My friends 9 year old daughter has not eaten properly since Feb 11 and has started peeing herself and wetting the bed.

[ttsharon123]

Hi
My friends daughter is 9 next month and since Feb this year has refused to eat any solid foods, she will however eat chocolate, ice-cream, chocolate moose and custard.
My friend has been to doctors and the hsopital who have told her she must only have these as a treat after a normal meal,
She will now have sieved chicken soup for lunch followed by custard and the same for tea she has nothing for breakfast as the hospital told my friend she should only have toast or cereals for breakfast ie normal breakfast food.
She is under 4 stone and has started to wet herself at night and when playing at my house with my daughter etc.
She doesn't think she is overweight/fat and at school a month or so back she did write down she wished she could put on weight so we know it's not that she thinks she's overweight.
I am so worried and feel my friend really needs help.
Sharon

[Ashelen]

Has she had any sort of a trauma, or any possibility of trauma? Change in behavior - especially with eating, and wetting, are major red flags for sexual abuse.

Not saying this is the case, but I'd definitely consider it.

[skepticalpeach]

I'm firmly under the belief that children will not starve themselves on purpose. There has to be an underlying reason. There are so many reasons why a child doesn't eat. Whatever you do, do NOT force her to eat or pressure her to eat. This will only makes things worse.

I would get her tested for Crohns/Colitis, ulcers, lactose intolerance, diabetes and IBS. Find a doctor who will listen and be very demanding and authoritative when you speak to them. Make them listen. My DD has a very sensitive stomach and is lactose intolerant. I had to experiment with a lot of different foods to find something that she would eat for breakfast. I figure if she has a small breakfast before school, drinks a whole container of Pediasure and small snack at school then she is fine. Then she gets what she wants for dinner at home. Some children don't need to eat a whole lot (just like some adults!) People worry so much over things that really aren't that big of a deal, especially when it comes to our children.

I would also add that when my daughter started out on solid food she wouldn't eat meat. My MIL actually bought her protein powder. I calmly gave it back to her and said that my DD would eat meat when she was ready. The pediatrician told me to reintroduce meat to her every 2 weeks until she accepted it. That way no one got stressed out and no one panicked.

[Devnir]

Did she ever have her tested for diabetes?

[ttsharon123]

Thank you for your reply I agree and will keep trying.

[ttsharon123]

Thank you for your positive comments they are greatly appreciated.

[allmymarbles]

With the information you have given, it would seem that the "doctors" are passing on to the parent a responsibility that is theirs. It seems unilkely that whatever is happening with her daughter, it is not the mother's fault, nor does she have the ability or the training to help her. Put pressure on the doctors.

[tiredbuthappy]

Sounds like something is going on in the home, especially if the hospital is pushing for parenting classes.
I would try a different approach if I were the parent. Clearly, pushing her to eat is not working. However, it is giving the little girl a lot of extra attention, both from the medical community, her mom, you and your daughter. This can actually encourage negative behaviors, especially if there is an emotional underlying reason.
I do have a child in my class who is considered anorexic. She is 4. We are getting her to slowly start eating. The first thing is having her join the class to sit during meal times, even if she chooses not to eat. It's not a big deal- it's just made the routine. We offer food but don't push it. Her mother does get her to drink a nutritional supplement drink in the morning before she comes to school so we don't have to worry so much about calories. I hope that the hospital has told your friend to at least offer those. It sounds like she may be willing to try one of the chocolate flavored shakes. That will remove some of the stress on the grownup's part since you will know that she is at least getting some nutrition.
So, she has the shake in the morning before school, and we have established a routine where everyone sits together. The meal times are cheery and the kids talk. Teachers talk about the foods everyone is eating in a positive way and facilitate casual conversations about food. We normalize food and eating and make it a fact of life. If we are eating something too, we offer tastes to the children and respect if they choose not to. We do not allow children to say "ew" to anything. We teach them that it is someone's food and it is not respectful to respond like that, and instead they can say "no thank you" or "i don't care for that." This makes it OK to have likes and dislikes in an appropriate way, and shows that we respect that. Again, we do this all casually to normalize everything. Everyone eats, you have to eat something, you may not like everything.

Looking at the list of foods, I do wonder if she may have sensory issues. Eating only foods of a certain texture and avoiding other textures is a sign of this. That is why I asked of developmental delays or issues. I wonder if she would eat other foods pureed. This can help you determine if it is a flavor issue or a texture issue. Perhaps try something you know she liked in the past and see if she will take it in a pureed form? For example, if you know she used to eat carrots, maybe try a container of baby food. It's not a long term solution but may help you figure out what's going on.

[ttsharon123]

Hello
Thank you for your reply, I think it will end up with her in hospital and maybe this is what is needed as I am so worried that something bad will happen to her.
I have even spoken to teachers etc myself as I am not giving up on this and feel I may rub my friend up the wrong way but this is a smal price to pay to get her daughter sorted.
Thanks again.  

[ttsharon123]

Thanks for your reply,
She has not had a full medical examination I think that would be a good thing.
I have spent many hours with my friend and have brought up the subject that people will start thinking there may be abuse especially when other mums at school are noticing.
The hosptial keeps wanting my friend to go on courses for better parenting etc but don't seem to want to speak directly with the daughter which I can't understand.
An example of her wetting was last night at my house she was watching tv with my daughter and changed from sitting on the sofa to kneeling, she then just wet herself and didn't say a word we only noticed when she got up and had a wet patch.
My daughter tries everything to make her eat I can here her in her bedroom trying to get her just to taste things, things she ate previously.
My friend has now been advised to see an incontience nurse but I think she is so fed-up with everything she hasn't gone down this route yet, I try to make her and will go with her to any appointment but she doesn't ask.
What annoys me is that the doctors, hospital tel her she has to be firm but how firm is firm?
Does she make her daughter sit there until she has a small bite/piece of something, does she stop her going out to play etc if she doesn't eat, does she stop giving her soup as she has it 2 times a day? I just don't know.
My friend was advised to collect her for lunch everyday to try to encourage her to eat, this lasted about 2 weeks but as she would only eat soup my friend now sends her in with a flask.
She ate fine before but now looks like a 5 year old and I feel I am the bully as I can't ignor this and like last night I told her not in a nasty way that she is 9 and can't just wet herself the neighbourhood kids are seeing she wets herself and I can see the next set of problems with them starting to take the micky, luckily my daughter doesn't say anything but she has an older brother who has noticed and now can't stand her in the house.
Thanks again for reaading my story.

[tiredbuthappy]

Does she have any other behavioral quirks or problems that would indicate a neurological or developmental problem?

Has she had full medical exams to rule out medical causes?

is it possible that she is being abused in any way? How stable is her home life?

[allmymarbles]

This may not be anorexia, but it shows many of the same traits and should be treated in the same manner. My niece was hospitalized and was under the care of someone specialized in the ailment.