Why does my preschooler refuse to eat

4.5 year old daughter won’t to eat. She sits at the table & stares at her food. We have to tell her to take a bite, remind her to chew and swallow & then repeat the process. Breakfast is a waste - she goes to school with little in her stomach. Maybe, 3 ounces of juice & 1 or 2 bites of something - whatever she will eat. At school, occasionally eats a little snack of something, just a bite or two. She rarely drinks anything unless she is reminded to drink. Lunch is 2 hours to eat half a peanut butter sandwich (doesn't like jelly) on 1 slice of crustless bread or a hot dog. At dinner she eats what we eat - smaller portions. Same routine, 2 hours, tell her take a bite, chew, stop holding the food in her mouth and chew, finally swallow and repeat. If we leave the table, she says she's lonely - we are 10 ft away cleaning. She finds excuses to get away from the meal - going to the bathroom, etc. She urinates enough, but bowel movements are pale in color. Complains her tummy hurts for almost every meal, and sometimes gags, not in any pattern (no similar textures, flavors, etc). Sometimes throws up, mostly at breakfast, for no reason. If we leave her alone and don't remind her to eat or drink thru the day, we end up in the ER for dehydration. She says she doesn't like to eat & drink but doesn't know why. It started 3 yrs ago. We have tried rewards, penalties, talking to her. She understands not eating is bad and eating makes her healthier and happier and us happier.  She hit milestones on or before time, is bilingual, has normal relationships with children at school. She had feeding therapy, occupational health exams (no problems) and is a healthy little girl.  

[Renee Radenberg]

Her weight is between the 50-25th percentile and her height is above the 95th percentile for her age. She is normal for her age. Engage her with preparation of food. Have her help you set the table or do something for the meal. Children love to be a part of making food. Hopefully it will increase her interest in food. Suggest giving her milkshakes (ice cream, fresh fruit or frozen fruit, milk) or yogurt smoothies (yogurt, fresh fruit, and frozen fruit) instead of formula and for additional calories, protein, and vitamins and minerals. She can help make them, too. The most important thing is to RELAX. Let her eat what she wants. Slowly introduce new foods, and if she does not want it, do not make a fuss over it. Let it go and enjoy your meal. Try again in a few weeks. The Expert Child Behavior Forum will give you additional information. Hoped this helped you.