Why Did My Weaned Kid Stop Eating?
Elisabeth Kraus, MA and Kirstin Nelson, MS, RDN, CSP
Getting off of the tube is one thing, but staying off the tube feels like a completely different minefield. A lot of parents worry about whether they’ll have to re-tube the child they just weaned, and that fear is never more present than the times when your child stops eating the way you hope or expect for them to do after a wean.
We believe that when a child stops eating (or begins to eat less), there is always a reason. Our job is to figure out what that is so that we can address the situation mindfully and responsively. So, when you see your child eating less than before, ask yourself if one of these reasons fits your situation:
Normal fluctuation:
When you’ve lived with tube feeds for a long time, it can be challenging to not expect your child’s oral eating to look like their tube feeds did: same volume in, in the same routine, every day, day in and day out. But the reality is that eating typically looks nothing like the medical paradigm of tube feeds.
We all have meals and days where we eat a ton! And meals and days where we eat very little. And in the end, it all balances out to being exactly what we need to thrive. So if you notice that your child goes through “feasts” right before what feels like a “famine,” keep an eye on outputs: if pees, poop, and energy are looking good, then lean into the support you need in order to embrace the “ups and downs” that comes with parenting an oral eater!
Illness or teething:
We expect people to eat less when they don’t feel good, and kids are no exception to this. Often, a drop in appetite is the first sign of an oncoming illness, so if you notice a dip alongside extra tiredness or symptoms such as a cough, runny nose, fever, tummy ache, etc., you’re likely looking at the normal response to feeling terrible.
Respond to this dip in ways that are supportive and comforting. For instances of teething, consider comfort measures like teethers (frozen or otherwise), chomping on a cold cloth, or safe over-the-counter pain interventions. For cases of oncoming illness, shift your focus towards hydration even more than nutrition, and do your best to maintain a DOR mindset that’s a bit more present. My kids mostly veg out on the couch when they don’t feel well, and I always have a few drinks nearby (water, Pedialyte, broth, tea, etc.). When you offer the chance to eat, focus on comforting foods that match/relieve their symptoms, such as popsicles, jello, warm broth, chicken noodle soup, toast, applesauce, etc. And when they refuse, which they inevitably will, just keep the food nearby for a bit, so that they can nibble if they want.
Constipation:
There is nothing to stop eating in its tracks quite like constipation, so if you notice a dip in eating that coincides with a lack of poop? Your first priority is to get those poops moving! And to do that, we think about “mushers” and “pushers.”
“Mushers” are the things that pull water into the colon to soften the poop (Miralax, magnesium, and juices like apple, pear, prune, grape and cherry). For kids who struggle with constipation, any “musher” option will work better if given every day, rather than “as needed.” Similarly, “pushers” are the things that stimulate the movement of the colon, to help push poop along its way and OUT! This includes things like senna, ex-lax, etc. If you feel like “mushers” aren’t cutting it, it might be worth talking with your pediatrician about adding in a “pusher.”
Mealtime stress and pressure/inconsistency:
When eating goes down, anxiety goes up! And if we aren’t careful, anxiety can cause us parents to abandon the strategies that helped weaning in the first place, and opt for the strategy that just gets more into that mouth for this one meal! But if there’s one thing we know for sure it’s that “pressured eating always leads to less eating in the long run.”
So when you see less, rather than taking it as a cue to change up the strategy, take it as a cue to take care of yourself – to help yourself to be ok so that being ok doesn’t rely on how much or little your kiddo eats. Fluctuation is normal. Dips in interest is scary, but ok. Hold tight to the pressure-free strategies that brought eating about in the first place. If you can trust your child to wean from tube feeds, you can trust your child to eat enough to stay off of them.
If you’re in the post-wean phase where your kiddo is eating less, know that you aren’t alone. The ebb and flow of typical eating feels weird when you’re used to the predictability of tube feeds, but less eating is usually the result of one of the above factors. And if it’s not, your GIE team is here to help you put the pieces together.