Question about child's diet

August 2, 2005 12:50 PM

I'm looking for resources that specify how much and what kind of food is considered normal for young children.

When the daughter of some family friends was about a year old, she would regularly continue eating until she vomited. They took her to a doctor who said that she has a condition that prevents her brain from getting the message that she is full, sorry I don't know the specifics. As a result her parents have restricted her food intake since then and to a degree that seems excessive to me and my spouse. We have made gentle attempts to raise the issue in the past but they have not been ready to hear it.

Now their pediatrician has told the mother that he is concerned because the girl's height and weight are very low (she is 4-1/2 years old, about 32 lbs. and 39" tall I believe). Also she does not have much energy for running around and so on compared with her peers.

I believe this may be a time when the parents would be open to reevaluating their approach but I would like to have some information at hand, the more authoritative the better to overcome any skepticism they may have, that documents what sort of diet children need to thrive. I'm looking for things like minimum/average/maximum calories, recommended amounts of protein, carbohydrates, etc. Thank you!

posted by anonymous to health (6 comments total)

I don't know where I heard this, so it could be way off. I am a person with a lot of stomach issues and I used to work in a former life with the mentally retarded, who often have the shut off valve issue. Anyway, what I have heard is that a person's stomach capacity is about equal to the volume made up of their two hands together. For a child, this is a small volume, for a big person this can be quite a lot.

Anyone want to dispute/concur with that assessment?
posted by Pollomacho at 1:31 PM on August 2, 2005

Pardon me for a temporary derail here, but I can't help thinking that most parents feel they and/or their child's doctor are the best authority on their child's health. If this family has stopped heeding the doctor's advice, it's likely that anyone with fewer credentials is going to meet with even less success at convincing them--no matter how well researched. In part because I get the feeling that logic/fact is not really what's guiding this decision. Emotions/instinct can easily take over: they've witnessed the scary effects of too much food, and may see intake control as the magic talisman that protects their child from further harm.

But whatever's in their mind, I think it would be helpful if you can find about more first about why they've chosen to disregard the doctor's advice. One, because under gentle probing from a friend they recognize on their own that objections aren't persuasive. Two, because you'll have a better sense of who they'd trust to advise them in this--whether or not that's you. And three, if they are in fact willing to hear your take on the situation, you'll know in advance what their objections are and can be prepared to effectively respond.

(The other possibility is that after you question them about why they've ignored the doc, you discover you agree with their reasons. Then you can focus on helping them find an expert that the family can better trust to guide them through this difficult situation. While you get to avoid looking like some nagging butt-in-ski.)

Okay, derail over.

Here's an interesting nutrition calculator from Yale Medical. It sounds like for a child with special health issues and/or taking medications/supplements, standard guidelines may not be applicable. A registered dietician is probably the best person to help you find guidelines that fit the child's specific circumstances.
posted by nakedcodemonkey at 1:45 PM on August 2, 2005

a condition that prevents her brain from getting the message that she is full

Prader-Willi Syndrome
posted by essexjan at 2:16 PM on August 2, 2005

Picking up on nakedcodemoney's dietician idea, maybe you could suggest they consult a dietician to figure out *what* to feed her. If you frame it that way, they could see it as going a step farther to protect their daughter's health (rather than see it as returning to allowing her to eat too much).

If they see a dietician, the dietician will likely also talk about how much to feed.

If you feel like your having hard numbers would be helpful, presumably the doctor hasn't really provided any of that sort of advice. Sounds like not so great a doctor to me...maybe dealing with another professional willing to put in some more time to working a solution into their lives would be helpful.
posted by duck at 5:15 PM on August 2, 2005

anon, everyone who's contributed above has provided very good suggestions for dealing with the question you've asked.

This is a derail and feel free to ignore it once you've read it, but please do read it. There may be something else going on with your friends. I'm not suggesting deliberate abuse (or any abuse), but apparently in some situations it's difficult for the parents to recognize that their child is starving. They see the child all the time, so they're blind to the change you see from week to week, or even day to day. The starvation results not from any sort of intention to deprive the child, but from a misguided adherence to the dictates of an outside authority, such as
veganism. Or an earlier and speculative diagnosis from a pediatrician, which may no longer apply.
posted by vetiver at 7:14 PM on August 2, 2005

I don't want to play web doctor, but the Prader-Willi syndrome might be inaccurate. It is common for Prader-Willi to manifest itself as a refusal to eat at a young age, and then an inability to stop eating. I don't know what the common cut-off is but I was under the impression that it was generally slighly older than a year.

Prader-Willi also shows other symptoms which you don't mention, such as mild retardation and shortness (the doctor seemed to be concerned about shrotness, if it was PW, then it wouldn't surprise him).

Also in my limited experience PW kids are very unlikely to be skinny as the urge to eat is just enormous, to the point where they break into homes or steal from a store. While four is young, I have yet to see a PW kid who can be called skinny (again, limited experience).

In any case, PW or not, this doesn't sound like a condition you should be talking to the mother about. If it was real malnourishment (read: abuse) then the doctor would certainly report it. I'm not saying it's intentional abuse, but if it was something the doctor was seriously concerned about then he'd be obligated to report it.

I should also point out that if it is indeed PW, kids will almost certainly scream bloody murder to get food and is often really heart wrenching to parents (why they have a hard time not giving them that extra helping). Talking to them about food will certainly be very sensitive.
posted by geoff. at 7:49 PM on August 2, 2005