I am asked to provide advice on HOW to get kids to eat or to end food fights between parents and children. The request might come up when a parent worries that a child with ADHD may not eat as much if they are on stimulant medications or if a child had a hard time growing and feeding as an infant. More often than not, it might be more the typical toddler challenges when meals are no longer fun and parents are feeling like short order cooks.
The perspective I take is not because I am an expert in nutrition, growth or hormonal issues. As a behavioral pediatrician, I like to think about any behavior concern in terms of positive parent-child interactions and behavior change. While feeding (or attempting to feed) a child, it is important to look at the parent-child interaction during those problem scenarios.
We know that when children have selective eating patterns (AKA ‘picky eaters’) it can cause tremendous stress in the family and can lead to behavioral problems. However, it is quite normal for toddlers to be picky and only want certain foods that tend to be starchy or non-colorful (does mac n’ cheese & chicken nuggets sound familiar?). It is important for the pediatrician to determine, after careful questioning and review of growth and development, whether there are specific medical reasons for a child’s limited diet versus a long-standing (and stressful) pattern of food refusal. The pediatrician will also consider whether the child has any swallow coordination problems that sometimes can show up as choking or gagging with foods. They will plot children on growth charts to see how the child has been growing over time, talk with the parent to ensure no problems with loose stools or vomiting and rule out other medical causes like food allergies or celiac disease.
In general, children have the ability to self-regulate and if parents provide regularly scheduled healthy meals, children who may not eat well during one meal will have future events to make it up. But let’s face it, it doesn’t make it any less stressful.
Food problems can be thought of as falling into 3 different types:
- eating too little at meal time
- eating only limited types of food
- fear of eating
RELATED LINK: How to Please Picky Eaters (Healthychildren.org)
Children with autism are perhaps another type of picky eater with a very restrictive palate that usually requires a team-based approach for treatment. See this post on, Mealtime and Children on the Autism Spectrum: Beyond Picky, Fussy and Fads.
Keep meals fun and involve children in as much of the grocery shopping, food prep and meal serving as possible. Have them make and decorate place cards for everyone at the table. Have them help plan the menu.
When you are at the grocery, give the child a list of their own and have them help find the foods. Talk about how the food looks (color), feels (texture or weight) and smells. When introducing foods, use fun dipping sauces or cut food into interesting shapes. Use toothpicks to spear finger foods or serve little tasting dishes.
Most of all, try not to despair. Keep things light at meal times. We want children to look forward to meals as happy times to reconnect with family members and to create memories and traditions.
Remember 15 & 30: it takes up to FIFTEEN times of offering new foods before children accept them and don’t make your child sit longer than THIRTY minutes at the dinner table. Allow children to leave the table & come back when ready (but with the message of, “Ok, I’ll save this for you and you can try again later when you’re hungry”).
If you’re worried about weight loss: Offer healthy calorie dense foods that are NOT low-fat or non-fat. Don’t skimp on butter.
DOWNLOAD a one-page handout of these tips that I designed to use with families that have eating & feeding challenges when major medical issues are NOT a concern.
Help me continue to improve! Please feel free to reach out to me (tweet, email or reply to this post) with comments or reactions to the handout!