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Just want to check that the advice we are getting is standard.
My 11 year old daughter has AN.
Diagnosed for a month now.
She was told to write a traffic light system with red foods being her real fear foods and orange ones that cause milder anxiety and green being fine.
We've been told not to give her any of the red foods for now as it's more important to feed her up.
However...it's making finding meal options v difficult since pasta, bread etc are in the red foods and I think it's allowing the ED to have control still.

So a typical day will be porridge (make with ff milk and some cream, with nuts/seeds/honey and granola, cereal bar snack with a Weetabix to go drink, lunch is where I'm struggling, we have jacket potatoes with beans or tuna (made with ff mayo) or a rice salad with full fat mayo and tuna/chicken and afternoon snack of nuts and dried fruit with an innocent smoothie..  Tea again is difficult but usually fish/chicken, potatoes or rice and veg and bed snack of more nuts/dried fruit and oat cakes.  SHe drinks fresh OJ with all meals and milk before bed.

she did fess up at the weekend to  hiding food but that is another post for another time, I just wondered about this traffic light system.  The rationale the ED nurse said was to feed her up with food she'll eat for now and then tackle the fear/red foods once weight restored. 

Hi Colette_71,

You pose an interesting question and one that parents have handled in different ways. I haven't heard of this before; where a provider and a patient make a list of foods that they don't want to eat but I think it gives you a very clear roadmap about what fear foods your daughter has and what you will need to work on to get her to eat a diet with more variety again. The goal or endgame is for her to be eating normally, eating a wider variety of foods and not worrying about them. However you get there is the right way for you and her. 

Some families rip the bandaid off and feed their child everything.
Some families do it in stages, which is what we did; eating many of the same things over and over (as long as they had enough calories and nutrients) before adding more fear foods and laddering some of those foods.
I might start by asking: How many calories is your daughter getting each day?  

The first priorities right now are to make sure she is eating enough to gain weight and that she is gaining steadily. And to keep her medically stable. 

We used a laddered approach to reintroduce fear foods.
So for example I might suggest starting to give her pasta in dishes which are not typical pasta dishes, You could make chicken soup with rice one day.
The next time you serve chicken soup, put orzo in it instead of the rice, (pasta which looks like rice). 

For breads, they come in many forms, maybe try some of the ones that don't look like a traditional slice of bread first. Naan is really tasty if you put it in the oven for a few minutes with some melted butter and garlic on top and warm it. You can serve a dinner with a small piece of the naan on the side to start with.  Another "bread" which doesn't look like a slice of bread might be bagels. And then of course there is banana bread. You could try making some banana bread with lots of bananas in it and some on the top. 

If she is drinking smoothies that is great news and there are many ways to get calories in using them. 

Eva Musby has a.good description of laddering in her book, which I found helpful.



I think it depends on wether you see progress and weight gain with green and yellow food or not. We had something similiar but not with traffic lights but categories that ment the same and here it was a rule that there must be at least 3 carbohydrates in yellow or green. So it was not possible to refuse pasta AND rice AND bread here.
There is no rule and no right or wrong with fear food, some do the laddering approach (we did, my d was 17 in refeeding) and some rip the band aid off (this works often well with young kids like your d is).

"However...it's making finding meal options v difficult since pasta, bread etc are in the red foods and I think it's allowing the ED to have control still."
If that is a problem and you want to change it, tell the team that you want to introduce pasta next week and that you expect them to support you! 🙂
You are the parent, you are in charge!
Keep feeding. There is light at the end of the tunnel.
My first focus was always: Is she gaining?  If yes, then a lot of things are going right.

Of course the fear foods also need to be tackled.  It is up to you if you want to do that now or later, or a little now and a little next week.  Someone here had a system kind of like your red yellow green, but with different labels.  Every week, ED-kid had to move one red to the yellow column, and one yellow to the green column.

Once a food has been re-introduced, it is prudent to keep serving it every week so it does not become a fear food again.

Please let us know how you decide to tackle this, and how it goes for you. xx

"We are angels of hope, of healing, and of light. Darkness flees from us." -YP