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Will NHS Dietician be any help for Vegan 2-3 year old refusing to eat?

(114 Posts)
Squibsy Sun 24-Oct-21 19:29:28

Hello folks,

Does anyone has insight/experience of what to expect/outcome, etc of an NHS Dietician referral for a two-and-a-half year-old?

I’m concerned if a referral for GS might boil down to, little more than a leaflet for parents?

GS is a Vegan, ongoing breastfed baby-thru-toddler... who's been 'low on Vit B12 and iron' in blood tests in blood tests, is tiny, and very underweight - not only does another 9-month-old GC weigh much more, but I sat GS on my lap and I can feel all the vertebrae in his spine sticking out!

His parents - I'm sorry to say about my own DS and partner – seem stauncher about their Vegan beliefs than their little one's nutrition; I ask about his 'protein' intake, and get a diatribe about the evils of the global meat industry destroying the planet. That wasn't the question.

I would never nag, but knowing they were trying and getting nowhere trying to feed him lentils etc, tried a suggestion that “just right now, while GS palate and taste-buds are still evolving”, for the sake of vital nutrition, his health, and development, just try anything, even if not Vegan e.g., a simple teaspoon of egg yolk, occasionally! Just to get some iron and B12 into him, instead battling [and getting stressed with failing] to get supplements and pulses into him? Once you’re past this stage, and get things balanced out, then introduce the Vegan diet back in?”

This, literally a simple two sentence suggestion of a teaspoon of egg yolk… [maybe occasionally?] provoked a horrifyingly aggressive reaction from DS and no contact for weeks.

BTW – there’s no other grandparents involved here: DS’s GF is an orphan. And I really sympathise with this and – with all due respect to DS’s GF – it’s probably hard to take on another ‘mother’ without resentment, even just emotional resentment. But that’s not the issue here: the issue is an undernourished and malnourished nearly-three-old, they are apparently concerned about, and at a loss to know what to do with.

And, I’m shocked that under the circumstances, I don’t observe a stronger nurturing instinct kicking in towards the GS – I’ve had GF shrieking on the phone at 1am, threatening to commit suicide – with the baby in the house – because they’ve had a row and “no one cares about her”; and so self-obsessed that she kept posting ‘boastful’ type pics on social media, each time GS fell over and ended up with big bruises on his face - then wondering why someone [no idea who] contacted social services. Seriously.

I have a background in nutrition, qualifications, and worked alongside global child nutrition experts ... More recently, I worked as a Dementia care manager, and one person who was ‘starving themselves’ i.e., not eating, I was delighted to find, after six months, I’d raised their cognitive function results by 50% simply by adjusting their nutritional intake. Dementia starves the brain, and nutrition for dementia sufferers is as vital as that for a little one.

I'm not trying to say to the DS/GF that I know better, or more - just, trying to be supportive while GS lack of growth and development is sliding into an extreme situation. They don’t seem to notice anymore…

GS came over, at lunch, wan, speechless, staring into space, not interacting – I managed to get a Weetabix and half into him – and suddenly he was like a different child. Giggling, babbling, colour in his cheeks. His blood sugar levels must have been at zero! And DS was oblivious, “Oh, but we’ll be eating later”.

But, both DS/GF noticed and been surprised that GS will sit and eat at least something at Grandma’s house: well, for one thing, at Grandma’s house there’s easy rules, like not wandering about in front of a 48” TV screen, while picking up food, playing with it, or throwing it at the dog.

However, GS has no serious interest in consuming anything except breast milk, OR packets of various highly processed 'snacks' [crisps, fruit bars, muesli bar] fed to him if the packets have a 'V' [vegan] label on it.. GS points at food and ingredients, gets interested in seeing it cooked, but eating it? No way.

I try to say, about training GS food tastebuds, and DS argues back that the long list of highly processed artificial ‘ingredients’ in a packet of salty crisps are ‘ingredients’ exactly as ‘milk’ is an ‘ingredient in ‘cheese’.

Then, DS’s GF is not especially bright [my firmly schtum-kept observation], and is very domineering... with a tactic of talking relentlessly over and deflecting any simple conversation, with she can "look it all up on the internet". And, makes astounding comparisons such as, feeding a teaspoon of egg yolk to GS would be as revolting as… DS consuming one of her own eggs!

And in answer to my mild observation that - cultural norms - around the world, throughout history, all humans, and primates, evolved, eating some level of animal protein, even if only occasional scavenged bird eggs [viz cavemen hunter-gatherers and chimpanzees] ... Apparently, "Yes, but we know better these days …and … in some societies it’s probably culturally normal to rape children..." OMG. Yes, that was the – jaw dropping – response to shut up Grandma.

Please don’t anyone think I nag these parents!! Seriously, I don’t. I have very tentatively tried to get to some bottom line, about what is their priority: their beliefs or their child’s wellbeing?

I lived in sub-Saharan Africa for almost a decade – surrounded by kids impacted by under-nutrition, and malnutrition, who, in the words of health experts I worked with, will, sadly, “Never reach their full potential because of lack of protein.” And here we are, in UK, with a GC staring into space, or at the TV, while his parents are staring at their flipping phones, telling me, “He can eat meat when he’s old enough to buy it for himself…” and offering him days-old, cold, pasta, and shrugging off his food refusal – like somehow in decades to come he’ll be a fully cognitive, developed adult regardless of lack of nutrition. Not acknowledging he’s NOT an adult like them, able to make nutritional decisions for himself.

The irony is my DS used to complain as a kid because I hardly ever served up meat; we also know plenty of other families who’ve reared strapping six feet children on a vegetarian diet. However, those parents actually some good idea about child nutritional requirements.

My DS seems to have lost all backbone to stand up as a father or in the relationship [GF is an appalling spendthrift getting them into £1,000s of debt] - and he seems to have retreated into Vegan moral high ground, to have any sense of control in the relationship... even GF admits this.

He’s also lazy. Sorry, he’s my DS and I can say that about him, so he’ll try a couple of bits of toast with GS and then, toxic-snacks aside, let GS wait all day, til GF comes home after work, before any ‘meal’ is prepped. And then's surprised/depressed that GS is too far past it, to want to eat, anything apart from breast-milk.

But, while all the relationship issues are 'theirs' to deal with as a couple - at the heart of this is a little GS, who's turning into a stunted little dwarf, and whose learning and development is regressing... with his spinal vertebrae sticking out etc.

I couldn't seem to have a simple conversation to draw out their concerns, without either triggering the 'meat industry' angry response, or the astounding comparisons of 'raping children' ... So, I've changed tack, keep my mouth shut and instead cook and serve up delicious homemade vegan meals for when GS comes over. Even if GS doesn't eat them sad then DS can learn some recipe ideas to take home.

I was a Nutritional Counsellor, and Chef, and can ram every vitamin, mineral, amino acid, you name it, into a simple dish. Sad;y, these 'hidden' nutrients also seem to escape GS parents’ [just blend up veggies etc into a pasta sauce... ffs]. Apologies for swearing. But, no - they also seem to be lazy parents. I go and babysit and what's in the fridge to offer GS?
... nearly one week-old cooked, cheapest, plain white pasta. Nothing else aside from a soya yoghurt. Not even fortified Vegan 'growing up milk' which I kept buying for GS [because they have no money, or care that it might be a stepping-stone [from breast milk] towards a wider dietary intake] - they just left it in their fridge until it was way past the use by date).

The fridge and cupboards are joyless and/or empty – it seems there’s an acceptance that GS won’t eat – he refuses almost everything – so they’ve given up trying to feed him.

But, GS will go out – of the house – and happily eat vegan chocolate cake and 'vegan milk-shakes' when his Mum goes off for regular, so-called 'self-care', trips to cafes [all documented on social media, together with close-up images of her nipples expressing milk, for 450 ‘friends’ to see].

I think GS would be even more underweight if it weren't for consuming those 'empty calories' of sugar and fat?

I’m concerned what an NHS Dietician will come up with for a little one just not interested in eating a thing – apart from sugary cake, and breast milk.

Yes, his parents are concerned - hence the dietician referral - but that’s offset by a GF’s shrugged, "Well, I was picky as a baby, I turned out alright", laissez-faire expectation of whatever happens at the referral. As though, whatever advice they’re given they expect to ignore, because “I can look it all up on the internet anyway, and they [the professional experts] don’t understand and are just prejudiced about Veganism and breast-fed children”.

Worrying about my little GS welfare keeps me awake at night.

Squibsy Mon 25-Oct-21 19:23:46

"... other DS"

I meant other DS's DS, the other GS

valdali Mon 25-Oct-21 19:44:47

I think Misadventure's suggestion is the one I'd go with. By the way, I find this post heart-rending, it would be my worst nightmare to be in your shoes, I would not go to SS. If I was the neighbour the nursery teacher, one of the "friends" who you sometimes hear concerns from - a thousand times yes. But not as DS mother. But I think you could help by emailing or speaking to the dietetics department and getting the message through that you have seen truly disturbing things and that some of the parents' views and statements when they attend the referral may need challenging. They will at least know how malnourished he is - what centile he's on- and if you combine this with your insights, hopefully they will be able to move forwards with this family in a positive way, and if nothing changes, then to make sure your grandson suffers no more neglect.

trisher Tue 26-Oct-21 07:59:25

Well SS are vastly over stretched at the moment so lets look at some practical things you can do. Your GC is entitled to 15 hours childcare if you are in the UK so at least 2 days of nursery, why is he just doing 1? If he is nearly 4 his entitlement will go up to 30hours. If he isn't could you ask to care for him 1 day a week. This would give him 3 days when he would be getting a reasonable diet.
Finally if he is so badly malnourished I'm surprised the nursery haven't picked up on it. The staff there are experts and if he is slipping behind in development they will be recording and watching that. Perhaps you should talk to them.

MissAdventure Tue 26-Oct-21 08:05:49

Nurseries have been known not to pick up on things.
As have all of the other agencies involved in a child's care.

trisher Tue 26-Oct-21 08:47:33

MissAdventure

Nurseries have been known not to pick up on things.
As have all of the other agencies involved in a child's care.

Perhaps but they have more chance of feeding the child immediately and helping than SS which at present are overwhelmed because child abuse has gone through the roof during lockdown. They were stretched beforehand because of cuts now they are not coping.

25Avalon Tue 26-Oct-21 08:59:20

There are loads of vegan recipes for toddlers online and companies who supply ready made meals, perhaps you could try some for when gs comes round or even persuade dil to try them. The trouble is gs is probably going to be picky as he hasn’t been nurtured properly which is going to be a problem for the dietician. Gs probably breast feeds all night, not so much for food as there is little nutrient at his age, but for comfort. Dil thinks she’s doing well and he is getting food when he blatantly isn’t.

This brings me to another point. If she is breast feeding all the time and at night then it will be taking it out of her and she won’t be getting much sleep. She appears to have little understanding of vegan diets so probably isn’t eating properly herself which will affect her mental state. As for ds men often don’t see what they don’t want to see and will go into denial or make excuses. Getting ds to accept the stark reality may therefore be difficult. Surely friends and relatives must have noticed gs is malnourished. Could they be persuaded to have a quiet word?

Farmor15 Tue 26-Oct-21 08:59:26

Trisher he's not nearly 4, only 2 1/2. So wouldn't be entitled to more nursery time, I think.
And OP said family couldn't afford to send him more days.

MissAdventure Tue 26-Oct-21 09:06:29

Since the issue is related to food, a dietician is best placed to deal with it, and I believe that will.
They certainly have in my workplaces, setting out suggestions, and monitoring that their suggestions are adhered to.

trisher Tue 26-Oct-21 09:17:27

If he is 2+and the father isn't working or the family is claiming Universal credit they can claim for nursery care . If the child is significantly behind in development he could have an EHC assessment and plan. That would mean he would probably be entitled to more nursery time and his health needs would be scrutinised. SS are not the only route to proper care.

Shelflife Tue 26-Oct-21 09:17:30

This is not about having access to help with nursery fees or about a vegan diet . If what we read is genuine it is about ABUSE!!!! I find it hard to believe that the obvious red flags have not been acted upon by GM or indeed anyone who sees this child. If this causes me and other people who read this thread anxiety then why are others who actually see him not raising a safeguarding issue. I really do wonder about this ?

trisher Tue 26-Oct-21 09:26:40

You don't know what actions have already been taken Shelflife he may be in the system. The problem is the system isn't functioning. Lockdown and covid have massively impacted on an already stretched service.

Squibsy Tue 26-Oct-21 09:27:02

Valdali, Trisher, MIssadventure - these are all good points.

Yes -SS are overstretched and from experience in a couple of instances [unrelated, and 100% not these parents] it was weeks before SS got in touch with a family ... and one instance even involved a convicted Class A drugs scenario.

Also, SS can get "blagged off" - first contact is a usually a phone call and if they hear that the child [GS in this case] is under referrals to dietitians and the GP etc, they'll most likely to see this as a child already 'in the [medical] system' and not, at this stage, their remit - because, those other agencies should be picking up the issues. SS have a drawn out process for removing a child, and only at the very last option when all others avenues have been exhausted. I was astounded to learn that even being a Class A drug user, or an alcoholic, doesn't make somebody deemed unfit to be a parent, if it's not impacting on their abilities to care for their child. Best leave that there for now.

Firstly, the suggestion of more nursery is a good one - GS saw the Dietitian late yesterday, who agreed that would be good for GS's not-eating habits.

MissAdventure is qute right though, about nursery not picking up on things - the other GS was going down hill towards Leukemia and even the GP was saying it was something else.

But, back to the SS question - someone earlier mentioned a Support Worker for the parents: that sounds a route to go down ... there's a EHC [Education, Health, and Care] Plan I just came across - which although primarily for SEN, might have mileage in getting SS Support Worker help with ... because, if the only way of getting adequate nutrition [for growth and development] into GS is at nursery, and GS isn't going to nursery, then he will end up with SEN. GS seems 'behind' in speech and communication areas. That's been assessed recently too.

I'll go and put Grandma's big concerns, suggestions on the table. Past experience: GF is hopeless at dealing with 'multi-agencies' [EHC requirement] - and I can support with that.

I'll also take a shopping basket of the dietitian's vegan food suggestions GS should eat and put a rocket up DS backside, as the daytime 'caterer' [or, non-caterer, DS is currently].

MissAdventure Tue 26-Oct-21 09:30:16

There have been many, many cases where abuse hasn't been picked up on.
There was a little boy deliberately starved to death a few years back.
The staff noted that he would try to steal others' food, and would eat the dried food used for crafts, but nothing was done.
One staff member stated that he looked as if he had cancer.
Nothing was done.

My own neighbour was banned from seeing her grandchildren after pointing out that her son and his wife were drunk when picking the children up.
The police visited her and said she would be charged with harassment if she went anywhere near the school, her son, or the grandchildren.

Squibsy Tue 26-Oct-21 09:37:18

Hi - sorry ... I missed the post by Trisher about the EHC and just also came across it ... thanks Trisher smile

PaperMonster Tue 26-Oct-21 09:41:33

Just in case you’re concerned about the breastfeeding not providing adequate nutrients - this is a good resource: kellymom.com/ages/older-infant/ebf-benefits/

Please don’t dismiss SS out of hand. Just a couple of months pre-Covid I reported a case of neglect in a teenager to then. This helped speed the process up for the teen’s mum to be rehoused and reunited with the teen during Covid. I’ve also had to deal with SS during Covid for a self-neglecting vulnerable adult and they were very prompt with their investigations.

Squibsy Tue 26-Oct-21 09:43:37

MissAdventure - the GM barred from seeing her GCs - this worries me, about wading in, with the SS angle. If that goes wrong, then I'll not see GS and unable to keep eyes on what's actually going on.

Squibsy Tue 26-Oct-21 09:45:32

PaperMonster - good point ... I WILL push the SS angle to GS parents to support a EHC and whatever else SS can support with.

FarNorth Tue 26-Oct-21 10:02:30

A rocket up DS bum re getting enough nourishment into GS is definitely needed.

Squibsy Tue 26-Oct-21 10:02:32

25Avalon

There are loads of vegan recipes for toddlers online and companies who supply ready made meals, perhaps you could try some for when gs comes round or even persuade dil to try them. The trouble is gs is probably going to be picky as he hasn’t been nurtured properly which is going to be a problem for the dietician. Gs probably breast feeds all night, not so much for food as there is little nutrient at his age, but for comfort. Dil thinks she’s doing well and he is getting food when he blatantly isn’t.

This brings me to another point. If she is breast feeding all the time and at night then it will be taking it out of her and she won’t be getting much sleep. She appears to have little understanding of vegan diets so probably isn’t eating properly herself which will affect her mental state. As for ds men often don’t see what they don’t want to see and will go into denial or make excuses. Getting ds to accept the stark reality may therefore be difficult. Surely friends and relatives must have noticed gs is malnourished. Could they be persuaded to have a quiet word?

25Avalon - I'm taking on points you raise
* Breastfeeding all night - GF tiredness etc
Also, the lack of understanding of vegan nutrition - as said, she's not especially bright, looks it up 'all on the internet' then I hear her repeating nutritional information, that's all back to front.

MissAdventure - I found the Dietitian contact details so I'll flag up the concerns from firsthand observation.

MissAdventure Tue 26-Oct-21 10:06:38

Oh that's good, squibsy.
I'm not denigrating any of the other agencies, just wary of your concerns getting "lost" amongst the red tape.
Do whatever needs doing.

Squibsy Tue 26-Oct-21 10:29:41

FarNorth - 100% agree... what I'm observing tho is DS too intimidated to be assertive in case he 'upsets' GF.

GF has no manners at the best of times, is very domineering, orders him about ... there's other very obvious issues of a 'controlling and coercive' relationship. When DS was working FT, I was horrified DS finally admitted working himself into the ground, with OT, trying to pay off debts GF had racked up. Then, with GF threats, 'I'll commit suicide', which frightens the Hell out of him, he seems unable to push back on anything.

Esspee Tue 26-Oct-21 12:02:32

I have just looked in to discover what the OP has finally done to protect the child.
Have you reported the situation to social services or the child’s doctor Squibsy?

Squibsy Tue 26-Oct-21 13:07:51

Putting my concerns down on email, after conversation with Dietitian
Waiting for a call back from SS

Shelflife Tue 26-Oct-21 13:07:52

Squibsy, you haven't answered the vital question. Have you rung SS? You have a lot to say but show very little action. I recognize this us a very complex situation but your GS is the priority here!! Forgive me if your GC is already in the system but that is not the impression I have. Of course the pandemic has had a huge impact on social services and other support agencies, but you must keep pushing to protect your GS. What on earth is going on ?

Shelflife Tue 26-Oct-21 13:08:53

Thank goodness for that , well done !