Does my 4 year old have an eating disorder?

[rachvt]

My 4 year old daughter has never been an enthusiastic eater. Recently she's becoming worse, average daily intake would consist something like a bowl of oats in the morning, about two-third cup of food for lunch, and one or two-third cup of food for dinner. She would not eat no matter what we tried. She's now about 103 cm tall and weighs about 15 kg, though she was born 3.55 kg and measured 50 something centimetres at birth full-term. Her weight gain dropped from the 50th centile at birth to just below the 25th centile now for the last 3 years. The only food she eats are junk food which we always limit to a bare minimum or ban completely since we don't eat junk food. As far as proper home cooked meals go, she would only eat spaghetti bolognaise and nothing else. She would not eat no matter what we did and would just throw a tantrum if we made her sit at the table until she would finish at least half of her food.

She has been quite poorly in health ever since she started diminishing the already small amount of food she used to eat. Comes down with fevers or flus quite frequently these days - about two to three times a month if she goes to school, and about once or twice a month during vacations. She also seems to have lesser energy than kids her age, she hates any kind of exercise, dancing, walking or activity, preferring to just sit or stay put in one spot all day. I'm just a bit concerned, but maybe I'm overeacting?

I feel like I must be to blame here. I've always been very concerned about the amount and quality of food that goes into my children's stomachs. My husband thinks I'm overreacting, and he's not helping because if I'm not home to watch what she eats, he would just let her do whatever she wants  - worse still, he will eat her food from her plate if she doesn't want to eat most of it, and let her get away with it... then later when she's hungry he'd just give her ice cream or whatever she wants. My youngest daughter has no eating problems whatsoever, she's 9 months old but eats almost anything we give her... which makes me get more concerned about my eldest one eating so little.

Any advice??? I feel I'm at my wit's end here.
What can I do? Should I just make her spaghetti bolognaise day in day out for lunch and for dinner? Which is not very practical and probably not the healthiest thing to do...

[koukla29]

Take her to see the pediatrician.  Find out if she is malnourished due to her lack of food.  Is she healthy? -  I mean get a physical completed on her to find this information out.  She sounds anemic.  In addition, I don't it's healthy for her to eat spaghetti all day long, but if my daughter wouldn't eat anything else, I would motivate her to eat a bit of new food in exchange for a reward - her spaghetti.  Yes, one bite of steak and lunch, dinner, or breakfast even of spaghetti!  The point right now is she starts eating normal portions.

In addition, bring this up to the pediatrician for more permanent solutions, and add a multivitamin to her meal plan to get her nutrients.

I don't think your daughter has an eating disorder, I think she doesn't eat with you.  She obviously eats with your husband because he doesn't force her to eat what she doesn't want to eat.  

[RockRose]

I agree with koukla,  she sounds anemic.  

And I think you should let her eat what she wants,  when she wants to.  As long as you don't stock the house with cheetos and gummi bears,  let her eat anything she wants.  Bananas,  ice cream,  spaghetti,  cheese,  strawberries,  raisins,  healthy cereal,  whatever.

The more you make this a power struggle,  the more she'll make it one.  

Best wishes.  I know this is hard - I had a son who stopped eating at the age of 3 - literally completely stopped eating.  He was anemic and it was a long climb back to health.

[Cleveland Mom]

You mentioned that she has been in the 25th percentile for weight for some time.  This means she at the slim side of normal.  Both of my kids are at or below the 25th percentile for weight and have there since they were 12 months old.   I will admit that I freaked out when my oldest my son was in the 10th percentile when he was 12 months old.  In fact, I panicked.  I ran around the house with food trying to get him to eat.  My parental anxiety only made the situation worse and he ate less!  Feeding problems in children can often be tied to parental anxiety.  The more anxious the parent is about getting the child to eat the less the child will eat.

We obtained a referral for a nutritionist from our pediatrician and she was very helpful in educating us.  I agree with the other posters about discussing the possiblity of anemia with your dtr.s' doctor.  Her activity level sounds decreased as compared to what one would expect of a 4 year old.  

My 4 year old son, almost 5 year old weighs 35 lbs, this would be about 10th percentile and is 43 inches tall.  He is very slim and tall but very active and healthy.  Often times genetics are behind these issues, I'm 5'8" and weigh 128 lbs.  My son rides his bike w/training wheels around the block and more 2 times per day and can play on the playground for 3 hours at a time.  He is a picky eater but its all healthy foods i.e. plain yogurt, cottage cheese, fresh berries, hard-cooked eggs, pasta etc.

I very much agree that its not important what they eat as long as its healthy.  Setting up battles over food will increase the likleyhood of a child having long-term problems with food.  As stated its hard to watch a child not get the nourishment they need or the nourishment we feel they need.  

Best wishes...

[Michigan mom]

I agree with all the posting above.   I can see your concerns.  I kind of have a similliar situation with my step son.   He is 6 years old and eats really nothing.  He is always sick, has no energy for a 6 year old, has black circles under is eyes and ears a size 4 T cause 5 T fall off his waist.   My husband doesn't see anything wrong with his eating habits.  He only eats cereal, P & J, mac & cheese, McDonalds chicken nuggest, grilled cheese, and pancakes.   He also throws a tantrum at the table if you make him try something.   He'll go without eating if he thinks I am going to make him eat what we are eating.  I won't cook to meals.  But my husband will feed him something else.   I told my husband we need to talk to  the pediatrician about his son's eating habits and not having energy that he should when we take out daughter in for her 1 year check up.  Cause he doesn't seem to concerned or willing to make him eat healthy.   He said there is no point since we only have him on weekends.  But our 11 month old will eat anything you give her.  She has been in the 90-95 % for both height and weight.  
You need to get him in to see the pediatrician with your husband.  That way he can see what giving her ice cream and what ever she wants is doing to her or not doing to her.