Getting a good night's sleep

Q. My granddaughter will be 5 in January. She eats only when forced and lives primarily on soy milk, chocolate and plain, and chicken strips. She refuses any vegetables, fruits and most meats. She will not even taste a food to see if she likes it. She has episodes of screaming in a panic in her sleep but is easily consoled. She grinds her teeth in her sleep.

She is also very aggressive, frustrated over minor things, but can sit and color for long periods of time. She seems tired a lot, but refuses to go to bed on schedule, sometimes keeping her mother up until midnight or later.

Is this an eating disorder or a control tool?

She had terrible stomach problems from birth to about age 3.

Any help you can give to increase her appetite or encourage healthier eating will be greatly appreciated. Her parents are at their wits end and fear for her health. Maxine, Medford, OR

A. As long as she is gaining weight, her eating habits are probably a minor concern right now. I would that it would be much more important to improve her sleep habits.

At age 5, she should be getting about 11 hours of sleep each night. Not getting a good night’s sleep can lead to children being aggressive, easily frustrated, inattentive, and tired during the day. And being tired and irritable likely isn’t doing anything to make her more agreeable to eating well at meal times.

To start with, a visit to her Pediatrician would be a good idea. If she really has such poor eating habits, her Pediatrician will likely do a blood count to make sure that she isn’t anemic. Keeping a diary of everything she eats and drinks for a few days may help your doctor better evaluate her eating habits.

Your Pediatrician can also evaluate her to make sure that she doesn’t have obstructive sleep apnea. Children with OSA often don’t get a good night’s sleep and are tired during the day. Since she is waking up ‘screaming in a panic,’ it is even more likely that those episodes are being caused by night terrors.

But even the night terrors likely aren’t her main problem. The fact that she goes to sleep so late is probably even more of a factor of her being tired during the day. Her parents likely needs to be more strick about her bedtime and stick to it. If it is still a battle to get her to go to sleep, some experts recommend that a parent let the child stay up until the time that she would naturally easily fall asleep. And then once you get into a pattern of an easy bedtime, you can then move her bedtime back 10-15 minutes every few days.

Although she doesn’t have good eating habits, having a poor diet isn’t really an eating disorder. Many children are picky eaters and do not eat a variety of things. Our article on picky eaters may be helpful to get her to eat a larger variety of foods.

Although it seems like there are a few separate issues here, you may be able to tie them all together into one basic problem, either that of a child who doesn’t recognize any limits or who simply has poor sleep habits and is overtired all of the time.

Parenting Books These aren’t easy issues that can quickly be fixed. In addition to getting help from your Pediatrician, these books may be helpful:

• Setting Limits with Your Strong-Willed Child – Eliminating Conflict by Establishing Clear, Firm, and Respectful Boundaries
• Coping with a Picky Eater – A Guide for the Perplexed Parent
• Poor Eaters – Helping Children Who Refuse to Eat
• Healthy Sleep Habits, Happy Child

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