My daughter is sitting in a child-sized chair at a child-sized table spread with plastic plates and bowls, spoons and forks. The furniture dwarfs her. There are dark circles like thumbprints under her eyes, and she swivels her head to avoid the food that the feeding therapist is aiming expertly at her mouth. She claps a hand over her lips to keep out the dreaded unfamiliar food — a pickle. When she's told that she's not allowed to cover her mouth, she tries distraction, the technique that is usually so effective with gullible grown-ups. "Hey!" she says brightly, with narrowed eyes, "Wet's count to ten! One, two, thwee…"

The feeding therapist is not gullible like the average grown-up. She does not count to ten, and she continues to calmly but firmly insist that the pickle should be eaten. Eventually she breaches those defenses. A single bite of pickle enters Miriam's mouth. Miriam swallows it entirely by accident, and shudders in horror, a tremor that resonates across the length of her body.

It is the first bite of a vegetable that Miriam has ever eaten in her life. She is a few weeks shy of her third birthday. She weighs just over nineteen pounds. On the initial intake evaluation, the therapist notes, "She is the weight of an average 10 month old."

By the time we get to that appointment, we have been living with "failure to thrive" hanging over our heads for almost a full year. We have seen specialists who threw around terrifying, fatal possibilities; we've gone for tests that turn up nothing, no organic reason why the plotted dots on her growth chart sketch a flat line far below the happy curves of normal children. Normal children begin to look to us like giants, aliens, visitors from an exotic land. In our house, the scale never budges. There is no need for new clothes, new shoes, new carseats. The old ones still fit just as well as they had the year before, and the year before that. Every month, her peers get a little bigger while she stays the same. Every month we get farther from normal, far enough that we start attracting attention in the street. We carry Miriam in our arms like an infant; strangers and acquaintances stop and stare when this apparent baby opens her mouth to reveal the verbal skills of a child twice her actual age. We console ourselves that at least her brain is developing, even if her body seems frozen in infancy. But it is cold comfort. There is always another round of doctors, nutritionists, stern looks and long lists of high-calorie foods. How many times do we have to explain that we can't get her to eat any of those high-calorie foods? She eats nothing but dry cereal, plain bread, pasta with a scant spoonful of grated parmesan cheese and a dot of sauce, and an occasional spoonful of yogurt or ice cream. Mashed avocado, said one professional firmly, as if handing us the Secret to Life. Avocado? She had to be kidding us. Miriam asks for rice cakes, plain. The day we persuaded her to eat potato chips, we were triumphant. Here, at last, was a fried food, something with calories! The nutritionist shook her head. "Chips?" she said disparagingly. "That's diet food."

Diet food. We ply her with ice cream for breakfast, cupcakes for lunch. She takes a single, tiny bite and pushes the plate away. We offer her sippy cups filled with whole milk and heavy cream. She takes a single sip and announces that she is done. She begs for water, dry bread, a handful of Cheerios. We can measure her total food intake in tablespoons, and she'd sooner put her head in a lion's mouth than allow a vitamin into hers. Every day, every meal, every snack, we struggle to get her to eat and drink enough calories to sustain basic life processes. We worry every moment, and especially at the table. The act of eating with the family becomes a toxic combination of stress and accommodation, boiled up in a pasta pot. Pasta is the only thing she will accept for dinner. My husband and son adore pasta; it is their favorite food, and the food they crave most in times of stress. Times of stress, like, for example, dinner, when we are most starkly confronted with our inability to keep our daughter from starving herself. We have pasta every night for months. Everyone else in the family accepts this state of affairs, but, as the cook and the only person in the family who has any desire to eat even a minimally varied diet, I am trapped between the pasta pot and the starving place. If anything besides pasta is on the menu, Miriam refuses to eat, Sammy argues like a lawyer, and my husband gets so worried by Miriam's refusal to eat that he can't eat, either. I lose my appetite, too. What on earth is the point of eating yet another bowl of pasta, anyway? I take to reading cookbooks like other people read escapist fiction. Cookbooks, food blogs, the collected works of M.F.K. Fisher. I dream about spice racks and exotic foods. When I find myself muttering under my breath at mealtimes about running off to join the French Foreign Legion, I start cooking two separate meals, one for me and one for the rest of the family. But it's only twice as much work, plus the same dangerous levels of frustration and worry. The scale holds steady. I have nightmares that Miriam is shrinking, getting smaller and smaller until she finally disappears.

That first bite of pickle marks the turning point. We have, at long last, a diagnosis: a feeding disorder with both sensory components and behavioral issues. Miriam cannot tolerate the sensation of most foods in her mouth, and has evolved a whole host of behaviors cleverly designed to avoid the intolerable — by manipulating the people who feed her. (Those gullible people. Us.) Finally we have a treatment plan and someone to help us make it work. To start, Miriam needs to learn to register basic feelings of hunger and satiety. She has never in her whole life mentioned being hungry. The pediatric gastroenterologist had prescribed an appetite stimulant, but we have not been able to get her to take it with any consistency. The first order of business, then, is to teach Miriam to take her medication without resistance. The technique that works best on our little bibliophile is the first one the therapist tries. We read a book; Miriam has to take a sip before we will turn the page. In a week, she has learned to take her medication easily. Her appetite increases, and she sometimes comes to us in wonder, saying, "I'm hungry!" We move on to our next goal: getting her to drink measurable amounts of a nutritional beverage. We buy the little plastic bottles by the case and watch them disappear slowly, one tiny sip at a time. I start the ritual: a page, a sip, another page. Eventually my husband takes over. Some days it seems like he spends all of his waking hours sitting on the couch, Miriam on his lap, a stack of picture books at his side. A page. A sip. A page. A sip.

Her weight begins to creep upward. We are jubilant, but the hard work is only beginning. To overcome her sensory discomfort, she spends her weekly therapy sessions making crafts with messy foods, getting accustomed to dirty hands, and trying the tiniest bites of unfamiliar foods. Then she spends time working on foods we bring from home. I bring things I could plausibly serve her for lunch. It seems like the most pliable meal: she's genuinely not hungry for breakfast, and dinner has so many players at the table, reinforcing old patterns. At lunch it's just her and me. I bring crackers spread with hummus to her therapy sessions for what seems like months before it finally happens: we are sitting at the kitchen table going over her choices for lunch. "You could have hummus crackers," I say neutrally, like I do every day. But for once she does not wrinkle her nose and threaten a tantrum in response. "Okay," she says. "I'll have two." I hide behind my hair while I'm spreading the hummus on the crackers. I don't want her to see me cry.

There are no easy victories. We successfully add a new food to the rotation every month or two — but how many thousands of different things are there to eat in this world? And, because nothing is ever simple, some of the foods that Miriam takes to most enthusiastically are ones that my son (who has always managed a respectable upward trend on the growth charts) finds so difficult to consider that he gags while bringing the fork to his lips. Sensory issues run in families, and we are the proof. He starts therapy, too. Slowly we add new foods to his lunch box. As he gets more adventurous, we get better able to address his sister's eating behaviors, the manipulation at the dinner table, the ways in which we have became active participants in Miriam's quest to wield absolute control over not only her own eating, but ours, too. We all need to learn that the adults set the rules about what's on the menu every night. But we can only do that now that we have a little faith that she won't starve herself to death if we don't cater to her every whim. We cautiously try new foods. Quesadillas. Rice. Asian noodles. Black beans. Carrots and celery. Sweet potato fries. Lentil soup. I start reading cookbooks again, but not for idle fantasizing. I'm looking for recipes that might be worth a try.

It is one year since we started feeding therapy, almost to the day. In the morning, Miriam goes to see the pediatric gastroenterologist, where she is weighed and measured and plotted, landing on the growth chart within the "normal" range for the first time since she was nine months old. That night at the dinner table, she sits down to a plate of rice, marinated tofu, sauteed onions and spinach. She eats all the rice, and a cube of tofu. She eats all the onions and asks for more. She at least tastes the spinach before rejecting it. It is a meal we could not have dreamed of a year ago.

After she is done, she looks askance at a colander filled with cherries. She demands that her daddy try one, and he does, gingerly. (Sensory issues run in families.) "Now I will try one," she announces. I pit a cherry with my thumbnail and hand it to her. She holds it to her lips; she licks it; she parts her teeth and takes a careful bite. She swallows. She smiles. "These are SO GOOD," she crows. "I can't stop eating them!"

I pit 15 cherries for her before she has finally had enough. She goes off to drink her Pediasure on the couch with her daddy and a stack of books. As I am cleaning up the rest of the dinner dishes at the sink, I hide behind my hair again. This has been the hardest thing I've ever done, the hardest thing she's ever done, the hardest thing we've ever done as a family. But we are doing it. Every meal. Every snack. Every day.