My son has a severely restricted diet and, like many autistic people, he has strong sensory aversions to the appearance, smell, texture and tastes of a variety of foodstuffs.
He was breastfed and weaning started well. He tried and enjoyed a range of the usual weaning foods but slowly started refusing foods he had previously enjoyed. By the time he was 3 he was refusing to eat most food offered and by the time he started school his diet had settled into a now familiar routine of Marmite sandwiches, Marmite rice cakes, yoghurt, smoothies and fig rolls (fig newtons).
This image shows a plate holding crustless Marmite sandwiches, a small yoghurt and a multivitamin tablet. Alongside is a carton of smoothie. This is a standard breakfast for my son.
Sometimes the bread will be toasted. The carton of smoothie is vital as he refuses to eat fruit and vegetables, apart from a very occasional banana (which must be at an optimum level of ripeness, have no blemishes and, open easily and in a tidy fashion). Supplementing with a multi-vitamin and mineral tablet is vital to top up the essential nutrients he lacks in his diet.
Breakfast is the easiest meal of the day in many ways. It is almost always eaten at home and is fairly easily replicated if we are away.
This image shows crustless Marmite sandwiches, a chocolate chip brioche and a Frusli cereal bar. On a school day he will take a packed lunch of Nutella sandwiches and a small chocolate bar. He does not have butter in his sandwiches and dislikes the way Marmite soaks into the bread.
Sometimes the brioche is swapped out for a crepe, and sometimes the Frusli is replaced with fig rolls. If we go out for the day we have to take a packed lunch as finding a place to eat which will have suitable options available is unlikely. The cereal bar is a new introduction to his diet and followed an extensive tasting session to find easy snacks for out and about.
This image shows a bowl of Marmite rice cakes. They are served in a bowl as my son struggles with the sensations of eating from the bag. On a school day he will have these rice cakes when he gets home from school and they have become part of his after-school decompression routine.
This image shows 3 plates. One plate holds some well-done smoked streaky bacon. One plate holds crustless Marmite sandwiches and a pot of chocolate mousse. One plate holds a piece of homemade chocolate birthday cake.
My son has not eaten what might be considered a ‘proper dinner’ for many years. The last such meal was spaghetti bolognese about 7 years ago.
Bacon is the only meat my son will eat, and he would happily eat it every day. The sandwiches at dinner time are often replaced by a toasted bagel or little rolls, but always with Marmite. The chocolate mousse on this occasion was a treat and this element would usually be a yoghurt. Homemade cakes are a good way to introduce some eggs and butter into his diet and cocoa contains trace minerals.
He will occasionally eat very dark chocolate which offers some micro-nutrients and iron. Nutella contains some nuts, as do occasional Ferrero Rocher and peanut M&Ms. His favourite Innocent smoothies now come in varieties which include beetroot and carrot. Every little bit of goodness, wherever it comes from, helps when a diet is so restricted.
Despite the limited nature of his diet, my son is healthy, growing, developing and learning. An analysis by a dietician a few years ago found very little lacking and we were able to make little changes to address these deficiencies.
What have I learned?
- Some children will not ‘eat when they are hungry enough’. A child like mine would rather starve than eat unpalatable food.
- Hidden food will be discovered. I have still not been forgiven for the smidgen of soft cheese in a Marmite sandwich 10 years ago.
- Hiding food in a favoured food might lead to the refusal to eat that food again. Trust is important. I ignored the advice to blend tofu (!) into a smoothie because smoothies are my son’s only reliably consumed source of fruit and vegetables.
- No, he won’t copy his peers and eat what they eat. He doesn’t even notice his peers, let alone want to be like them.
- Growing our own fruit and vegetables is fun, but his aversions and sensitivities are too powerful to overcome by novelty.
- Getting him involved in cooking, ditto.
- Just because he tried it and ate it once does not mean he will continue.
- Carrying out ‘scientific’ tasting sessions with score charts has resulted in small successes.
- Agreed changes and diversions are more likely to be accepted than subterfuge. My son needed to up his fibre and protein, we discussed a range of sources and he agreed to eat wholemeal/seeded breads and bacon.
- It is ok not to eat together. My son eats at his chosen meal times and likes us to chat at the table as he eats. He often comes and talks to us when we eat our meals, depending what it is, he likes the smell of Italian and Indian foods but not the smell of fish or Chinese takeaway.
I am hopeful that my son will broaden his diet as he gets older. I try to make sure he can identify different foods and he has learned to cook a few basic meals. We talk about food production, sourcing, ethics and welfare. It is important he has a vocabulary to draw from should he choose to become more adventurous in the future.
I used to worry a lot about my son’s diet. It’s an area where parents face a lot of judgement and get given a lot of unsolicited advice. It’s hard not to think we aren’t trying hard enough, though I’ve yet to encounter a parent of a child with a restricted diet who hasn’t tried very hard indeed.