Why Won’t He Eat???

We hear this over and over again in the Russell-Silver community….
Why won’t he/she eat????

There are no proven studies per se that confirm why an RSS child is rarely hungry. We conjecture that it is due to gut dysmotility, delayed gastric emptying (DGE), sensory issues….among other things. And there are a select few of RSS children who ARE hungry. My son Ian is one of the select few who would actually eat. Although, when he is experiencing DGE, low blood sugars or an illness – his desire for food wanes considerably. So, it would be safe to say that 40% of the time – my son likes to eat. Of course, he prefers M&Ms, Goldfish, pasta and Steak over any other food item – especially any healthy food item. 

And then there is the RSS child who has no appetite at all. I get asked by parents all the time….”How am I supposed to feed my child if he isn’t hungry?” It is incredibly frustrating as a parent to not be able to attend to the most simplistic of human needs….feeding our children. And, as parents, we struggle to ensure that our children are getting adequate vitamins and minerals – let alone calories for an RSS child. For instance, Ian refuses to eat the bread – when I make him a sandwich. Ian will not eat yogurt, pudding, oatmeal or even hamburgers. But he LOVES macaroni and cheese and rib eye steak.

I’ve always been the type of parent that says, “What do you mean he won’t wear a collared shirt? My children are not allowed to wear anything but a collared shirt to school. No T-shirts here.” But, when it comes to food – I have to put my tail between my legs and say “No, Ian will not eat your spaghetti with meat sauce. He will only eat the pasta part of the meal.”

There really is no perfect approach to feeding an RSS child. Obviously, DGE and sensory issues are complicated factors that require medical intervention – such as drugs/medicine and/or therapies. Due to blood sugar issues, we had to resort to the g-tube. Which for Ian – since he was unable to sustain enough calories volitionally (by mouth) – Ian began to have severe low blood sugar issues due to his disproportionate head to body size, thus, the g-tube (tube placed in his belly for feedings) was our saving grace. But for many – this is not an option. Of course, there are the usual therapies and suggestions by professionals that we “not let our children eat in front of the television”. But, I have to be honest – this was THE only way we could get Ian to eat – by distraction. So, if my funny faces, enlightening conversation and/or game playing didn’t work…..we turned on the television. Shhhhh…..it’s our secret – but, it worked. Ian would put food in his mouth without even realizing he was doing it – as he was very engrossed in the television <wink>.

What also helped for Ian were his continuous appointments with the nutritionist, sensory therapies, and feeding therapies. As part of those therapies, I came across an exceptional chart which listed specific food additions for increasing calories in a child’s diet. We were provided a copy by the Children’s Hospital in Richmond, Virginia. It was a great source for adding calories to Ian’s food – in many instances without him even knowing the additive was there. Obviously, all changes in a child’s diet should be approved through your Pediatrician.

We will continue to monitor Ian’s lack of desire for bread (gluten/wheat allergy maybe?) as well as encourage him to eat a bite of broccoli now and then. For now though…..I will let the kid eat his steak. 

Calorie Boosters

 Your child’s calorie boosting prescription is 1 _____ per 2 oz food.    When using oil or butter, cut the amount added in half.

High Fat Calorie Boosters

High fat calorie boosters generally give you “more bang for your buck.”  That is because fat has more calories per gram than carbohydrates or protein.  Sometimes extra fats can make reflux or delayed gastric emptying worse.  If your child has these problems, please discuss what boosters would be best for your child with your dietitian and or physician.

Calorie Booster

Calories per Tablespoon(on average)
Heavy whipping cream 50
Margarine 50-70
Butter 100
Parkey Liquid Margarine 70
Peanut Butter 100
Scandishake 35
Squeeze Cheese 50
Shredded Cheese 35
Salad dressing 30-80
Cream Cheese 50
Sour Cream 25
Egg Yolk 50-60/ 1 large
Coconut milk 30
Oils (vegetable, canola, corn, olive, peanut) 120
Mayonnaise 50-60
Benecalorie 110
Microlipid 68


Lower Fat Boosters

These calorie boosters contain more of a combination of fat, carbohydrates, and sometimes protein.

Calorie Booster

Calories per Tablespoon(on average)
Duocal 42
Dry whole milk powder 40
Carnation Instant Breakfast 22
Sweetened Condesed Milk (low-fat) 60
Sweetened Condensed Milk (whole milk) 65
Nesquik 45
Avocado 25
Infant formula powder 40/ scoop
Wheat Germ 25

 Fat Free Boosters

These calorie boosters are fat free and many contain a lot of sugar.   Some of them are best used in combination with other boosters so that they don’t make the food too sweet. 

Calorie Booster

Calories per Tablespoon(on average)
Maple syrup/pancake syrup 50
Sugar- Brown, white, or raw 50
Chocolate Syrup/Strawberry syrup 50
Corn Syrup 60
Honey (do not use under the age of one) 50
Fruit Jam/Jelly 35
Apple butter 35
Polycose 23
Non-fat dry milk powder 30
Molasses 50