I had a conversation with a new mom friend yesterday. Upon finding out what I do, she gave me a quick synopsis of her daughter's eating habits, including several earlier strategies "to get her to eat," such as following her everywhere with a plate of food. At the end, she proudly shared her latest solution: "She only gets a dessert if she finishes her plate." Then she looked at me triumphantly.
After all, her child was eating, wasn't she? So her strategy was working, right? She also added that she was somewhat worried that recently her daughter started asking how many bites she needed to eat in order to get a dessert, but it was no biggie, was it?
And then, it dawned upon me. For every parent who thinks they have a feeding problem there must be dozens who think that what they are doing is working just fine. The child is getting the food one way or another. However, alongside the plate of chicken and broccoli, these children also may be getting a portion of bribing with dessert, coercion, restriction, unlimited grazing and a "whatever else works for now" attitude.
Seeing this makes me want to jump on the nearest roof and shout: "STOP!" All these strategies used by parents out of love, desperation and lack of trust do not work, and may increase a child's chances of developing bad habits or eating disorders later in life. I know because, in addition to the the hundreds of research articles I've read on long-term effects of feeding mistakes, I have encountered dozens of stubborn cases in my private practice.
For example, the cheerful 5-year-old girl who started hiding bread in her bedroom and sneaking into the kitchen before her parents were awake for sugary cereal. The doctor had pointed out a year earlier that her parents needed to "watch her diet," so they were restricting most sweets and carbohydrates in the past few months. And there is the 7-year-old boy who only eats vegetables that have been ground into meat patties. Although he knows vegetables are hidden in the food he eats, nothing in the world seems to make him willing to try vegetables in their natural form. And there is the 8-year-old boy who has never joined his family for a Thanksgiving or Christmas meal. Being around so many new foods he may be required to try causes him such anxiety he gets nauseous and vomits.
It's important to recognize a feeding problem and act to fix it, getting help along the way if needed. Here are the signs parents can use to recognize a feeding problem.
- Mealtimes are full of negotiations about dessert, number of bites and second helpings.
- Your child seems preoccupied with certain foods and tends to sneak them when she has a chance.
- Your child is becoming increasingly anxious around new foods.
- Your child has not tried anything new for months.
- Your child is rarely hungry for meals, but is frequently hungry for snacks.
- You exhaust yourself to get your child eat certain foods or amounts.
- You feel stressed out by the feeding situation and do not enjoy mealtimes with your child.
Below is a list of what you can do to improve the feeding environment in your home. I wish it were as simple as "three easy steps," but, unfortunately, it is not always so straightforward.
- Talk to your doctor to rule out gastrointestinal problems, food allergies, oral motor delays and sensory issues. An assessment by a team of health professionals may be required in complex cases.
- Read all you can on Division of Responsibility (DOR) by Ellyn Satter. It is a research-based feeding strategy that has been shown to work with kids of all ages, temperaments and degrees of feeding problems.
- In accordance with the Division of Responsibility, focus on mealtime structure, plan family meals with a mix of acceptable and less liked foods, and trust your child to take care of his eating by letting him choose what and how much he eats.
- If dessert has been treated as a reward for good eating for a while, neutralize its appeal by serving a very small portion of it with the meal, not after.
- Be mindful that not all children (and very few toddlers) are good candidates for the one-bite rule, which states you must try at least one bite of every food on your plate. Focus on the quality of the time you spend at a table together instead of counting bites and begging to try something new.
Feeding problems are not always obvious because we are so used to focusing on what the child is eating rather than on how they are eating it. By recognizing the signs of problems, you can avoid long-term complications of an ineffective feeding strategy and help your child grow into a happy eater.