealtimes.

Involve your toddler in simple cooking and food preparation (if you have the time and patience). By handling and touching new foods without pressure to eat them, your toddler will become familiar with new foods and may be more likely to try them.

Change the venue of your toddler’s meals. For example, have a picnic outside. This will make eating a fun experience for your toddler and will allow them to see others enjoying food.

What shouldn’t I do?
Don’t rush a meal. Some toddlers eat slowly and rushing your toddler to eat can reduce her appetite.

Don’t pressure a toddler to eat more when she has indicated to you that she has had enough. Never insist she finishes everything on her plate.

Don’t take away a refused meal and offer a completely different one in its place. A toddler will soon take advantage if you do. In the long run it is always better to offer family meals and accept that your child will prefer some foods to others. Always try to offer one food at each meal that you know she will eat.

Don’t offer the sweet course as a reward for eating the first course. You will make the sweet course seem more desirable than the savoury one.

Don’t offer large drinks of milk, squash or fruit juice within an hour of the meal. Large drinks will reduce your toddler’s appetite. If she is thirsty, give her a drink of water instead. Try to phase out bottles so that all your toddler’s drinks, including milk, are given in cups or beakers.

Don’t offer snacks just before or just after a meal. Don’t give a snack soon after a meal if your toddler hasn’t eaten well at her main meal. It is tempting to do this just to ensure that your toddler has eaten something. However, it is best to have a set meal pattern and wait until the next snack or meal before offering food again.

Don’t assume that because your toddler has refused a food she will never eat it again. Tastes change with time. Some toddlers need to be offered a new food more than 10 times before they feel confident to try it.

Finally, don’t feel guilty if one meal turns into a disaster. Put it behind you and approach the next meal positively. Parents also learn by making mistakes.

I hope this of some help to you

Best of luck

Kind regards

Dr. Sanjay Woodhull
Consultant Paediatrician

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Panel of Experts:

Dr. Eeson Sinthamoney
MD (Mal), MRCOG (Lon),
Fellowship in Reproductive Medicine (UK/Singapore)
Consultant Obstetrician & Gynaecologist
Fertility Specialist

Dr. Pong Kwai Meng
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FRCP(Edin),M.Med. (Paeds),
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Speciality: Paediatrics and Neonatology

Dr. Hoe Tuck Sang
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MRCP (UK), FRCP (Glasgow)
Consultant Paediatrician
Specialty: Paediatrics

Dr. Khoo Phaik Choo
MBBS (MAL), LRCP (London), MRCS (UK), DCH (London), MRCP (UK)
Consultant Paediatrician
Specialty : Paediatrics

Dr Sanjay Woodhull
MBBS (Manipal). MRCP (UK). FCCP (US)
Consultant Paediatrician
Specialty: Paediatrics

Dr. Patrick Chia
MBBS (London) MRCOG (UK) FAFP (Mal)
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Specialty : Obstetrics & Gynaecology and fetal medicine

Ms. Jennifer Hor
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Specialty : Breastfeeding Support

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