Diabetic/Not Eating

[Hunni Bee]

A child with diabetes started at my center a short time ago. He is on insulin shots, and gets checked a few times a day. He eats our lunch, but brings his own snack. He was dx only about a month ago.

Well, at every meal, this child refuses to eat. His own food nor what we serve. Our policy is usually to serve it and forget it, not make an issue out of eating or not eating. Of course, we can't do that with this child. We spend every meal cajoling, begging and bribing this kid to eat. The parents send a (sugar-free but sweet) treat that he only gets if he eats sufficiently, and now he starts whining for that without eating anything.

Naturally his blood sugar drops, so we end up giving him more attention about eating, which he seems to be looking for - he gets this puppy-dog "well I'll just sit here and starve" attitude.

The mom seems to be expecting us to "make" him eat, and then she does dumb things like send the same thing for the kids snack as we're having for lunch, send weird things no one would want to eat (raisin bread/jelly sandwiches), etc.

We know we probably aren't going about this correctly but we don't have any experience in this area and are admittedly afraid of what might happen if his blood sugar drops too low - the readings are usually not too good.

Anybody have any experience with this or advice?

[melonieb]

My done is like that. Make sure to supply him with plenty of fruit. Most kids like oranges, bananas, and apple's. If the child refuses to eat what you put in front of him, try to give him orange juice or just oranges. If his sugar drop real low make him a cup of orange juice with 2 tsp sugar. Snacks can be cheese and crackers, fruit/veggies with peanut butter,

[Cradle2crayons]

A child with diabetes started at my center a short time ago. He is on insulin shots, and gets checked a few times a day. He eats our lunch, but brings his own snack. He was dx only about a month ago.

Well, at every meal, this child refuses to eat. His own food nor what we serve. Our policy is usually to serve it and forget it, not make an issue out of eating or not eating. Of course, we can't do that with this child. We spend every meal cajoling, begging and bribing this kid to eat. The parents send a (sugar-free but sweet) treat that he only gets if he eats sufficiently, and now he starts whining for that without eating anything.

Naturally his blood sugar drops, so we end up giving him more attention about eating, which he seems to be looking for - he gets this puppy-dog "well I'll just sit here and starve" attitude.

The mom seems to be expecting us to "make" him eat, and then she does dumb things like send the same thing for the kids snack as we're having for lunch, send weird things no one would want to eat (raisin bread/jelly sandwiches), etc.

We know we probably aren't going about this correctly but we don't have any experience in this area and are admittedly afraid of what might happen if his blood sugar drops too low - the readings are usually not too good.

Anybody have any experience with this or advice?

I would ask what are his favorite things. Such as complex carbs not simple carbs. Simple carbs will bring up his sugar for an hour but then it will go down again. His insulin may need to be adjusted also. What kind of insulin is he on.. That determines his diet.

It's normal for kids who are newly diagnosed to test he boundaries because they know they can manipulate with food.

Most important, mom needs to be on board and it sounds like a conference is needed.

Is he refusing food at home?

[Hunni Bee]

Well, I'm assuming he does because dcm felt the need to send a "reward" for eating on the first day.

I really do think its also a control thing and we're giving it too much attention and its backfiring.

I also think that Mom needs to provide all meals until he's on a better eating routine and be ready to pick up if we can't get him to eat. We are a large center and lunch is the same for everyone, we cannot fix individual meals on demand.

This is exactly what I'd say to mom because I felt like she is confusing our admittance of a child with this condition with us managing his condition. That's still her job. But, he's not actually in my group and the teacher he has is not likely to be so cut and dried.

Any other ideas about we can make this work for us?

[Blackcat31]

Well, I'm assuming he does because dcm felt the need to send a "reward" for eating on the first day.

I really do think its also a control thing and we're giving it too much attention and its backfiring.

I also think that Mom needs to provide all meals until he's on a better eating routine and be ready to pick up if we can't get him to eat. We are a large center and lunch is the same for everyone, we cannot fix individual meals on demand.

This is exactly what I'd say to mom because I felt like she is confusing our admittance of a child with this condition with us managing his condition. That's still her job. But, he's not actually in my group and the teacher he has is not likely to be so cut and dried.

Any other ideas about we can make this work for us?

The above bolded part.

Please do NOT just give him orange juice when he doesn't eat and please do not give him orange juice with sugar

He needs to be on a specific diet plan and needs to have the support AND intervention of his parents when he doesn't eat.

I would do exactly what you said above and call the parent every time he chooses not to eat.

The parent's practice of rewarding him with food for eating is not going to have a good outcome if done long term.

It IS hard to get a young child on a plan, especially a newly diagnoses diabetic but it HAS to be done.

He HAS to have a good well balanced diet and simply surviving daily on fruits and/or orange juice is NOT ideal.


Hunni.... I feel for you guys having to deal with this. It is so hard and so important to maintain a healthy well balanced diet. I would suggest that EVERYONE who is responsible for this little guys daily care take some sort of training about the correct ways to deal with this.

It is vital that his parents, caregivers and doctor's (as well as nutritionist) be on board with the SAME plan for care.

[Blackcat31]

I think the key to your situation is training. I think ALL caregivers in your facility should be trained. As a matter of fact, I think it is a law that you are if you have a diabetic child in care.

To facilitate the appropriate care of the student with diabetes, school and day care personnel must have an understanding of diabetes and must be trained in its management and in the treatment of diabetes emergencies.
(http://care.diabetesjournals.org/con...pl_1/s131.full)

I would also check your state requirements as each state seems to have different ones in regards to diabetes management and medication.

Here is a really good resource for caregivers and/or families with diabetic children. LOTS of great info!

http://kidshealth.org/kid/centers/diabetes_center.html

[Kabob]

I agree strongly with Blackcat. My family has a history of diabetes...it is not an easy situation to deal with and there is no simple solution. It requires planning, training, and lots of communication. It is important that everyone sits down and comes up with a plan for the safety of that child that includes a balanced meal plan, emergency plan, and backup plan if management at daycare isn't working (ie the refusal to eat, sudden fluctuations in glucose levels). The parents must be on board every step of the way or else that child's life is at risk and that is a hefty burden for you to bear alone. Low or high blood sugar can land them in the hospital very quickly...

[Hunni Bee]

I think the key to your situation is training. I think ALL caregivers in your facility should be trained. As a matter of fact, I think it is a law that you are if you have a diabetic child in care.

To facilitate the appropriate care of the student with diabetes, school and day care personnel must have an understanding of diabetes and must be trained in its management and in the treatment of diabetes emergencies.
(http://care.diabetesjournals.org/con...pl_1/s131.full)

I would also check your state requirements as each state seems to have different ones in regards to diabetes management and medication.

Here is a really good resource for caregivers and/or families with diabetic children. LOTS of great info!

http://kidshealth.org/kid/centers/diabetes_center.html

Thanks BC.

I wouldn't dream of the orange juice thing. We don't serve juice and don't have any onsite anyway.

A care plan was made and very rudimentary training was given to some of the teachers, but not all that would have contact with this child daily. It didn't include any information about diabetes in general or about this child really, just what to do daily as far as his meds and checks, and what to do in case of emergency.

I will definitely be sharing these links with my coworkers.

[Blackcat31]

Thanks BC.

I wouldn't dream of the orange juice thing. We don't serve juice and don't have any onsite anyway.

A care plan was made and very rudimentary training was given to some of the teachers, but not all that would have contact with this child daily. It didn't include any information about diabetes in general or about this child really, just what to do daily as far as his meds and checks, and what to do in case of emergency.

I will definitely be sharing these links with my coworkers.

Here is another great link http://www.diabetes.org/living-with-....html?state=VA

Also, this child *could* potentially qualify for services under IDEA (individuals with disabilities education act) and receive an in school aide or other services.

Check here for more info http://www.diabetes.org/living-with-...abilities.html