Feeding children can be a complicated and stressful proposition for any family but couple that with a restricted diet due to food allergy and that could be enough to make even the most laid back parent turn into a drill sergeant that would make highly trained soldiers cry.
Why do kids sometimes refuse to eat? Why do they stop eating foods they claim to love? Why do they eat one thing one day and then the very next day decide that they hate that food?
If you ate a few bites of food and then experienced a pain so severe it took your breath away, would you be willing to eat that food again? How adventurous would you be in trying new foods?
And, what if these bad experiences with food are happening to you when you are only three years old with a limited vocabulary? How would you protect yourself? You would probably only eat a certain number of foods or foods that always looked the same.
So how do you feed a child on a restricted diet that just does not want to eat? Seek to understand the child’s perspective.
First, it is important to understand that food is a major control issue for all children starting at a very young age. Most children have many decisions made for them and the one decision that is theirs and theirs alone is what and how much to eat. Some children will let their parents or caregivers coerce them to eat while them others will push back and may push back hard.
Second, it is critical to understand that as a parent or caregiver, you cannot force feed a child. It WILL NOT work. Children have absolute and total control over what they put in their mouth and that is the way it should be. Even if you are not physically placing a spoon in a child’s mouth, using pressure language such as “take one more bite” or “no dessert until you finish your broccoli” is an attempt to force a child into eating against their will.
Regardless if your child has to avoid one food or ten foods, eating needs to be a relaxing experience for everyone. Sharing a meal with other people needs to be a time where children learn table manners, how to engage in conversation, how to sit still, and how to use a fork, among other life skills. Eating and learning to eat are life skills. It should not be a time that they are badgered, begged, or belittled into eating the food in front of them. If you find that mealtime in your home is incredibly stressful then it is time for a change.
The good news is that there is help--and change for the better is possible.
As an Associate in training with the Ellyn Satter Institute, I am a huge fan of Ellyn Satter’s work. Her techniques and recommendations for feeding children (and adults) can encourage food seeking instead of food avoidance behavior in children with food allergies.
The Ellyn Satter Institute (ESI) website is filled with an amazing amount of information to help you on your journey of adjusting how you approach food and feeding at your house. Until you have time to read one of Ellyn’s books and information on the ESI website, here are a few tips to get you started:
Division of Responsibility. As the parent or caregiver, you decide what food, when to eat, and where the eating will take place. It is up to the child to decide if and how much they will eat. Drop the drill sergeant act, take deep breaths, and let your child decide on their own what and how much they want to eat. For most children, skipping a meal will not cause immediate harm. You have provided the opportunity for the child to eat. It is up to the child to decide if they will utilize that opportunity; but take comfort knowing that as a parent or caregiver, your job is done.
Eat at a table without distractions. Turn off the screens (large and small) and make eating the main activity. Eating at a table is especially important in situations when cross contamination is a concern or if young children may try to take food off of someone else’s plate that may not be safe for them.
Serve the food family style. Let the child choose what foods they want on their plate. It is important that the child sees other family members eating the same food as them…even any hypoallergenic supplements that may be included in your child’s diet. If the child feels that their food is just like everyone else’s food, they may be more inclined to eat it.
Trust your child. If they say they do not want to eat a food do not pressure them. They may not be able to fully explain the feelings of worsening acid reflux, difficulty swallowing, or anxious feelings over trying something new.
How do you know if a child is just “going through a phase” or if they are truly becoming fearful of eating?
This is a more difficult question to answer. If you find that your child starts to self-restrict and refuses to eat foods that are safe and this lasts longer than a week, it may be time to have them evaluated by a professional that is specially trained in eating and feeding disturbances. This can be a speech therapist, an occupational therapist, or a registered dietitian. A family counselor or therapist may also be able to help identify how much anxiety your child is experiencing around food.
Continue to follow low-pressure techniques such as those recommended by the Ellyn Satter Institute. Provide emotional support by backing off, backing down, and letting your child have some control over their food and food choices. All children want control, but for those with health issues control is something that is harder for them to gain. They spend more time at the doctor’s office, less time at a friend’s house playing, and may feel like they have fewer privileges then a sibling without food allergies. Find ways to allow your child to have some control over their world. Control over other parts of their world will translate into better experiences at the dinner table.
A diet needs to have as much variety as possible in order for it to be a healthy, well balanced diet. If you find yourself in a situation where your child only wants to eat five foods (for example), consider adding a hypoallergenic supplement to fill the holes while variety is worked back into the diet. This is important to ensure that your child is getting all of the vitamins and minerals, protein, and calories they need to maintain a healthy immune system and grow.
All children, regardless of any medical conditions, go through different phases with their eating habits. As a parent or caregiver, listen to your instincts. Do not hesitate to have your child evaluated by a professional if you are concerned that they are developing a fear of food. It is a very real fear and do not assume that your child is simply trying to manipulate you into only getting the food he or she wants. Do not feel embarrassed if you find you need professional help to help your child through it. With the right help, your child will get past their fear or anxiety and everyone will be happier on the other side.
- Alexia Beauregard, MS, RD, CSP, LD
Our guest blog today comes from Alexia Beauregard. Alexia is a food allergy specialist dietitian who also specializes in eating and feeding disturbances and is based in Greenville, South Carolina. She loves working with food allergy families to help make food fun again. Alexia believes that eating should be one of the basic joys in life and wants everyone to be able to enjoy whatever foods they can. She works with families in an outpatient setting and also teaches college courses. Her professional organization memberships include the American Academy of Allergy, Asthma and Immunology (AAAAI), American College of Allergy, Asthma and Immunology (ACAAI), the Council for Pediatric Nutrition Professionals (CPNP), and the International Network for Diet and Nutrition in Allergy (INDANA). She speaks regularly at conferences for medical professionals and for families. You can find her on her Facebook page www.facebook.com/thrivewithfoodallergy or in her private practice--Seagrass Nutrition & Therapy (www.seagrassnutrition.com). Her three children and husband keep her pretty busy at home. The Beauregards love sailing, biking, hiking, and just being outside in general. As a family, they are very active in sea turtle conservation and believe in conservation through education on the importance of preserving marine life habitat. You can often find them enjoying the beaches of South Carolina.