Choking reaction in a 9 year old warrants an evaluation
My 9 year old has this fear that every time she eats, something is stuck in her throat. It happens on and off. She'll go thru a period of eating really well and then times like now where she'll eat very little which will be only liquids. She cries when you ask her to eat solid food. I'm not sure if she's depressed about me going back to work and is rebelling. I'm about to lose my mind as I myself suffer from depression and anxiety. Please advice me on what I should do.
From: Dina, Hamilton (no state given)
Dear Dina,
Since you say this has happened "on and off" before, and that you suffer from anxiety and depression, it's possible that your daughter's behavior is linked to yours, not necessarily because you are going back to work per se, but to your general state of mind. Our children are sensitive to our moods, our worries and our anxieties. When you get anxious, that can make her anxious on many levels, including making her wonder, "If mom isn't feeling good, can she still take care of me?" On the other hand, it's possible that there are other things in her life, like academics or friendships, that make her anxious. I wouldn't make any assumptions about why this is happening.
What I absolutely would do is talk to her pediatrician. Childhood anxiety can manifest itself in disordered eating. If she hasn't had a medical evaluation for her eating and stomach issues, she needs one. If she hasn't had an evaluation for anxiety disorder or other mental health issues, I suspect she needs that, too. I'm not a doctor, but I urge you not to put this off.
I also hope you are getting the professional help you need.

Thyroid disorder.
Definitely a physical examination is first priority as well as asking the pediatrician about disordered eating. If there is some physical cause it should be looked for immediately. Could be something serious.
I have noticed that Drs tend to look for one or the other according to their prejudices or the way the problem is presented to them by the parent. So, if it were my child I would not go in and say "I have anxiety and depression issues and I think she does/might too." I would relate the symptoms and if they say 'eating disorder" I would say 'are there possible physical causes that should be ruled out first?" and vice versa.
Dina,
My 9 year old went through (and is still dealing with) a very similar issue. Last year she suddenly developed a fear of choking on food - literally overnight - she went from an adventurous, healthy eater, to a liquid only diet. The notion of eating solid foods would throw her in to a full anxiety attack. After months of reading, talking with our pediatrician, councilors, family and friends, she is back to her old self. Based on our experience, I can offer the following thoughts:
1. This is an anxiety disorder, not an eating issue. While our daughter has been able to go back to eating normally, her anxiety continues to manifest itself in other ways.
2. She needs to know that you are there for her, love her, and support her. Don't (ok, try not to) get frustrated, angry, aggravated with her unwillingness to eat. In the short term, if she only wants liquid, give her liquid - tomato soup, Ensure, broth, etc. Anything to keep her calorie intake up and keep her hydrated. We had to work very hard to not decide that our daughter was just being a brat about eating and understand that, for her, the fear was very real and she really didn't know how to get it under control. Our daughter hated how she felt, but had no clue how to change it. Support, support, support.
3. Get her help. Talk to her teacher and school counselor. You can bet that if she's having these issues at home, she's also probably having them at school. She needs to feel like, when she's at school, she has a support system. Our daughter spent several weeks checking in with the school counselor daily - it really made a difference in how she felt at school. But, more importantly, get her professional counseling from someone who specializes in kids - your pediatrician should be able to give you referrals. Again, this is an anxiety disorder - she needs professional help to learn the skills she will need throughout her life to deal with anxiety. Let the professionals treat her, you just love her.
4. Take care of yourself. Try not to get frustrated, try not to dispair, try not to turn yourself inside out looking for a cause (we still have no idea what triggered this for our daughter, and ultimately decided it didn't matter). From the reading and talking we did, not only is this type of thing somewhat common, it is very common at this age. My wife and I lost a lot of sleep and spent countless hours worrying - which would then result in our lack of patience in dealing with our daughter. Know that with counseling, this will improve.
Good luck!
Does your daughter have post-nasal drip? I developed post-nasal drip around that age, and it felt like choking or my throat swelling shut. It also causes stomach upset and can put you off a lot of foods.
Has it occurred to anyone that she has a physical problem that flares up under stress?
The dichotomy of physical problem vs. emotional manifestation is often a false one, but it comes up when the problem is something one can't see. One is accused of either making it up, or having something psychosomatic in the sense that you can't say what's wrong so your body manufactures an excuse or an attention getter for you.
It would be easier if it were, say, hives, but eating problems, headaches, etc. get written off as "only" emotional. If stress causes a physical manifestation directly, or indirectly due to lack of sleep, etc. then you need to fix both the stress and also derail the process by which stress turns into a physical problem. Ask anyone with migraines.
This may have a physical cause. A young family member has a problem with his esophagus (perhaps called esophageal dysphagia?) which the doctor says may have been caused by acid reflux or GERD as an infant. Something happened to the cells lining the esophagus.
Can she explain why she is reluctant to eat solid foods? I agree with the other comments, there is a possibility that this might have a physical component -- something that causes her throat to tighten (or feel tight).
Would strongly recommend a thorough exam by a specialist. (ENT?)
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About the author
Barbara F. Meltz is a freelance writer, parenting consultant, and author of "Put Yourself in Their Shoes: Understanding How Your Children See the World." She won several awards for her weekly "Child Caring" column in the Globe, including the 2008 American Psychological Association Print Excellence award. Barbara is available as a speaker for parent groups.
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