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Faecal Loading
due to refusal to eat


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#1 undecided2011

Posted 24 April 2012 - 09:00 PM

I hope i have posted in the right spot.
  
  I have been seen 3 different Dietitians over the last 3-4 years for my DD6 due  to her continual refusal to eat. she is VERY picky with what she will eat  (heres a little example)
Eats
  Chips (no gravy, NOT gems)
Sausages  (plain, NOT made into a meal such as sausage casserole)
Pasta
Mince  (will pick out all chucks of veggies )
Up  and Go’s (off and on)
Bread  – with Nutella
Lollies
Chips  (packets)
Scrambled  egg’s (won’t eat boiled or fried)
wont eat
Chicken
Fruit  (ANY)
Steak
Yogurt
Cheese  dips
Mash  potato
Unmashed  potato
Veggies  in general
She's  seen our GP today and he's finally agreed to give us a referal to a Private  Pediatrician (he is a GREAT doctor, how we have only just been dealing with for 6 months)
Today i mentioned DD6 has been complaining about 'bleeding poo' and crying on the toilet. She's been doing it more recently (last week or 2) but i can (now) recall as far back as 8-10months ago she'd made a off hand comment about blood on the toilet paper, but didn't think to much about it as she didn't seem worried (i wish i had of thought more of it sad.gif )
Anyway the GP ordered an x-ray to check for faecal loading which DD6 had this afternoon, They send the reports electronically to the GP (which will be available on Thursday morning) but i asked the lady doing the scan today could she see any (as i already mentioned what it was for) and she said 'yes, there's a bit' but obviously wouldn't tell me more than that till the report was done.
I know what faecal loading is, and i am sorta aware of what they are going to do to 'fix' it but i just wanna know if anyone elses child has/had this and how did it all go. I am so sad for DD6 and wish i could just fix it all.
The issues is she's ONLY eating enough to sustain herself, she's 16kg and 123cm (which makes her BMI 11.1 which is significantly underweight) she still wears size 3 clothes, and has NO weight to loose if she gets sick.

I've tried everything to get her to eat, i've tried polyjule but she's not eating/drinking things for me to put it into, and when i get it into her drink she can taste it?! I've tied the peadsure powder but she hates it, I've tried the tetra packs which she will have in chocolate only but i can't find somewhere that has the Chocolate (only Vanilla - which she wont have). unsure.gif
She wont have fruit (ANY) she dry reaches and throws up, she wont drink fruit juice. I seriously have tried everything!!
This faecal loading issues will just happen again if she doesn't start eating but i can't get her to eat the stuff she needs too cry1.gif
The Private Pediatrician isn't available till the of AUGUST and my GP implied he didnt know what else do do with DD6's lack of willingness to eat which is why we got the referral.
can anyone help me with any of this?



#2 Arthur or Martha

Posted 24 April 2012 - 11:01 PM

.......................

Edited by ambwrose, 01 October 2013 - 07:42 AM.


#3 Feral Nicety

Posted 24 April 2012 - 11:19 PM

A speechie or a dietician ASAP.  A generalist paed is not likely to be necessarily that useful with this issue.  Can you ask for a referral to a gastro (in some states, you need a paed to do that referral).

If you end up with a hospital admit or consult for an NG tube, leverage that as much as you can to see a gastro.

#4 melanieb530

Posted 24 April 2012 - 11:48 PM

I've also found a speech therapist helpful in regard to eating issues and given her age maybe consider someone psychologist/counsellor dealing with anxiety if she is fearful of trying foods that she is not comfortable with.
Good Luck

#5 ellie1326

Posted 25 April 2012 - 09:06 AM

Hey I have similar problem with DD2, she doesn't even eat enough to sustain her and she was not eating enough for her bowels to work properly. She gets constipation and gets all backed up, csn't push it out and struggles day in day out with it.


Ok so here is what we have done And we did this on advice from our Gp and dietitian.

PROFORM - comes in vanilla and white chocolate flavour. Mix it with water and/milk. Delicious drink and I give it to her all brought the day. She might have 3-4 of them in a day. It dies not give her enough calories but does give her enough nutrients, vitamins and minerals.

Beauty  of this- I can mix other stuff with it.

Multivitamin - one of those chewy ounces

Parachoc- when she starts showing signs of constipation we mix it in her PROFORM in the morning until she starts going regularly and than another week and than slowly decrease unroll stopped.

Benefibre- once she is all empt and is going to toiled regularly I mix a little bit of Benefibre in her PROFORM .

Hope this might help.

We are also working on increasing the stuff that she would eat. She is very sensory. If you'd like some tips on that let me know. Good luck hope it will fix itself soon. It is do so hard and worrying.



#6 FuzzyMum

Posted 25 April 2012 - 10:16 AM

Hi OP

Does your child have any underlying conditions or special needs that could be influencing her choices? An example would be if she has asd it could be sensory related (i.e. textures, colours etc). If she has apraxia/dyspraxia it could be due to low muscle tone like another pp suggested.

From my experience what you have listed is actually quite a a good list. People I know have children whose list features around two-three foods they will eat and that's it.

I would definitely seek assistance medically and include a nutritionist with experience in dealing with children with special needs. A nutritionist with this experience will tend to look at specific nutrient levels that could influence the way a child eats. They will look at zinc, iron, vitamin d levels and will also suggest making sure your child is getting enough magnesium and Omega 3. For example, if your child's zinc is low, this can affect the way foods taste (can be either non existent or taste different).

I found with my own DS that after we cleared an impaction, we were advised to keep him on probiotics to help prevent it from happening again. Has worked.

#7 undecided2011

Posted 25 April 2012 - 04:04 PM

QUOTE
Have you tried a speechie?
NO! But i am going to talk to my GP about it now tomorrow. I've written a list thanks to you guys original.gif

QUOTE
A speechie or a dietician ASAP.  A generalist paed is not likely to be necessarily that useful with this issue.. . . .

referral to a gastro. . .


The paed we are going to see is my DS7 (who has Asperger's, ADHD, ODD, CD and Anxiety issues) Paed. So i am hopeful he will be able to help us with this issue. Although if he can't is there another type of paed we can see for diet?
I have seen 3 Dietitian's, the best (and only one to really listen) was in NSW but we dont live there anymore and the 2 i have seen here we're not very good. one i only saw a few times before she moved clinic's , so then DD6 was sent to the other one who kept saying i was putting to much food on DD's plate, or i wasn't putting enough on her plate, she told me DD wont starve herself, send her to bed hungry she'd soon eat and the thing that made me stop seeing her was when DD was lost 500grams in a month and she asked me what i did wrong!! rant.gif

***edited to add*** what will a gastro person do?

QUOTE
maybe consider someone psychologist/counsellor  dealing with anxiety if she is fearful of trying foods that she is not  comfortable with.
She doesn't appear fearful of trying new food, just looks at it/smells it and will (usually) take an instant dislike to it and refuse pointblank to eat it and when we try and make her eat it she will dry reach as soon as it touches her lips. However i will talk with the GP about this as well and see what he thinks.

QUOTE
Does your child have any underlying conditions or special needs that could be influencing her choices?
I asked my DS7's Paed a while ago about this (DD6 doesn't have the same father as DS7)  and i think its something we might be looking into. sad.gif I had a friend say to me a few times that DD6 and DS7 are very alike so either i refuse to see it, or my friend is seeing things blush.gif

The GP said he would 'run bloods' if we couldnt see the Paed for a few months, what would this be for? I know i will find out tomorrow, but tomorrow is just so long away. LAst night all DD ate was the meat inside a rissole (which wasn't very much) and she didnt touch anything else, this morning she had half a wheatbix (no milk) and for lunch 1 peice of bread (no Margarine) and a small hand full of chips. . . its simply not enough

Edited by undecided2011, 25 April 2012 - 04:07 PM.


#8 FuzzyMum

Posted 25 April 2012 - 04:12 PM

QUOTE
QUOTE (undecided2011 @ 25/04/2012, 04:04 PM) <{POST_SNAPBACK}>

I asked my DS7's Paed a while ago about this (DD6 doesn't have the same father as DS7)  and i think its something we might be looking into. sad.gif I had a friend say to me a few times that DD6 and DS7 are very alike so either i refuse to see it, or my friend is seeing things blush.gif

The GP said he would 'run bloods' if we couldnt see the Paed for a few months, what would this be for? I know i will find out tomorrow, but tomorrow is just so long away. LAst night all DD ate was the meat inside a rissole (which wasn't very much) and she didnt touch anything else, this morning she had half a wheatbix (no milk) and for lunch 1 peice of bread (no Margarine) and a small hand full of chips. . . its simply not enough



You poor thing. I so feel for you. I know how anxious you are. Firstly it does sound to me like sensory issues are part of this. With the blood tests, your GP would be looking for iron levels primarily. They may look at other nutrient levels but GPs tend to just check for the main things. Do look at your child's zinc levels. Kids who are particularly poor eaters are often deficient here. Low levels can affect the way food tastes. You can test using a drink available through some pharmacies (no taste indicates a deficiency and a metallic taste indicates adequate zinc levels).

#9 CFMummy

Posted 25 April 2012 - 04:23 PM

What tetra drinks have you tried?
My DD2 is on nutrini drinks as she is a non eater. Its very frustrating to watch them not eat

#10 wanting_more

Posted 25 April 2012 - 05:50 PM

sad.gif

Edited by wanting_more, 25 April 2012 - 06:11 PM.


#11 undecided2011

Posted 25 April 2012 - 06:12 PM

QUOTE What tetra drinks have you tried?

We tried the peadsure Tetra drinks in Chocolate, Vanilla and strawberry.
She would only drink the chocolate.
We  got them on a prescription thing in NSW by the dietitian we had there.  She faxed it through to a place in Sydney and we paid about $50-$60 for a  carton of 24 then they got delivered in about 24-48 hours by Courier  (usually 24hours). They are like little poppers and i think they have a  picture of a monkey on them.

You can buy a  900g tin in Vanilla  from the chemist, which i have done, but she wouldn't drink it, I even  tried adding chocolate icecream topping into it to make it chocolate  (she still wouldn't have it)

I  saw a few chemists in the area, and the most resent one said they can  get the Vanilla Tetra packs (12 drinks) in for about $40  from their  distributor (they were about $3.75 each or something) but she said they  didn't stock AT ALL the other floavours and asked if i had EVER seen  them in QLD (which i haven't)

The Dietitian said she could  literally LIVE off the peadsure drinks, so if she didn't eat for 24  hours, as much as that wouldn't have been an ideal situation, it  wouldn't have been a major concern either

CFMummy - are the nutrini drinks similar to what the peadsure drinks sound like?

QUOTE Do look at your child's zinc levels.
I will for sure!!

#12 CFMummy

Posted 25 April 2012 - 06:18 PM

There are the "adult" ones for age 3 and up http://www.nutricia.com.au/clinical/ecn/fortisip.aspx
but this is what my DD is on http://www.nutricia.com.au/clinical/ecn/fo...multifibre.aspx


#13 undecided2011

Posted 25 April 2012 - 06:22 PM

Can i get them from a chemist? What is the cost like? I've not ever seen them before. They sound like the paedsure drinks she use to have.

#14 CFMummy

Posted 25 April 2012 - 06:43 PM

We get it from our hospitals chemist and sorry I dont know the price we get it for free I know you can buy them online as I was looking them up one day.

#15 undecided2011

Posted 25 April 2012 - 07:07 PM

Okay thanks, i'll talk with the GP tomorrow about it see if our hospital can supply them for us

#16 Emby

Posted 25 April 2012 - 09:03 PM

I found pediasure chocolate online, if this is any help

http://www.nextag.com/pediasure-chocolate/stores-html

The powder seems to only be available in Spain - but they do do international shipping

http://www.farmacialanucia.es/pediasure-ch...tml?language=en

#17 undecided2011

Posted 25 April 2012 - 09:08 PM

BUGGER!! I looked at they dont post here it says 'The Abbott Nutrition Store can ship to virtually any address in the  United States. We currently do not ship overseas (with the exception of  U.S. territories) or to PO Boxes'

Thanks anyway!! biggrin.gif

#18 belindarama

Posted 25 April 2012 - 09:21 PM

I have a fussy eater who is on the improve. He is 5 and only weighs 15 kilos. His 2 year old brother is almost as tall and heavy as he is. He has some real issues around food, displaying some of the behaviors you have described but not as severely.

Our problems are not as bad as yours so I have no suggestions other than to say the specialist children's clinic I take DS2 to has a feeding clinic. There is one paed who specialises in nothing but eating problems. Have you tried to find a specialised paed in feeding issues?

We are in Sydney so not that helpful to you. They might be able to tell you who else does something similar closer to you though. I can PM you the details if you are interested.

It is very stressful when they won't eat and the small amount they eat is very limited.

#19 FeralZombieMum

Posted 25 April 2012 - 09:34 PM

QUOTE (undecided2011 @ 25/04/2012, 04:04 PM) <{POST_SNAPBACK}>
I asked my DS7's Paed a while ago about this (DD6 doesn't have the same father as DS7)  and i think its something we might be looking into. sad.gif I had a friend say to me a few times that DD6 and DS7 are very alike so either i refuse to see it, or my friend is seeing things blush.gif

Your friend will be seeing your kids in a different environment than you do, and maybe she does see things, or maybe she doesn't.

Some kids with ASD have limited diets - they can have sensory issues with food, like texture and smell and may need to stick to a routine with their meals.

When you go back to the GP, ask for iron levels to be checked - low iron can affect appetite. Also ask for the Coeliac screening blood test - as you might as well get it tested for whilst a needle is going in.

My oldest has Aspergers, and was restricted in her diet. She's not officially Coeliac, but within a couple of weeks of being gluten free, her appetite changed dramatically. (She had a positive Coeliac antibody test).

My youngest DD has the official Coeliac diagnosis. She was also restricted with her diet - because food made her sick! She has only improved slightly with her food choices since she has been gluten free, but just before her diagnosis, she was hardly eating anything, she was wasting away.

I suspect she has issue with fructose as well, just haven't got around to testing it with removing and re-introducing it into her diet.
Other food intolerances might also cause problems - and a good dietician can help you with this. Your DD's body might know what isn't good for her - so maybe that's why she's refusing to have things like fruit!

I have a friend whose DD had blood in her poos, and her Doctor had her trial an elimination diet, and things seemed to improve.

I give my kids Hospital Strength Sustagen with the fibre - chocolate flavoured. It's only available in the chemist, the supermarket ones aren't as high in protein.

Some of these drinks might taste yucky if drunk from a cup, but if you use a straw, it might help - as a lot will bypass the taste buds on the tongue - I picked that hint up a few years ago when I was trialling a meal replacement weight loss shake. biggrin.gif

Edited by ZombieMum, 25 April 2012 - 09:36 PM.


#20 Emby

Posted 25 April 2012 - 11:07 PM

QUOTE (undecided2011 @ 25/04/2012, 09:08 PM) <{POST_SNAPBACK}>
Thanks anyway!! biggrin.gif




blush.gif

#21 undecided2011

Posted 26 April 2012 - 04:29 PM

we got the x-ray results of her tummy back today

Findings were:
Moderate  to severe faecal loading is present throughout the entire colon with  rectum distended with faecal matter. Gas is seen in non-distended loops  of small bowel - appearances do not suggest obstruction.

So we have to use Movical for  the next next 3 days starting Friday to see if that will clear whats  there. Then we will have another x-ray to make sure its all gone.

I asked the X-ray Clinic to fax a copy to the Paed we had been referred to when DD had the X-ray.  Seeing thought the appointment was for August i figured this would be easier than me having to remember to bring a copy with me then. . .anyway the receptionist  called me today and said they got her X-ray results and would be moving her appointment forward to the 14th of May!!!! WOOHOO!!!! so we only have to wait another 3 weeks and she'll get seen and we can hopefully get some more answers.

Thanks for everything you guys llove.gif  


#22 mumtoactivetoddler

Posted 27 April 2012 - 11:08 PM

Can I also suggest not a standard speechie but a specialist speechie in eating issues. If you are in Sydney I am happy to pm you the recognised expert in this field. She is in Burwood but I know people that travel from Hornsby and also Woolongong to get to her. A specialist in eating issues can help work out what is the issue with not eating and help you to correct it. We have found using a specialist speechie made such a difference.

#23 mela

Posted 28 April 2012 - 12:57 AM

Clifford Hallam does the chocolate pediasure in Australia, the phone number I had was 1300 658 936 but I haven't used it for 3 years now so check the link also. Depending on your state, if you get a dietician to write up an order for the pediasure it may be subsidized. From memory we were getting it for around half the price you mentioned, we lived in NSW (on the border) but went through a Victorian hospital. I think Vic is better for this, we live in Vic now and DS's Nutrison is all covered by HENS (Home enteral nutrition), oral feeds are also subsidized by that I am pretty sure. A hospital dietician should know exactly what to do to get the ball rolling with that.

We don't use the pediasure anymore, not that he ever drank very much of it but DS is tube fed now. He also has Aspergers, very limited diet and is very, very skinny. He too had terrible constipation before his tube.

Hope you find something that helps.

#24 claptrap

Posted 28 April 2012 - 05:02 PM

I really hope that you find something that helps, too, OP.  Your poor little one - how distressing for you all.

It's probably much too early for you to be thinking about this but just for future reference, I'm reading an interesting book ATM called "Just Take a Bite - Easy Effective Answers for Food Aversions and Eating Challenges"  Authors are Ernsperger and Stegen-Harrison.  Foreword by Temple Grandin.  It is targeted towards children who are so-called resistant eaters - so not "picky" but further along the scale than that - and in particular children with ASDs and/or intellectual impairment.

It does take an approach looking at oral/motor delays, and sensory integration/processing disruption, and the effect on eating.  It also makes it clear that resistant eaters WILL starve themselves, unlike the popular theory would have it.

It's practical, with exercises and suggestions.  It is also what I would call "mainstream", so no horse-riding in Mongolia or similar.

But I'm only 1/3 of the way through and haven't actually tested any of it yet!  nonetheless it wasn't that expensive and easy to get on Book Depository, so when you are ready to look at strategies to broaden the diet, it might be worth a look.

Great news about the appointment being brought forward though!



#25 undecided2011

Posted 29 April 2012 - 01:47 PM

dogged: Thanks so much i will be looking for that book now for sure!!!
QUOTE
It also makes it clear that resistant eaters WILL starve themselves, unlike the popular theory would have it.
YES YES YES!!!! I have been telling the Dietitians that but do you think they would listen to me?!
I might give resistant eaters a Google and see what i can find out

QUOTE
Clifford Hallam does the chocolate pediasure in Australia, the phone number I had was 1300 658 936
I will give that number a call and check out the website (though its not loading at the moment)

QUOTE
Can I also suggest not a standard speechie but a specialist speechie in eating issues
I asked my GP about this, he didn't think there was any in this area (we are QLD) but i will talk to the paed when we have the appointment and see what he knows.

Thanks guys original.gif




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