How do I get my ADHD child to eat?

How do I get my ADHD child to eat?

One question that has come up again and again is: what can you do when your child with ADHD has lost their appetite and won’t gain weight? How do I get food into them when they’re not hungry?

I asked Accredited Practicing Dietitian Belinda Martin of Advanced Dietitians Group if she could provide some tips.  

Their practice in North Perth and Murdoch has a special interest in nutrition for babies and children and lots of experience in this area.

Over to you Belinda …

Top tips to maintain growth and good nutrition on ADHD medication

We see a lot of kids on ADHD medication with poor growth and concerns about their nutritional status.

As a parent this can be quite worrying. A common side effect of ADHD medication is to suppress appetite which can then cause poor weight gain and poor growth.

Here are our top tips to help growth and good nutrition on ADHD medication.

Pancakes, butter, peanut butter and berries are a great option for breakfast

Breakfast is usually the best time of the day for your child to eat as much as possible before the ADHD medication kicks in – so make the most of it.

Remember, there are no rules about what food your child must eat at breakfast.

Aim to include a good quality carbohydrate, a good protein source and some fruit or veg.  Add some extra fats to make it high energy.

Here are some of my top suggestions:

2-3 weet bix with full cream milk topped with a banana and a dollop of cream

2-3 pieces of French toast (bread dipped in egg and fried with avocado or butter and maple syrup)

Ham, cheese and tomato toastie (with extra butter or margarine) with some mushrooms and spinach

2-3 croissants with Nutella and strawberries

2-3 pancakes with butter, peanut butter and berries

Overnight oats made with full cream milk, cream, fruit and honey

Extra tip: serve breakfast with a cup of milk to add some extra calories and protein.

Understanding when your child's ADHD medication peaks can help you manage the side effect of appetite suppression by finding windows of nutritional opportunity

Work with their medication

When on ADHD medication, your child’s appetite is gradually dropping off at the start of the day, so your child may or may not eat their recess or lunch.

Send their favoured foods for recess and it just might entice them to eat a small amount.

Lunch time is often the peak time that your child’s ADHD medication is working and it’s likely your child’s appetite will be non-existent.

We often talk with families about sending lunch to school but quietly accept that your child probably won’t eat it. 

If you can make peace with the lunch box coming home full then it will take a lot of stress off yourself and your child.

It’s a very normal side effect.  Parenting is tricky enough without giving yourself a hard time on this.  

Perth dietitian Dr Kyla has created special stickers for lunch boxes that can help manage expectations around eating at school.

Send lunch - even though they won't eat it

Kids don’t like to be different to their peers, especially in primary school, so it’s still important to send them with food in their lunch box, even if they don’t usually eat it.

It is also worth talking to your school about yours and their expectations around lunch to make sure everyone is on the same page.

Make sure your child is not pressured to eat at school as this will probably make the situation worse.

Try offering a meal instead of a snack when their meds start to wear off - this can even be their lunchbox.

I'm home and I'm hungry

You may have noticed a particular time in the day when your child’s ADHD medication starts wearing off.

For most kids this is usually around 4.00pm. Instead of offering the usual afternoon snack, try offering a meal instead.

This can be a simple as offering the food that is left in their lunch box or offering an early dinner or left overs from the night before.

You might find it easier to change your routine a bit and cook an extra serving of the meal the night before to have ready for afternoon tea time the next day.

Think of this meal as replacing recess and lunch if your child hasn’t eaten at school.

Still offer dinner at the usual time, or a bit later depending on when afternoon tea was.

A high calorie milkshake or snack before bed can help make up some extra calories

Give a high calorie snack before bed

Give your child a high calorie milkshake or snack before bed.

This could be a Sustagen or an Up & Go but can also be a home-made milk shake made with milk, ice cream, milk powder and flavouring.

It could also be a nice warm hot chocolate made with extra milk powder or cream.

Other options before bed are toast with peanut butter or crackers and cheese.

This makes up for some extra calories that haven’t been eaten during the day. Just make sure those teeth get brushed afterwards!

Your doctor should monitor your child's weight and growth

Keep an eye on growth

Once our kids are past the baby and toddler stage, we don’t often keep an eye on their growth.

Because ADHD medication commonly affects growth, make sure you know what your child’s weight and height are before they start the medication and have their weight and height checked every three months or so.

Try not to make a big deal of it if you are measuring your child at home.

It’s a good idea to get these measurements done only at your doctors to avoid any potential body image issues developing.

If you are at all concerned about your child’s growth or nutritional status, come, and see us and our experienced dietitians can work with you and your child in a positive way.

Over to you

What works for you in managing appetite and ADHD medication?  Drop your suggestions below.

Picture of Belinda Martin

Belinda Martin

Belinda Martin is a Perth dietitian specialising in paediatric nutrition, infant nutrition, neurodiverse children, children with disabilities. allergies and pregnancy nutrition.

She is one of the Directors of Advanced Dietitians Group and loves working with people and families.

She has been a dietitian for 25 years and has worked as a Senior Dietitian and Paediatric Dietitian in various teaching hospitals in Western Australia and the United Kingdom.

Outside of work Belinda is a ‘boy mum’ and has 3 very active boys aged 8 years, 6 years and 18 months who keep her on her toes.

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About Advanced Dietitians Group

Advanced Dietitians Group was founded in 2014 by Belinda Martin and Ingrid Roche, Perth dietitians with a combination of over 50 years’ experience in the industry.

Their team has now expanded to include 5 more Accredited Practising Dietitians with a range of experience in nutrition across the lifespan and specialising in infant and paediatric nutrition, allergies, pregnancy and maternal nutrition, women’s health, neurodiverse children, children and adults with disabilities and the ketogenic diet for the treatment of epilepsy.

They provide up to date evidence-based nutrition advice. This coupled with their wealth of experience in dietetics ensures you get the best possible nutrition service.

They get a buzz out of helping their clients and their families.

They are also Mums and understand what it’s like to be worried about your child’s nutrition and growth, so they are awesome at squeezing in children for an appointment ASAP. 

They are very conveniently located at The Kidd Clinic in North Perth and the Murdoch Specialist Physicians Centre in Murdoch.

References

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Poulton AS, Melzer E, Tait PR, Garnett SP, Cowell CT, Baur LA, Clarke S. Growth and pubertal development of adolescent boys on stimulant medication for attention deficit hyperactivity disorder. Med J Aust. 2013 Jan 21;198(1):29-32.

Stevens JR, Wilens TE, Stern TA. Using stimulants for attention-deficit/hyperactivity disorder: clinical approaches and challenges. Prim Care Companion CNS Disord. 2013;15(2):PCC.12f01472.

Swanson JM, Elliott GR, Greenhill LL, et al. Effects of stimulant medication on growth rates across 3 years in the MTA follow-up. J Am Acad Child Adolesc Psychiatry. 2007;46(8):1015–1027.

Waxmonsky JG, Pelham WE 3rd, Baweja R, Hale D, Pelham WE Jr. Predictors of Changes in Height, Weight, and Body Mass Index After Initiation of Central Nervous System Stimulants in Children with Attention Deficit Hyperactivity Disorder. J Pediatr. 2022 Feb;241:115-125.e2.

Waxmonsky JG, Pelham WE 3rd, Campa A, Waschbusch DA, Li T, Marshall R, Babocsai L, Humphery H, Gnagy E, Swanson J, Hanć T, Fallahazad N, Pelham WE Jr. A Randomized Controlled Trial of Interventions for Growth Suppression in Children With Attention-Deficit/Hyperactivity Disorder Treated With Central Nervous System Stimulants. J Am Acad Child Adolesc Psychiatry. 2020 Dec;59(12):1330-1341.

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