Feeding Fixes for your Toddler and Preschooler
DISCLAIMER: This information is NOT meant to apply to children with oral-motor or other medically- or physically-based feeding difficulties or disorders of sucking, biting, chewing, swallowing, or digesting, or for children where a thorough medical and developmental feeding evaluation is indicated by medical professionals or a speech-language pathologist. The information in this section is intended to address typical toddler/preschooler feeding issues.
Later in this book you will find “F.E.A.T.S.™ Techniques” for the teaching of many aspects of feeding (e.g., Giving Up the Bottle, Drinking From a Cup Independently, Using Utensils, etc.), but now it’s time to go over some general feeding information, and to address the most commonly asked questions about the behavioral aspects of feeding.
“FEEDING FACT FIASCO”
FACT 1: A child’s rate of growth decreases by about the 2nd birthday.
FACT 2: A child’s appetite accordingly decreases at about the 2nd birthday.
FACT 3: At about age 2, defiance/limit-testing is likely to increase.
Put these 3 FACTS together, and we have the possible making of a “Feeding Fiasco!”
We primarily eat for four reasons:
- NUTRITION (ask your pediatrician about giving your child a vitamin each day)
- GROWTH (ask your pediatrician about your child’s height, weight, and head circumference)
- PLEASURE (and a focal point for social interaction)
- ENERGY (a calorie is a unit of energy)
When deciding to address a behavioral issue related to a child’s feeding, it is important to understand which area needs to be improved for your child. For example, if a large child has poor nutrition, then a certain solution may be indicated, but if a small child has issues with growth, then a very different solution may be indicated.
20 BEST (& 10 WORST) FOODS for KIDS:
According to Mindy Hermann, R.D., Registered Dietician and Mom. The lists are ordered alphabetically (not nutritionally).
20 BEST: American cheese, baby carrots, baked potato, breakfast cereal, broccoli, cantaloupe, chocolate milk, eggs, frozen mixed vegetables, ground beef, ketchup, kiwi fruit, orange juice, parmesan
cheese, peanut butter, pizza, sweep potato, tortillas, whole wheat bread, and yogurt.
10 WORST: Chicken nuggets, chips, donuts, french-fries, fruit roll-ups, hot dogs, fruit flavored drinks, pre-packaged lunches, soda, toaster pastries.
Give realistic amounts of food.
A typical toddler portion is about 25% of an adult-sized portion.
Avoid foods that are choking hazards, or modify to make them safe (e.g., cut grapes into quarters; cut hot-dogs into tiny pieces, cook carrots until they are soft). Take an Infant/Toddler CPR course.
“GRAZING” verses “TRADITIONAL” FEEDING (3 MEALS & 2 SNACKS)
“Grazing” involves leaving nutritious food available frequently throughout the course of the day. The premise is that most children will eat when they are hungry (we adults would be better off if we did that!).
“Traditional Mealtime” involves sitting together and eating as a family. If you prefer the social aspects of mealtimes over “grazing”, begin by placing your child at the table in a developmentally appropriate chair.
There are plenty of strong opinions on this issue, but there is no overwhelming evidence to support either “Grazing” or “Traditional Mealtime”. Thus, “Grazing” or “Traditional Mealtime” is simply a personal choice.
“WHATEVER FLOATS YOUR BLOAT!”
Some children have decreased appetites due to high calorie intake from juice or milk. The American Academy of Pediatrics has issued a policy statement announcing. “Intake of fruit juice should be limited to 4 to 6 ounces per day for children 1 to 6 years old.” Ask your doctor about milk intake.
“HOW DO I GET MY CHILD TO REMAIN AT THE TABLE DURING MEALS?”
Here are some T.I.P.’s (Teaching, Ignoring, Punishing): If your child resists during mealtime, you can “Ignore” the protests and continue eating, “Teach” the appropriate meal-time response, or Punish (e.g., in a calm, matter-of-fact, but firm manner remove your child from the table and contain him/her in an area where there is nothing to do, until he/she is ready to join you at the table).
“HOW DO I GET MY CHILD TO TRY NEW FOODS?”
- “If at first you don’t succeed, try and try again (15 to 20 times, to be exact).” If a child rejects a food when it is first presented, it takes an average of 15 to 20 exposures to that food before the child will try it.
- “Presentation Pointers.” Place a very small amount of the food on the same Plate as some of your child’s preferred foods.
- “Act Matter-of-Fact.” Present the food without a making a big fanfare.
- “Do Not Use a Head-Lock.” Do not “force” your child to eat the new food.
- “Timing is Everything.” Present the food frequently over time (e.g., give the food 20 times over 2 months, not 20 times over 20 months).
“If I don’t feed my child exactly what he wants, he will never eat anything!”
What if you simply make nutritious food available for your child, and let him decide whether or not to eat (even at an age as young as 2!) This is a very sensitive topic, with no shortage of passionate opinion on all sides of the issue.
Let’s say that you work very hard to feed your child, and in spite of your efforts, he rejects most foods and eats only a very small range of his favorite, familiar, “comfort” foods. Now what? This is a point at which you have to make a crucial decision, but many parents simply act without even realizing that they can be empowered and actually exercise some decision making authority. Specifically, here are some philosophical beliefs and choices you have to make about kids and eating. Which do you believe? And which do you choose to implement? Hopefully your answers to these questions are the same!
The “Everything is OK right now” Approach
“Most kids are picky eaters, so I don’t stress over it. I am content to let my child eat just his favorite foods, because he eats an adequate variety of foods, and his favorite foods are not unhealthy.”
If you are in a good situation and of the belief that “Everything is OK”, then everything is indeed adequate/acceptable, and you will have “fight-free” meals, which is, of course, very nice. Also, you will be happy to know, that most pediatricians would probably condone your practice (although they may prescribe or recommend use of a vitamin to supplement your child’s nutrition).
The “I’m Powerless” Approach
“Most kids are picky eaters, so I don’t stress over it. I let my child eat whatever he wants.”
If you are in a situation and of the belief that “I am Powerless”, then you will indeed have “fight-free” meals, but you also run the risk of having a child who makes poor food choices as he grows up. For example, if at age 2 your child is allowed to choose to eat mainly brown things (e.g., chicken nuggets, french fries), rather than green things (e.g., broccoli, string beans), then when (if ever) will he begin to make healthy food choices? If you assume that your child will “someday” grow to like healthy foods, you may be right, but, of course, you could be wrong. And at what cost? Eating habits among adolescents and adults are quite difficult to change, and so much of our health depends on what we eat. Most adults who eat unhealthy started out as kids who also were allowed to eat unhealthy. I am always amazed at otherwise caring and proactive parents who are quick to “give-in” on this important area of their child’s health, and feed their child excessive amounts of junk food. Parents who would never dream of verbally insulting their child are quick to drive through a fast-food greasy spoon and, thereby, physically “insult” their child with chemical-laden, over-processed, unhealthy food.
The “Eating Something is Better than Nothing” Approach
“My child must eat every day, and, therefore, any type of calories are better than no calories. I don’t mind being a ‘short-order cook’ and preparing many different meals at my child’s insistence.”
If you take the “Eating Something is Better than Nothing” approach, then you can beg or coax your child to eat the new foods that you prepare, offer, prepare, offer, prepare, offer, etc., but based on your belief, you will be begging/coaxing from a position of weakness. You may achieve some degree of success, but be forewarned, people in general and children in particular are quite resistant to coaxing when it comes to feeding, and you will be in for a struggle that probably will have a limited pay-off.
Of course, the “Eating Something is Better than Nothing” approach is occasionally strongly indicated. For example, if a child is medically compromised, below the growth chart for weight, and at risk for being placed on a feeding tube, then giving that child anything and everything that he chooses to eat may be a great idea (for obvious reasons).
The “Mealtime is Madness” Approach
“I will do anything and everything I can to feed my child because it is my responsibility as a parent to get him to eat. Even if he resists, I will work hard to get him to try new foods through playful engagement”
If you take the “Mealtime is Madness” approach, you will be in for many lengthy meals, and the dynamic is ripe for frustration and resentment among both the child and the parent.
The “Welcome to the Family Meal” Approach
“It would be nice if my child ate every day, but ‘skipping a meal’ never killed anybody, and, therefore, I will make good food available, and if my child rejects it, he will eventually get hungry enough and eat what I give him. It is my parental responsibility to make healthy food available to my child, but it is my child’s responsibility to choose what to eat (even if he is as young as 2!)”
If you take the “Welcome to the Family-Meal” approach, you have the greatest chance of raising a child who eats a good variety of foods, is willing to try new foods, and makes healthy food choices. But let’s examine this statement closely. Notice that there is NO mention of “forcing” an undesirable food on a child. Second, notice that there is no “power struggle,” yet the parent indeed operates from a position of “strength” (and this “strength” is in no way abusive, threatening, or demeaning). There is no rejection of the child at mealtime, and, quite the opposite, the child is very much welcomed as part of the family during mealtime. Specifically, the family meal is served and the child is welcomed and encouraged to partake. Further, it should be noted that the family meal would not be an awful tasting exotic dish, but, rather, the family meal may include three reasonable choices (e.g., chicken, string beans, and rice), and the child is free to eat as much of what he chooses from the three foods offered in the meal. The trick to increasing your child’s variety and willingness to try new foods is to keep offering a wide variety of new and different foods over time. If your child skips a meal (or two or three), he will surely eventually get hungry enough and go on to eat one of the next healthy food choices that you offer. Here’s where this approach often falls apart. If your child goes on a “hunger strike,” what will you do? Many parents panic, quickly “give-in,” and offer him his “comfort foods” again. If you choose to implement “The Welcome to the Family-Meal” approach, first ask your pediatrician, “How long can I let my child go without eating?” or “How much weight can I allow my child to lose before I go back to giving him his comfort food?” (because, obviously, your child’s physical safety and well-being is by far the highest priority). Also, if you choose this approach it is critical to keep your child hydrated, but do so without allowing him to compensate for decreased food intake with increased caloric intake in the form of liquids (e.g., milk, juice).