If you are experiencing mealtime struggles with your child, you are not alone – in fact 2/3 to 1/2 of all parents report at least 1 mealtime problem behavior that they experience with their child. Feeding your child can be stressful; after all, it’s one of a parent’s primary responsibilities to ensure that their child gets enough of the right nutrition to grow and thrive. When a child can not or will not EAT, it can become beyond frustrating.
Parents of children with special needs know feeding struggles all too well – did you know that 80% of children with special needs experience some kind of feeding difficulty? Feeding problems can range from physical swallowing difficulties (dysphasia) to picky eating and food refusals. These feeding issues can begin at birth or arise when a child is challenged to eat new foods. Almost always, a child’s feeding issues are influenced by many factors which may include medical diagnoses, sensory processing deficits, and environmental factors such as socioeconomic status, family structure, and parental stress.
While the answer to any feeding difficulty is never easy, here are some simple tips to help establish healthy eating habits in children:
- Establish a family mealtime routine. The power of a family mealtime routine is amazing; kids thrive on the social interactions that occur during family mealtime and they get to see great modeling of eating and enjoying food. The commitment of family mealtimes can seem daunting– take baby steps – commit to dinner once a week, then at least one meal a day, and then see how close you can get to regular family meals. Remember family mealtime can be just a mom and a child or the entire family, the point is is that the child has someone to watch who is eating the same foodat the same time as them.
- Eliminate distractions. UNPLUG at mealtimes. How can a child watch and learn how you eat when they are watching the television? or playing with a toy, or coloring… you get it, get rid of everything that is distracting.
- Foster INDEPENDENCE. It may be messy – scratch that – it WILL be messy at first but children are more motivated to try new foods when they can do it themselves. Not only do children feel a sense of pride when they can feed themselves, they also can prepare their body to accept the food.
- Offer a variety of foods, ALL of the time. Kids are fickle, what they may reject one time they may try again another time, but the opportunity HASto be presented. Often parents report that they have offered their children a variety of foods but stopped because their child always rejects new food. Don’t give up. See this helpful article: http://thefeedingdoctor.com/what-it-really-means-to-offer-food/ …and on that note, see number 5…
- Change your LANGUAGE. Move away from using the work “like” aka “you don’t like it?” to “you’re not used to it.”For typical children and adults, it can take up to 10 presentations of a new food before we are “used to the food.” When a child says “I don’t like it” remind them that they are just “not used to it yet.”
- Portion, portion, portions. Portion size seems to be a general problem in our culture but it is especially true when it comes to those with eating difficulties. There are three good rules of thumb when it comes to portions: (1) offer a grain, protein, and vegetable/fruit at every meal (2) offer a tablespoon of each food group per year of age – for example, offer a two year old two tablespoons of each food group (if they finish that and ask for more, it’s ok to give them more) and (3) for items difficult to measure, remember that a 2 year old eats approximately 1/4 of an adult serving.
- KID food = MYTH. Chicken nuggets, hot dogs, macaroni and cheese = kid food, right? Actually, there really is no such thing as kid friendly food, kids can and will eat everything. Did you know that children have the potential to eat up to 100-200 different kinds of healthy foods by the time they are one year old? It’s just that we don’t often present them with the variety of foods needed to build that huge repertoire. So forget the tater tots and applesauce and give your child a taste of what you are eating, you may be suprised!
- Share the RESPONSIBILITY. While sometimes the last thing parents want to hear about mealtime is that they need to relinquish control, that’s exactly what they need to do. Mealtimes are a shared responsibility amongst caregiver and child. It is the parents’ responsibility to (a) establish structure around mealtimes, (b) dictate when mealtimes occur and (c) prepare and offer the food. It is the child’s responsibility to (a) eat and (b) to determine how much they eat.
- Eliminate grazing. As a general rule, children should eat three meals and 2 snacks per day with approximately 2.5-3 hours between each to ensure optimal intake. Parents may think that their child eats more when they graze (i.e. snack here and there throughout the day) but in fact research shows, children who graze eat a significant amount of less caloriesthan children who sit for meals. And speaking of sitting, children should SITwhen they are eating for no more or less than 25-30 minutes for meals and 10-15 minutes for snacks to ensure adequate time for appropriate intake. And remember, juice and milk should only be offered at mealtimes; offering high calorie beverages throughout the day may dampen hunger and decrease intake of healthy foods.
- Seek HELP! Feeding issues, problems and behaviors cause enormous amounts of stress upon families and caregiver/child interactions. If you feel like you are stuck, seek help from a feeding specialist. You and your child may benefit from feeding therapy if your child:
- is being tube fed
- exhibits extreme rigidity around food preferences
- gags, vomits or chokes when eating
- demonstrates a difficult time when transitioning from breast/bottle milk to solid foods or from purees to chewable foods
- limited diet (eats the same foods all the time or food of the same color, texture)
- is demonstrating weight loss or difficulty gaining weight
- refuses to eat
- eats solids but refuses to drink fluids