My Two Year Old Went on a Hunger Strike.

I walked up to the receptionist and immediately felt awkward. I didn’t have a child with me. The receptionist met my gaze, and then seemed to look past me. It was probably odd for a pediatrician’s office.

I said Justin's name and date of birth. I was there for his appointment, but he wasn’t physically with me. She pointed over to a group of empty maroon office chairs next to a fish tank and told me to have a seat.

I watched several children crawling and walking around a central play center. Putting their hands in their mouths with ease. This side of the office was dedicated to “non sick kids.”

I saw him walking in with his foster mother. He scanned the room nervously looking for his biological mother.

I had just met Justin the day before, he silently stared up at me with these piercing blue eyes, wide and innocent. His slight overbite biting down on his lower lip, curious, but cautious, and a little scared.

Two days before we met, I received the anticipated call from the county social worker, Justin and his brother, Dominic, would be moving into our home in two weeks. We would be their third foster home, but possibly an adoptive home.

Justin was two years and nine months old, and quite small. He had some health issues, and was going to a lot of doctor appointments. In a matter of days I went from no children, to two toddlers, and multiple doctor appointments on my calendar.

It is hard to celebrate becoming a family without first grieving the loss of another one.

Justin's biological mother came in and sat a few chairs from me. She was young, about 22, and her gaze in my direction was cold and uncomfortable. I understood that the move to a new foster home, a pre-adoptive foster home, meant she was one step closer from losing custody of her children, and I was a huge threat.

There was no guarantee. At the time I met Justin, and his brother, Dominic, the court was still seeking to reunify them with their biological mother. Their county social worker and a guardian ad litem, the lawyer assigned to represent the children in court, were seeking to change that at the next hearing from “Return Home,” to “Permanency.”

Justin was small. He was just so small. He had stopped eating at his foster home about 6 or 7 months ago. At the time his doctor thought there must be a medical reason. Justin also stopped growing physically.

I was at this appointment today for a weight check. His foster mom told me he was only wearing 12–18 month clothes. While we waited to be called back Justin stood perfectly still next to his foster mother, as if frozen.

A nurse came out and called his name. It was strange how many women got up. All of us must have been a sight to the other moms waiting for their appointments. Among us an obvious social worker dressed in business casual and carrying a briefcase. There was no attempt to hide his status as a foster child.

People stared as we made our way to the nurse, my face got hot, Justin bit his lower lip and looked around at all the fuss. His foster mother leaned in and whispered.

The nurse took Justin's temperature, his height, and his blood pressure. She asked someone in the room to undress David and put a gown on him. I tried to leave the room, it was small and I was invading whatever was already incredibly embarrassing. The social worker stopped me with a smile and a thumbs up.

His biological mother undressed Justin and put the gown on him, but Justin shivered and she didn’t seem to notice. She thought this was unnecessary and was certain Justin was just fine. She held an air of superiority that was disguising denial.

The doctor came in and insisted the gown be off to get a proper weight. His biological mother carried Justin, naked, out into the hallway and into the nurses station, She put him down in front of the scale.

Justin turned and looked up at all of us, naked, surrounded by strangers, and in the busiest part of the doctor’s office. I could say nothing as to the injustice of the entire scene. He looked embarrassed, and I was embarrassed for him. He stepped on the scale and the nurse read loudly, “21 pounds, 0 ounces,” and just like that it was over.

Back in the exam room, the pediatrician talked about scheduling a surgery to put in a g-tube. He was going to see a specialist, a GI specialist, to cut a hole directly into his stomach so he could be fed directly through the tube.

I was a little surprised, and asked the doctor about why there was no discussion of an NG tube, which was a nasal tube that was more temporary and less invasive. I knew nothing about this child, but I continued, “We don’t even know what’s going on, we don’t even know if this is a medical issue.”

The doctor replied, “Of course this is a medical issue.” Still, I was aware I was talking to a pediatrician that despite a 6 month hunger strike and the 5 pound weight loss of a toddler, had yet to refer him to any specialist. “I don’t know,” I said, “I am not onboard.” Still, the specialist appointment was made. I had 6 weeks until the appointment to try and learn as much as I could about Justin's eating habits.

I made meatloaf for his first dinner. He sat in his toddler chair and stared at me. I said nothing. I knew they were forcing him to eat at his previous foster home, and this made the issue worse.

Justin refused to touch a single piece of food, and was expecting me to be upset with him. Instead, I turned and talked to my husband. I turned back and smiled at him. He ate nothing, but stared at me with those eyes and bit his lower lip.

He looked at me so intently, watching me as I talked to him. Despite being almost three he only babbled. After I ate, I got up and happily made 4 ice cream bowls for dessert, passing them around.

Justin didn’t want his bowl. He reached his hands out, pointing to my bowl of ice cream. I started feeding him a few bites from my spoon. We sat there in silence, enjoying dessert together.

Justin didn’t always want to be touched or loved by me, but he did eat off my spoon. In fact, he preferred it as his main source of nutrition. I would offer it up at odd times, between meals, on my lap in the living room, walking by him playing with his cars. Each time acting surprised at his request to eat.

He continued to eat nothing at dinner. He was most comfortable eating off someone else’s plate. My husband and I went to a family picnic and watched as Justin silently walked up to complete strangers and opened his mouth to ask for food off their plate. Then, he threw it all up in the parking lot before we got to the car.

I was convinced Justin had intense anxiety, and his hunger strike was an emotional response to try and control his chaotic and overwhelming life circumstances, and really all a three year old could do in protest that might truly illicit an adult response.

He eventually learned to eat at meals, but I had to always pretend that I never cared whether he ate. I had to pretend his hunger strike never bothered me, meanwhile behind the scenes weighing and measuring every calorie.

The goal was tricking him into eating, to keep him gaining weight even if it was just ounces. While Justin napped every day to the original Cars movie, I researched therapists, read online, and tried to get approval for him to see a therapist for an evaluation.

I received push back from the county agency because they thought he was too young. All the better now rather than later. I pretty much put my reputation on the line to finally get the approval, but therapy would prove to be a win for Justin and our family.

It wasn’t always an easy ride, and every meal wasn’t a win. Justin was slow to warm to me, and didn’t like to be touched. He experienced sensory overload, and would run around with wild abandon. Many days getting him to eat required a lot of patience.

I learned he LOVED pancakes, calling them “ha ha’s.” His doctor prescribed several cans of Pediasure a day, and he did drink SOME Pediasure, but winning with Justin didn’t end with him gaining weight, it ended when the hunger strike was over.

The hunger strike would never be over until Justin knew where he would be growing up. The unknowing was so painfully difficult for him, something I could clearly see but knew he couldn’t express.

After six weeks, my partner and I drove 90 minutes to a Gastroenterologist at the closest children’s hospital. During the appointment, Justin weighed 22 lbs, 7 oz. He had just celebrated his third birthday. It was a win, a slow gain, but not the weight gain everyone was hoping.

The doctor ordered several tests: bloodwork, MRI with sedation, xrays, endoscopies, and referrals for several other specialists. The hospital took so much blood that Justin got a severe rashes on both arms.

I spoke with the doctor by phone a week later, after a few tests came back normal, about my theory that this was a hunger strike. The doctor agreed, but indicated that Justin must be thoroughly tested regardless as it was the best case for the court to know how important permanency was for Justin.

He said, “It’s important for us to do all these tests, however uncomfortable, so the county can build a good case.” As his foster mother I was powerless to say no, my job was to drive him to all the testing, hold his hand in the appointment, and tell him how sorry I was whenever a test was painful. In the end, the doctors never found anything medically wrong with him.

Justin continued to gain weight, and never needed a g-tube to eat. He also ended up finding permanency. He was adopted a year and a half later, weighing only 30 lbs, but with a clear smile. He got to pick his new middle name.

He continued therapy because the abuse and trauma he experienced, along with multiple foster moves, left him permanently struggling with his anxiety. He is now 15, and despite being 5’8, he still only weighs 105 lbs. He still doesn’t eat enough, but has the words to tell me his anxiety is keeping him from eating.

He is a kind, compassionate, and friendly young man who gets excellent grades. His story is really a huge success. He was lucky to be adopted at such a young age, and receive treatment while still a toddler. Love is not enough for children who experience debilitating abuse and trauma.

Justin needed strong therapeutic support and consistency to help him become the best version of himself, but he was worth every second.