What topic, short of possibly children’s sleep, ever generates as much conversation and opinion as the topic of children’s eating habits.  What is your child eating? Is it enough? Is it always the same three foods? How many snacks? How much sugar? How much salt? These questions can feel overwhelming and judging as you face a toddler who as of today eats only spaghetti served in perfectly parallel lines.  However, you are not alone! This problem is wide-spread, with research documenting as high as 50 percent of parents describing their preschoolers as picky eaters[i].

Although parents often blame themselves when a child stops eating the wide variety of foods they ate as an infant, there is a developmental explanation for the “picky eater” phenomenon.  Children grow very rapidly until the age of two, which often means that they have great appetites and will eat anything.  However as they cross into their third year, the battles often begin. Several factors come together to cause this to happen.  First, young children naturally distrust new food and have a preference for sweet food over sour or bitter food. This was evolutionary adaptive as it helped children of our ancestors avoid substances that may be poisonous.   Also, because after the age of two the children’s growth slows down, children’s appetites often decrease as well, which looks to the parent as the child has “stopped eating.”  To exacerbate this problem, children may go on “food jags,” which are short periods of time when they actually refuse to eat.

Nevertheless, the factor that likely causes most of the parents’ problems is the fact that this is when the child first develops a sense of autonomy.   What results when this milestone combines with the factors discussed above is that a child who is less interested in food to begin with, begins to exercise his newly- developed autonomy to reject all but the most familiar and attractive foods.  The parent, on the other hand, who is already worried about the child eating less, is not able to see the above pattern for what it is, and instead interprets this age-appropriate behavior as disobedience, and this is what often leads to the battles over food.   Helping parents understand that this problem is temporary and can be mediated by parents’ action may help them keep focused on the long-term goal.  That goal should be establishing healthy eating patterns rather than the short term goal of making sure the child something at a particular meal or that the child obeys the parents’ demand to eat.  This is critical because when parents are focused on nothing more than getting the child to eat something at every meal, they establish a host of unhealthy eating patterns and these, unlike the age-appropriate resistance which passes on its own, become very difficult to break later, especially since much of a child’s eating habits are set by the age of five[ii].

Before we talk about strategies for widening a child’s repertoire of foods, let’s talk about some of the problems that may arise.  The label of “picky eater” may make parents feel resigned as they may interpret this as something their child “is” rather than something he is “going through.”  Therefore, instead of making eating habits a taught skill like anything else, parents give in and give the child the food they want.  However, these same parents are unlikely to use strategy in the context of other refusals.  For example, if a child refuses to brush their teeth, a parent rarely thinks that the child is just a “non-tooth-brusher” and they should just be allowed to remain that way.  At that point, the parents will develop strategies for encouraging the child to brush their teeth.

The opposite response, but equally detrimental, is if the parents respond to a child’s food refusal as disobedience and punish it.  This is problematic because now parents are punishing a developmental milestone instead of helping the child overcome this stage.  For instance, when a child reaches the stage of having stranger anxiety, the parents are unlikely to punish the child for not wanting to go to strangers but are likely to model and coach the child in the fact that unfamiliar people are not dangerous.  Here again, the more likely parental response is to help the child learn how to function in their new reality.

In developing a plan for overcoming picking eating behaviors, it is important to remember that for many parents reading this, the problem already exists and the child has likely been eating the restricted diet for some time.  Thus, it would be unfair to expect the child to change overnight, so it is important to start slowly and focus on introducing the positive elements of a broader diet.  Explain to the child, even a toddler, that starting today you are going to try new foods because that is a healthy way for them to eat.  Assuming that the child refuses the food, the parents can acknowledge the child’s autonomy by allowing the child ways to amend the request. For example, the child may be allowed to dictate for change, such as how much they eat, eating it without sauce or the opposite eating it with something familiar like ketchup.  Sometimes, it may be necessary to start even slower and just have the child keep the new food on their plate without actually eating it.  The parents need to be willing to accept the steps towards eating the food as progress.  This is especially critical as research has demonstrated that just pressuring a child to eat new foods may cause a dislike for that food[iii].   Thus, the negotiation needs to be more subtle and in the steps that the child can accept.  Moreover, a child needs 8 to 15 exposures to get used to a taste, so the child saying that she does not like the food does not mean that this food should not be reintroduced again.  Keep in mind that the benefit of trying the food exists even if the amount tasted does not really count as having “eaten” it[iv].

In addition to tasting the food several times, and probably even before the “trying” happens, children benefit from being exposed to the food many times in a short period of time in a very neutral environment.  This means that if the child sees the parent eating broccoli several times per month, they become very familiar with existence of broccoli as a thing that people regularly eat.  This applies both to healthy foods such as fruits and vegetables and unhealthy snacks.  Thus, watching a parent eat chips several times a month similarly teaches the child that chips is something that people regularly eat.

One way to expose the child to the foods that the parents eat is for the family to eat together.  Parents are often told that family meals are critical, not only for the purposes of food exposure, but also for the child’s development in general.  Although this may be true, research has also found that the benefit of the family meal may have been over exaggerated and that the family meal is not necessarily a positive experience.  This again relates to the child’s sense of autonomy, as a family meal gives the child a great opportunity to control what happens at the meal by refusing to eat the food.  Such an action on the part of the child shifts the focus from either a neutral situation for food exposure or from a pleasant social interaction to a situation in which the parents are trying to assert authority and make children comply.   The research demonstrated that if the family meal is positive and viewed by the mother as her opportunity to socialize with the children (the research only looked at mothers), then such family meals help children develop a better diet. However, if the family meal is negative, then the cons may outweigh the pros.  In such situations, what is important is not that the children eat with the parents, but that they eat the same food as their parents.

Moreover, not only should everyone in the family be eating the same food but there should be only one set of rules that govern how the family eats.  For example, if there is more than one child in the family and one child is overweight and the other one is not, there should be a consistent rule about having second portions that applies to everyone regardless of weight, which teaches the child that there is a consistent healthy way of eating.  Similarly, it is important that there be a rule about where children eat, as it has also been found that children who eat in a room that is traditionally meant for eating, namely the kitchen or the dining room, tend to have better eating habits[v].

When a family begins to introduce these changes into the family’s eating culture, it is important to be thoughtful about the order of the changes.  For example, if the children were allowed to eat nothing but pasta on the couch in the living room for the past year, and now they have to try a piece of broccoli with every dinner and the dinner is now at the kitchen table, the parents should expect there to be resistance to both the new food and the change in location Therefore, it is probably better to introduce the idea of eating in the kitchen first, and then introduce the new foods, so that the new foods do not get blamed for also causing the environmental changes.  It is also helpful to teach children food vocabulary so that they can explain why they like or don’t like a particular item.  It is helpful to teach words related to texture, to taste and to smell.

Children can also be enticed to eat new foods through a reward system, where they get a non-food prize or a token that can be exchanged for a prize every time they try a new food.  Also, the child can be enticed to try the food by making it look attractive, such as making a house shape out of celery sticks.  The child does not necessarily have to be convinced of the merit of trying new foods, he just has to actually try it and the motivation behind it is less relevant. Moreover, the shift can be attempted slowly where the parent builds on a food that the child already likes.  For example, if the child likes white pasta, make  whole wheat pasta but get it in dinosaur shapes.

If there is a conflict over food at every meal this is likely to color the child’s developing food habits.  However, parents also cannot give in to the child’s refusal and just feed them what they want.  Thus, parents have the difficult job of balancing helping a child develop healthy eating habits with doing it in a way that they are fighting the parents’ attempts. Hopefully this blog helps.

__________________________________________________________________________________________[i] Walton, Kuczynski, Haycraft, Breen and Haines (2017) Time to Re-Think Picky Eating? A Relational Approach to Understanding Picky Eating. International Journal of Behavioral Nutrition and Physical Activity. 14:62

[ii] Chan, Magarey & Daniels (2011) Maternal Feeding Practices and Feeding Behaviors of Australian Children Aged 12-36 Months. Maternal Child Health Journal, 15, 1363-1371.

[iii] Walton et. al. (2017)

[iv] Chan, Magarey & Daniels (2011)

[v] Skafida (2013) The Family Meal Panacea: Exploring How Different Aspects of Family Meal Occurrence, Meal Habits and Meal Enjoyment Relate to Young Children’s Diets. Sociology of Health and Illness, 35 (6), 906-923.

 

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