Apr 13 2017 By Dr. Carole Chidiac, M.D Family Medicine Specialist, Eating Disorders Practitioner
Picky eating is becoming a common problem in children as soon as they start solid food and
if not addressed properly, it can persist to late teenage years and even adulthood.
Severe forms of picky eating specifically what is recognized now as ARFID (Avoidant/Restrictive Food Intake Disorder), will affect the child growth, health and social and psychological wellbeing.
Feeding is an important aspect of parenting, unfortunately, when it comes to feeding common sense is not common anymore. Feeding practice to this day is still negative and controlling and leads to struggle, anxiety, guilt and shame. Social trends and attitudes, parents own issues with foods and work demands make it hard to be in sync with our children’s needs and to nurture them properly.
A toddler has to learn how to eat in a calm encouraging environment without forcing or bribing, not only to learn how to feed himself or herself but to relegate eating to its proper place as one of life’s great pleasures. To be successful at eating, help them be successful with other tasks as well. Children absolutely depend on family meals to do a good job with their eating. A pleasant family meal is the best classroom when it comes to learning how to eat and unfortunately family meals are eroding.
Ellyn Satter, a renowned paediatric dietician and therapist, first described the revolutionary “division of responsibility” concept. It’s a simple and logical concept that was proven to be effective by multiple studies over three decades. Despite all this strong evidence, and the common sense and wisdom behind it, it is still not universally applied and sometimes even feared by parents and health care professionals alike.
Fundamental to parents’ jobs is to take responsibility of what and when to feed their kids and trusting them to determine how much and whether to eat from what parents provide. When parents do their jobs with feeding, children do their jobs with eating:
Parents’ feeding jobs are:
- Choose and prepare the food.
- Provide regular meals and snacks.
- Make eating times pleasant.
- Step-by-step, show children by example how to behave at family mealtime.
- Be considerate of children’s lack of food experience without catering to likes and dislikes.
- Not let children have food and beverages (except for water) between meal and snack times.
- Let children grow up to get bodies that are right for them.
Children’s eating jobs are:
- Children will eat.
- They will eat the amount they need.
- They will learn to eat the food their parents eat.
- They will grow predictably
- They will learn to behave well at mealtime
Mealtime with picky eater is always a stressful time for the whole family.
Natalia Stasenko and Adina Pearson, paediatric dieticians and founders of “feeding bytes” address the topic in a very scientific and practical way with their 5 simple words that will change the mealtime environment immediately. This is what they say in one of their articles.
We know and we've seen that the more pressure parents put on kids to eat or to eat more, the worse kids do with eating. And it goes the other way too...the more parents try to control their child's eating so they don't eat so much, the more kids become obsessed with eating. There's a whole body of research in parent child feeding dynamics that addresses how parents feed and the impact that has on their child's eating.
Most people usually focus on what to feed their children, what to try to get them to eat, and ignore how they are going about it. Not that 'what' is unimportant but the 'how' is usually what help parents turn things around in a positive way.
5 simple words will change your mealtime environment for better immediately!
"You don't have to eat." That's it. Say this to your child during any mealtime battle and watch the power struggle dissolve. You don't have anything to fight about any more!
You know the old saying "you can lead a horse to water, but you can't make him drink" – it applies to children and eating too. You can make your kid sit at the table but you can't make her eat!
Kids are born with an innate drive to eat enough to grow according to their genetic blueprint. They want to thrive. They want to grow. They want to eat. But, making them do it will lead to the opposite results. Pressure backfires.
When you say "you don't have to eat" or "you don't have to eat that," in response to their complaint, you dissolve the power struggle and in that moment there's no food fight anymore. But they can't be empty words. You have to mean it. Your actions must match your words.
Kids have to believe that the family table is a safe, pressure-free area. Eating under pressure or with anxiety over the food makes the experience into a bad one. So you can't fall back into the old habits of bribing, bargaining, begging, or micromanaging their bites. Once your child trusts that the family table is a place of peace and trust, your child is likely to listen to his own drive to eat enough and to learn to like new things. Once your toddler knows and believes that eating is no longer going to be an issue to fight over, you've won half the battle.
You can then require he sit at the table for 5 minutes because family meals are not just about eating, but about being together-family time.
Perhaps you're thinking "Oh my goodness. I don't know if I can do that."
"What if I tell my little one 'you don't have to eat' and they take it to heart and don't eat anything and they're hungry all the time? What if they really don't eat?"
To take care of this concern, we need to look at what's going on before or after the meal. Is your child grazing through most of the day? Maybe not having enough of a break between the last meal and this meal or the last snack and this meal? Maybe they're just not hungry?
It's not uncommon for toddlers to just kind of not be hungry by dinner time. They've eaten enough during the day even if it's been small amounts here and there, and they're done eating for the night or at that point.
Here are a few more possible reasons they do not eat their dinner. It might be too late and they might be just tired by dinner time. Just grumpy and tired and not ready to be relaxed enough to eat. Maybe they've got more wiggles and they need to run around more--they've been cooped up all day. Maybe there's something else going on and they just need some time and attention. Maybe they need some help transitioning to the table.
So we have to look at what's happening before the meal and what's going on after the meal to effectively troubleshoot.
Realistically, aside from a medical problem, kids will eat. They might skip one dinner here and there. But they won't skip meal after meal after meal.
Here are some other useful strategies to help your picky eater:
- Ignoring any bad behaviour at the table (including not eating) and praising positive behaviours (including taking a bite of a new food or just sitting at the table). The golden rule is to ignore what you want to go away and praise what you want to stay.
- Look for clues of why your child is behaving badly (too full, food aversion…) and ask him/her to give you the food or spit it in a napkin instead of spitting it on the floor.
- If your child refuses to sit on the table, try to explain clearly what you expect from him or her and how long he/she needs to be at the table for. Explain that your child is free to eat or not to eat and what he or she can do after the 5 to 10 minutes expected to be on the table; all in a matter of factly manner. Prepare your child few minutes in advance. Make the whole process fun (washing the hands, setting up the table, get fun plates and cups, sitting at the table, start the meal with a short song…) More importantly make staying with you at the table the best option, a fun option, a happy family time, the only way to be with you during this particular time…
- Be consistent, look your child in the eye, say it once (you’re the boss), be clear about your expectations, calmly, firmly, nicely.
- Sometimes a step forward requires a step backward. Take a week or two to eliminate pressure at mealtime by presenting food your child is comfortable with.
- Expose your child to different types of food by involving him or her in supermarket trips, meals preparation, meals serving and by having a good variety on the table, being during main meals or snacks.
- For severe picky eaters, offer new foods one at a time. Prepare the child by talking to him/her about it while serving it.
- If a new food is not successful after several trials, consider modifying it. But first, keep trying for 10 to 20 times.
- Recognize that some foods are more challenging than others and keep them for later in the process, like meat and vegetables.
- Give your child advance warning but not too long ahead: we are going to serve dinner in 5 minutes, we are going to try something new today, I would like you to try but you don’t have to eat it if you don’t like it.
- Give your child couple of choices (not too many) so you stay on track and you increase the chances that he or she eats something.
- Time meals and snacks wisely around the child activities but keep a structure.
- Make sure your little one is comfortable
- Shift the focus off your child at mealtime as much as possible
- Keep distraction to a minimum
- Stay consistent, be a role model, eat with your child, eat what your child is eating and ask for help when it becomes overwhelming
Health care professionals specialized in eating and feeding disorders can help you determine if your child has any medical, developmental, behavioural or sensory processing cause behind the picky eating. They can monitor the growth and rule out nutritional deficiencies and guide you through portions and choices appropriate to your child’s needs. In difficult cases, they can offer multiple strategies to overcome obstacles to introducing new foods and solutions to mealtime struggles.
<< Back to blogs