My 7 year old boy is a fussy eater so underweight, he doesn't eat daal, his weight is 19.5 KG. Please give a diet chart so he can gain weight.

Question

Even children who have medical, temperamental, and/or neurological barriers want to learn to eat the food their parents and other trusted adults eat, and push themselves along to do it to the extent of their abilities. Based on trust in the child?s drive to learn, grow, and master, the intervention is simple: parents learn to feed based on Satter?s Division of Responsibility (sDOR), which allows the child to master eating. While parents and helpers must be attentive to the child?s medical, developmental, and oral-motor issues, most feeding issues are the same as those of any other child. Stages in feeding look the same; they just come along more slowly. Challenges at each stage are the same; the child just works harder and longer to master them. Eating quirks are the same; it is just hard to sort out the ?child? in these quirks from the ?special needs.?Understanding causes will restore your trust in your child to do her part with feeding. To fully understand those causes, you and your child need to have had a full assessment, including longitudinal and developmental history and growth and, most particularly, feeding dynamics past and present. Most medical and even nutritional assessments don't address feeding dynamics and history, and it leaves a gap in understanding. Medical assessments and labs are helpful with respect to indicating whether your child has recovered from early medical maladies and/or has some other malady. Swallow tests and oral-motor evaluation are helpful for the rare child who has a significant mouth, throat or esophageal problem.
Most feeding ?problems? tend to be variants of normal and those that the child can work through on her own in the context of positive feeding. Some children are exquisitely sensitive to tastes and textures, have a strong gag reflex, and throw up easily. Children who are diagnosed as having sensory processing disorders (SPD), simply react negatively to certain tastes and textures and must be protected from pressured feeding so they can gradually learn to accept those tastes and textures. Some children get a late start with eating because they have medical issues and/or are fed by tube during their early lives. However, even if your child has any or all of these issues, once medical issues have stabilized, s/he can learn to eat the food you eat, provided you provide regular and unpressured opportunities to learn. That means you follow Satter?s Division of Responsibility in Feeding. You provide the food matter-of-factly again and again and eat and enjoy it yourselves, and your child joins in with family meals. Here are some typical causes of children?s food refusal:
?Misinterpretation of normal growth and attempts to compensate: Children come in all sizes. A child?s height and weight are normal as long as growth is consistent, even if it plots at the extreme lower end of the growth charts or even off the charts so they have to be plotted using z scores. Trying to get a child to eat more or grow faster backfires by increasing the child?s resistance to eating and, in the long run, slowing growth.
?Pressured feeding. Any sort of pressure?even subtle, indirect, manipulative pressure?makes feeding unpleasant for a child. Making feeding unpleasant for a child creates negative associations?fear, anxiety, revulsion?that interfere with the child?s ability to eat what and as much as s/he needs. Children who are pressured to eat lose their desire to learn and grow with eating, and give the impression that they will go hungry rather than eat unfamiliar foods. Extreme pressure from parents or therapists canmake a child give in and eat, but enjoyment in feeing is sacrificed for both parent and child.
?Errors in feeding/misinterpretation of normal eating. At all stages, attempting to compensate for children?s normal extremes in eating behaviors can precipitate food refusal. From birth, some children don?t eat much, show little apparent interest in eating, or have atypical hunger cues. Even for the child who nurses well, the transition from semi-solid foods through the almost-toddler to the toddler period is full of pitfalls, any of which can concern parents, make them put pressure on feeding, and cause food refusal.
?Stress. Chaotic or under-supportive family dynamics, often manifesting as lack of structured and supportive feeding, stresses children, and they eat less well. Children who have had negative early eating experiences associate any feeding pressure with those early experiences and eat less well under stress.
Division of responsibility-based intervention. Have the right goal: your child?s developing positive eating attitudes and behaviors. S/he will relax at mealtime, enjoy being there, pick from the available food, eat or not-eat, ignore or matter-of-factly turn down food s/he doesn?t want, and ask to be excused. He should be given all homemade foods and not a diet chart based diet.

Sajeev Kumar · Accepted Answer

Even children who have medical, temperamental, and/or neurological barriers want to learn to eat the food their parents and other trusted adults eat, and push themselves along to do it to the extent of their abilities. Based on trust in the child?s drive to learn, grow, and master, the intervention is simple: parents learn to feed based on Satter?s Division of Responsibility (sDOR), which allows the child to master eating. While parents and helpers must be attentive to the child?s medical, developmental, and oral-motor issues, most feeding issues are the same as those of any other child. Stages in feeding look the same; they just come along more slowly. Challenges at each stage are the same; the child just works harder and longer to master them. Eating quirks are the same; it is just hard to sort out the ?child? in these quirks from the ?special needs.?Understanding causes will restore your trust in your child to do her part with feeding. To fully understand those causes, you and your child need to have had a full assessment, including longitudinal and developmental history and growth and, most particularly, feeding dynamics past and present. Most medical and even nutritional assessments don't address feeding dynamics and history, and it leaves a gap in understanding. Medical assessments and labs are helpful with respect to indicating whether your child has recovered from early medical maladies and/or has some other malady. Swallow tests and oral-motor evaluation are helpful for the rare child who has a significant mouth, throat or esophageal problem.
Most feeding ?problems? tend to be variants of normal and those that the child can work through on her own in the context of positive feeding. Some children are exquisitely sensitive to tastes and textures, have a strong gag reflex, and throw up easily. Children who are diagnosed as having sensory processing disorders (SPD), simply react negatively to certain tastes and textures and must be protected from pressured feeding so they can gradually learn to accept those tastes and textures. Some children get a late start with eating because they have medical issues and/or are fed by tube during their early lives. However, even if your child has any or all of these issues, once medical issues have stabilized, s/he can learn to eat the food you eat, provided you provide regular and unpressured opportunities to learn. That means you follow Satter?s Division of Responsibility in Feeding. You provide the food matter-of-factly again and again and eat and enjoy it yourselves, and your child joins in with family meals. Here are some typical causes of children?s food refusal:
?Misinterpretation of normal growth and attempts to compensate: Children come in all sizes. A child?s height and weight are normal as long as growth is consistent, even if it plots at the extreme lower end of the growth charts or even off the charts so they have to be plotted using z scores. Trying to get a child to eat more or grow faster backfires by increasing the child?s resistance to eating and, in the long run, slowing growth.
?Pressured feeding. Any sort of pressure?even subtle, indirect, manipulative pressure?makes feeding unpleasant for a child. Making feeding unpleasant for a child creates negative associations?fear, anxiety, revulsion?that interfere with the child?s ability to eat what and as much as s/he needs. Children who are pressured to eat lose their desire to learn and grow with eating, and give the impression that they will go hungry rather than eat unfamiliar foods. Extreme pressure from parents or therapists canmake a child give in and eat, but enjoyment in feeing is sacrificed for both parent and child.
?Errors in feeding/misinterpretation of normal eating. At all stages, attempting to compensate for children?s normal extremes in eating behaviors can precipitate food refusal. From birth, some children don?t eat much, show little apparent interest in eating, or have atypical hunger cues. Even for the child who nurses well, the transition from semi-solid foods through the almost-toddler to the toddler period is full of pitfalls, any of which can concern parents, make them put pressure on feeding, and cause food refusal.
?Stress. Chaotic or under-supportive family dynamics, often manifesting as lack of structured and supportive feeding, stresses children, and they eat less well. Children who have had negative early eating experiences associate any feeding pressure with those early experiences and eat less well under stress.
Division of responsibility-based intervention. Have the right goal: your child?s developing positive eating attitudes and behaviors. S/he will relax at mealtime, enjoy being there, pick from the available food, eat or not-eat, ignore or matter-of-factly turn down food s/he doesn?t want, and ask to be excused. He should be given all homemade foods and not a diet chart based diet.