Newly diagnosed toddler - refuses to eat

[sub]

My daughter was diagnosed type 1 exactly 7 days ago.
I caught it very early - no keytones in her urine, but a high glucose reading - then a BM of 28.6!
In hospital she did quite well with eating and amazingly well with BM's - injections are a working progress!
She was discharged on Tuesday and picked up a bug, so was sick most of the night - then off food Wednesday.
Appetite was back on Thursday, but she hypo'd before lunch.
Friday her appetite was gone again - really struggled to get her to eat. This ended up in a hypo at 4am!
Today, she point blank refused to eat her supper. She went to bed on a BM of 6.1.
I'll be checking her in a few hours to make sure it's not dropping too low.


My main question is....

How do you get a 2 year old to eat when they don't want to?
We're not making a big deal out of it - but she's not getting biscuits or sweets as a substitute to her cooked food.

I've found nothing online geared towards toddlers - everything is from age 7.

We're new to diabetes - although my younger brother was type one diagnosed when I was 10, and my father type 2 in his 40's (rapidly changed to type1) I have some knowledge - but its very out of date.

Charlotte is currently on a sliding scale, and we're due to see the consultant on Monday.

Any help and advise from parent of toddlers would be great - or anyone with advise.

 

[cugila]

Hi
Welcome to the Forum. No advice for you just to let you know that there are many Mom's and Dad's with very small children that are members here who I am sure will in due course answer your questions. As it's the weekend there may be some delay as they are not always around.

 

[leggott]

Hi, sorry to hear about your daughter. if she is on basal / bolus regime then it might be better to Inject after she has finished her meal so you don't give too much insulin when she doesn't eat all her food. If you are on the mixed insulin this can be a bit harder as you need to be a lot more regimented on this regime which is very hard to do with a toddler.

For treating the lows, you could give fruit juice or jelly babies as an alternative to the glucose tablets - I know my kids prefer this hypo cure.

 

[SophiaW]

Hi Sub, I'm sorry about Charlotte's diagnosis. My daughter was 4 so I don't have experience of a toddler with diabetes. Thankfully my daughter has always been a good eater so we've never encountered the problem of refusing to eat.

I'm unsure from your post whether her loss of appetite is common for her or is it due to her sickness. When my daughter is unwell and off her food I will offer her lucozade or fruit juice to bring her readings up if we're trying to avoid hypos.

Obviously you don't want to offer alternatives like biscuits as this could start bad habits, but if it means avoiding a hypo then you may need to do this occasionally. But I wouldn't offer the biscuit immediately, I'd monitor her blood sugars and only when she's bordering hypo then I'd offer it. I know when my daughter becomes hypo she gets very hungry so perhaps as her blood sugars fall she'll become more hungry.

Sorry I can't be more helpful, but I know a couple of other members here have toddlers so I'm sure they'll be along with better advice.

 

[Jen&Khaleb]

Hi there. My son was 8 mths old when diagnosed so had only been on solid food a couple of months. I still quite often only give insulin (novorapid) after he has eaten. Sometimes I do this because it just seems to work too fast some of the time.

The simple truth is that you really can't make a toddler eat when they refuse. I have always been very aware of the trouble I could get into so I've managed to avoid most food issues. A good way to feed toddlers is not to put a big plate in front of them but serve it up in small amounts. Don't let them have a huge drink half an hour before a meal time or they tend not to want to eat also. Keep them active but not over excited before a meal. Keeping a regular routine helps also.

Did you have food issues prior to diagnosis?

There have been a couple of times in Khaleb's diabetic life that as a last resort I've mixed up glucose powder (easy to buy from the chemist or supermarket here - Australia) in water or milk and forced it down him with a syringe. He was ill.

Khaleb has 3 small and 3 larger meals a day and they are small enough that he is nearly always hungry for the next meal. It is a little bit like 'treat em mean keep em keen' but he maintains a healthy weight and good glucose control with this method. He just doesn't get to pig out but still gets treat food in small amounts every day.

Hope you didn't have a terrible night. The lack of sleep drives me a little bonkers sometimes.

 

[nicolaknight86]

Hi im nic, mum to Jazmin who is now 3 but was diagnosed at 10 months so I do know how hard it is!
Answer to your question is you simply cant! I had this discussion with my dietician when jaz was going through the terrible 2s and basically you could end up doing more harm than good by becooming stressed and them picking up on it!
I have always injected after meals because then you can adjust the dose if they havent eaten a lot, we also carb count so for every 20grams of carbs that she eats she has 1 unit of novorapid which works really well so ask your nurses for help with this as its really easy to get to grips with.
Jazmin eats a lot of yoghurts, at least 1 a day and these are good when she is off her food as there full of carbs and easy for her to eat.
Speak to your dietician, they are there to help and this is so new to you both things will be changing all the time, Jaz has been diagnosed for 3 years now and were forever changing ratios and her background insulin as she is growing

 

[sub]

Thanks for your replies everyone.

Fingers crossed, its just been a glitch as she ate like a pig today!

Everything is confusing and contradictory at the moment.
Charlotte is on a sliding scale - they do not want us to count carbs and calculate her insulin until she has had her "honeymoon period".

We get told one thing one day, for it to be wrong the next!

Seeing the consultant tomorrow morning and will have a good chat about everything with her.
Currently she's on 2u Levemir and then from 1.5u - 5u Novorapid depending on her bm.
Most doses have been 1.5u.

Consultant said to give her the Novorapid before eating - we've ignored that and done it after eating (on advise from the nurse and dietician) - and adjusted the dose if we feel it is needed.

 

[leggott]

Hi. We too were told not to carb count but decided to anyway as we didn't understand how we were supposed to work out how much insulin to give. it's probably beneficial to keep a food diary so you can get An idea of how much insulin she needs for different meal/ foods. Children seem to be creatures of habit and like the sAme things, so it should't take you long to work out the insulin requirements for each meal.

I agree about giving insulin after she has eaten especially with food like pasta and pizzas as these foods release the carb very slowly and you cAn often find that the insulin is working before the food has had time to get into the blood stream.

 

[sub]

Appetite is definitely back.
Consultant had reduced her insulin doses and this seems to have had an improvement too.

Fingers crossed, we've now cracked it!

 

[toddlermum]

Hi Sub,

Just wanted to say, sounds like we're very much in the same boat!! My daughter turns 2 on Friday, she was diagnosed as type 1 in December.
It's certainly not easy getting good BG results!!
We have, like you been giving nova rapid after eating. To begin with we were only giving levemir in the morning, but a few months in we split it and gave some in the morning and some at night, this made a big difference (all in consultation with diabetes team of course!!)

It's very frustrating when they won't eat, the only thing you can do is reduce nova rapid/not give any for when she doesn't eat - she'll still need the long lasting insulin though.

Don't be too hard on yourself, it's takes time to get things sorted, though I know how frustrating it is!!
Good luck with everything.

 

[Aki]

Hi

My daughter was diagnosed nearly a year and half ago she is 2 and a half now. A couple of months ago she got ill. Anyway then she lost her appetite so of course she had many many hypos during the day and night. She is actually on a pump so on adivce from her diabetes nurse we would dcrease the basal rates on her pump. But it was a nightmare trying to get her to eat she wouldnt eat any of her fav foods and she didnt even want crisps. If she would eat it would come back up five minutes later. Alot of lucozade drinking and sleepless nights. To be honest i still dont know how i got through it. I would just have to treat her hypo as and when it would happen. lThe sleepless nights and the constant worrying and checking sugars in the middle of the night left me absolutly exhausted.

I dont know if my ramblings have helped but you will always get through these.