If Music Be The Way To Get Your Child To Eat, Play On...

Apparently 1 in 4 Irish primary school children is overweight or obese. As I look around my son's school, I don't see that reflected in the kids in the playground. There are really very few kids who seem to be to be overweight, maybe 1 or 2 per class. And no one I would describe as obese, although I know the technical medical definition for this is actually surprisingly lower than most people might think. So there must be some schools where about half or even two thirds of kids are overweight. 

We definitely do not have a childhood obesity crisis in our house - more of a 'pleeeeeeeaaaaase eeeeeeeaaaat' crisis.  When it comes to one of the boys anyway...  An example: this evening, Matthew asked for seconds after he quickly demolished a bowl of pasta bolognese. After the two bowls, he devoured a big yoghurt and skipped off merrily to play in the garden. Meanwhile, Adam was languishing on the other side of the table, listlessly poking at individual pieces of pasta. Eventually, he consented to eat 6 spoonfuls of his meal and didn't want a yoghurt or anything else for dessert.

The battle to get Adam to eat has been dragging on now for far too long and has been very very frustrating. I had really hoped he would have snapped out of it by now. 

Matthew was a terrible eater for a long time and I tied myself in knots getting enough food into him.  I learned the hard way that you really can't make a child eat what their stomach tells them they don't want. One evening I really lost it and nagged the food into him. The result was not pretty - he promptly threw up. Nice. When he was about 3 and a half, he just started eating and has barely stopped since.

I was much more relaxed about Adam's poor eating as I assumed he too would snap out of it and I didn't want a repeat of the vomit scenario. So we got to 3 and a half and Andrew and I watched him expecting the 'ta da' moment as he happily started eating. Then we passed 4, still no voluntary eating, unless you count crisps. He is now almost 5 and that 'ta da' moment is still but a hope...

Plenty of people have told me to relax and that he looks fine and that he will eat when he decides to.  However, in Adam's case, we don't really have the option to wait and see when he decides he has an appetite. As he has growth hormone deficiency, it is extra important that he eats in order to allow his medication to do its job. This was made evident when we were at a recent growth check up.  These take place every three months.  He had grown, but much less than any previous visits. And he had lost weight. The doctor was concerned enough to order blood tests to rule out any other causes, but I knew it was just that he doesn't want to eat, doesn't seem to enjoy food at all, doesn't even want desserts and seems to be incredibly active and healthy with very very little food. Except for his growth, which is clearly impeded by his lack of eating.

So, here began a series of all kinds of ploys and incentives to get the child to EAT. Adam is a very very strong willed, quirky and determined individual, who is not easy to persuade to do something he doesn't want to do. Of course, with parental authority, we could have just insisted rigourously that he eat every meal, but I also want him to learn to enjoy food and to know what is a good diet. The trick was to maintain healthy eating and resist the temptation to pump him full of saturated fats, thereby upping his weight, yes, but making him a good candidate to become a statistic in later life. So, three square meals, healthy snacks - here we go:

Reward charts, threats, bribes, setting the oven timer as a deadline...  All fairly exhausting, and all had some success, except for the oven timer. This led to him eating nothing for the first 19 minutes, ramming it all in in a panic in the last 60 seconds, and then, yes, more vomit. 

Then, unexpectedly, the best incentive yet...  We have been playing all kinds of tunes from Spotify, mostly in the kitchen and mostly very very loudly. One morning I chose a song I like, which the boys were getting sick of. Adam was dawdling over his bowl of yoghurt, which was part of his breakfast. He asked to choose his own song. Without really thinking, I said he could choose a song, once he had finished his yoghurt.  Well, I never saw him eat so quickly and so well!  Then he skipped over to the the iPad and chose his song and had a good little dance around the kitchen.  

This was repeated for several meals and has had a great impact!  Meanwhile, the hard work has paid off, as his last growth check up showed that his weight was up and his growth rate back on track. It is great to have found a way to tap into his enthusiasm for something completely different, music,  in order to try to get him to eat. I am not using this with every meal for fear of music fatigue and although I know it will have a limited shelf life, and we will have to come up with a new and creative way to motivate him to finish his meals, for now, it is making for a happier, and fairly noisy Keene kitchen.

GHD - but not the hair straighteners...

I can't remember when I first knew I was smaller than other kids my age. I certainly don't have any memories  of when I was first diagnosed with Growth Hormone Deficiency and started receiving treatment. This used to be injections twice a week, given by a nurse.  Eventually, as the dosage and medication changed, the injections were daily and my parents had to learn how to administer them.  They used to practise on teddies and oranges. Although they only used water, they used to joke about coming down in the morning to giant bears and fruit! When I was 13 I went on a dance tour for 3 weeks so I had to learn how to give myself the injections; something I really never learned to do more then tolerate.

We would travel for a check up every 3 months. (My sister also has GHD, so it was a family day out!)  We got to miss a day of school and always had chips on the way home.  That was the good bit.  We also frequently had blood tests, x rays and a doctor who always got a slightly higher number then our actual height out of the check up by stretching us up by our chin - painful!

Growth Hormone Deficiency is a hereditary, well, disorder, I guess, rather than illness.  In my family it comes from my Mum's side.  She had 2 uncles who were small, but neither had kids.  She is one of 6 kids; 3 of whom grew normally and 3 of whom also had GHD. My mu had 2 daughters and my sister and I both have GHD.  My sister has since found out that we had a 50% chance with each our kids of them also having GHD.  This has proven to be a very accurate statistical prediction as we each have 2 kids and in both families 1 of them has grown well and 1 of them has turned out to need treatment for their growth.

In my case it is Adam, my younger son (pictured here showing how big he is, but cheating slightly...) who more or less stopped growing when he was about 4 months.  His check ups at the local clinic showed such small amounts of growth for several months that it was pretty clear pretty early on that he was likely to need some help with his growth.  My niece had just been diagnosed, so it was not hard to figure out what was going on  When we went to Crumlin children's hospital for the first time to meet the consultant, I really wasn't sure how seriously we would be taken and how many months they might decide to monitor Adam's growth before starting treatment. So, I took my mother with me!  She was a brilliant illustration of our family history and the consultant was actually delighted to see 3 generations of GHD patients.  We were very pleased that he started Adam on growth hormone medication just 2 months later at only 14 months old.

It is very odd to take your child to their growth check ups every few months as a parent when you have such vivid memories of being taken as a child! The clunk of the measuring bar as it came down sent a shiver down my spine the first time Adam was old enough to be measured standing up.  His latest visit was last Wednesday and he is growing so well!  On our first visit, he didn't register on the growth chat at all for his age he was more or less under the 0% percentile! On Wednesday he registered at the 75% percentile! It is truly astonishing to be told by random strangers at the playground that he seems tall for his age!  That certainly never happened to my sister or me, but the medication has been developed since the '80s and we can expect Adam to achieve a completely normal height compared to his peers, which is just brilliant.

2 final thoughts on this:

I am immensely grateful for the Drug Payment Scheme in Ireland which covers his medication.  Apparently, the full cost would be about 15000 EURO per year. We do hit the full monthly charge every month, but that's much much less than the total should be.  I wrote to Mary Harney while she was still Minister for Health to express my thanks for this as I don't take it for granted!

And lastly, a visit to Cumlin absolutely exhausts me - I come home every time feeling flattened. Then I remember that Adam isn't sick in any way and that there are parents visiting the hospital while I am there to bring their kids to chemo appointments or to have serious and life limiting diagnoses confirmed.  Every time I come away wondering how they cope with the emotional and physical exhaustion this must bring. I hope I never have to find out.