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Sunday, January 16, 2011

Food failings and fussy eaters

Do you worry constantly about your weight? Do you automatically label some foods as 'bad' or 'good'? Do you reward yourself with food and then punish yourself by dieting? Do you eat when you're not hungry, just because it's mealtime? Do you overeat and then diet? Do you eat junk food and takeaways most of the time? Does this sound like an ad for Weight Watchers or Jenny Craig? 
Companies like that succeed because many, many women (and increasing numbers of men) answer yes to most of those questions without hesitation. 
What does that have to do with childcare?  Sadly, we also manage (albeit unconsciously) to teach our children these destructive behaviours- we pass on our attitudes to food as surely as we pass on our moral standards, political leanings and prejudices, by modelling them to our kids.  And childcare workers are just as guilty of this as mothers.
Before we talk any more about feeding children, let's get one thing straight. Scientific experimentation has shown that a baby who hasn't yet had attitudes and expectations forced upon him regarding food, but who can feed himself, will eat what his body needs, as much as he needs, when he needs it if given a range of foods to choose from. A tiny baby will naturally select a balanced diet.
Somewhere between this clean slate of babyhood and preschool age (the time when children start to demonstrate their grasp of the emotional power of making choices about food), we manage to teach this instinct out of them.  Suddenly we're stressing about fussy eaters who barely touch a thing, or kids who will only eat Nutella on white bread or pizza; we have children who nag us constantly for the junk food they see on TV and won't look at a piece of fruit; we have children who expect a bag of crisps if they're well-behaved on a shopping trip, and who tantrum when they're not allowed a piece of cake after misbehaving at a party. We worry ourselves sick over the child who won't eat her lunch, or frown at the child who's already well over a healthy weight at 6 but pop a sweet biscuit in her mouth to shut her up when she whines at us. Mealtime has become a battleground.
What happened?!?
What happened is that life got in the way.  We were in a hurry, we were tense and frazzled, we gave them too much choice or not enough, we modelled the wrong things, we repeated what our own parents did with us (or what our childcare centre's practices required), we were so busy pursuing our own damaged food agenda we didn't notice we were carrying the kids along with us. We're only human.
We probably started out okay, feeding our babies mashed vegies and stewed unsweetened fruit and then moving on to other soft, 'healthy' foods. At some stage our children started to show preferences for some foods over others, and perhaps we narrowed the field of what we offered instead of adding new options- because we were too busy, or too broke, or couldn't be bothered arguing with them, or just didn't think of any other options, or discovered that something sweet would stop them whining.  Maybe we wanted peace at our own meal times with our partner, and we didn't want to eat at 5pm, so we kept our baby's meals separate and lost the chance to model eating a wide range of foods. 
And we childcare workers were often way too busy to sit down and eat with the children, or maybe there wasn't enough food provided by a financially stretched centre for us to partake. Usually there was only one option on the menu, and it was a case of get the kids to eat it NOW or put up with them whining about hunger later. We have few disciplinary options available to us; why not use that rare and much adored party food as a reward and punishment?  All understandable.
But keep these patterns up, and before we know it we get a preschooler who will only eat Vegemite sandwiches and drink Coke, and refuses to do what we want unless he gets a cupcake. 
It's thoroughly understandable to fall into these traps, but they create both a stick for our backs and future problems for the child.  How do we avoid this scenario?
The moment we argue with a little baby about eating what's put in front of her, bribe her or reward her using food, or (god forbid) insist she eat everything on her plate even if she's not hungry any more, we're imposing our problem attitudes on her and telling her to ignore her body signals. Instead we need  to relax about food, be a bit creative about how we present it, and let our children listen to their natural instincts.  We need to take the stress out of meal times and treat our kids the way we'd like to be treated ourselves.
Would you like having food that's good for you but that you don't want right now forced into your mouth?  It might put you off that food for life.  And would you like to be forced or pressured into eating food that you hate the taste of?  Children are no different.  DON'T ARGUE with a child who doesn't want to eat what you just gave her; she's not going to starve while there's food in the building- she'll let you know when she needs something- and you may well building a lifelong hatred of that good food by insisting she eats it when she doesn't want it.  Chill, please!
If she clearly hasn't eaten enough during the day to sustain her, she may be ill; she may be distracted by something else she wants to do; her body may be telling her that this particular food is not good for her.  I used to babysit a child who suffered from extreme food refusal- he wouldn't eat anything that wasn't highly processed. It wasn't until he was in his teens that he was discovered to have a very rare bowel condition which meant that high-fibre food would collect in his intestines and go nowhere, causing pain and, ultimately, life-threatening blockages. Sometimes a child instinctively knows something that you don't.  If she doesn't want that food, don't force her.
As an adult, would you like someone to tell you you can't go to the coffee shop or pub with your friends until you eat a food you hate? (Come on- it's good for you! Yum yum!) No, you'd probably want to punch them in the face. Do you refuse yourself dessert or alcohol some days on the basis that you didn't eat the RDI of vegies with your meals? No? Well, don't do it to little kids. DON'T USE FOOD AS AN EMOTIONAL TOOL.
Food is body fuel; it can also be a social experience.  It is NOT a reward or a punishment until you make it so.  When you repeatedly give food an emotional dimension, you give the child a burden for life- much overeating is about rewarding ourselves in an inappropriate way (after years of our parents teaching us that this is normal). And those endless diets? We're punishing ourselves, just the way our parents did, for being naughty (ie for letting ourselves get fat).
Insisting that a child eats all the food on their plate encourages them to stop listening to their physical hunger signals.  Forbidding certain foods till other foods are eaten gives them no chance to listen to their instinctive body signals about what they need and teaches them exactly the opposite values to those you're trying to instil- you're inflating the desirability of the 'bad' food. Worse still, these strategies provide children with their first lessons in overeating.  Do you really want to teach them to eat when they're not hungry, and to eat food they don't actually want?  Overweight adults often eat both what they think they SHOULD eat and what they actually want (thus double-dosing themselves on kilojoules), and don't stop just because they're full, because that's what they were always forced to do as a child- fill themselves up with 'good food' before they got what they actually wanted. DON'T TELL CHILDREN HOW MUCH TO EAT, OR IN WHAT ORDER.
So much for the 'don't's- what DO we do instead?
To avoid narrowing down a child's diet in the first place, offer alternatives to the food they reject if it's an important part of their diet.  I'm a great believer in in the power of the number two; two is a great number of choices for a small child. A child confronted by half a dozen options will probably be overwhelmed.
For example, if they suddenly reject their usual glass of milk, offer them a choice of two other dairy products, or the same product prepared a different way. Cheese on toast, or custard?  Fruit yoghurt, or a glass of Milo? (Yes, Milo is chocolate- so what? It's also low GI and contains iron- don't impose over-general good food / bad food categories on kids if you don't want problems later on.)   
Also consider the possibility that this particular food may have started to make them feel ill- their body may be giving them an early warning sign that they're developing a sensitivity. Soy milk or rice milk?  You can still give choices.
Offering a choice gives a child a feeling of empowerment, and makes a flat 'no' to everything you say a less likely response- it deflates the battle of wills over whatever it is they DON'T want, and creates somewhere positive for both of you to go.  Backing a child into a corner or trying to impose your will on them will cause tears before bedtime for both of you.   Even childcare workers can ask children what parts of the meal they'd like on their plate, and relax if they don't eat everything.
Are you screaming 'BUT WHAT ABOUT THE WASTE?' Have you ever heard of a compost bucket? Recycle it into the garden or feed it to the chooks and relax, and next time ask your child what they want to eat before you start peeling that avocado (or whatever).  Obviously it's smarter to ask your child to choose BEFORE you prepare them a meal; have your choices lined up. 'Do you want bread or crackers? Vegemite or avocado? Grapes or apple?'  Childcare workers need to notice what foods the children consistently reject or prefer, and inform the kitchen staff.
Keep offering a choice, even if your kid is stuck in a rut- and sit with them and eat the foods they reject, in front of them.  Talk to them about what you're eating, and why you like it or think it's important that you eat it.  Modelling, modelling, modelling!  Both parents and childcare workers need to MAKE time to sit down at meal times and do this.
At home, include your children at the adults' table and let them sample what they fancy from your menu, if it's different to theirs. Take them shopping with you and let them choose some fruits and vegetables they'd like to try (you don't have to buy huge quantities of them, just enough to taste-test).  Take them to a cafĂ© with you and let them look at the food on display, before ordering something to share if they want it. (I don't recommend taking a tantrum-prone toddler on these excursions, of course; know your child's stages and adjust my suggestions accordingly!)
Present food attractively, especially new foods which you want them to sample.  Use reverse psychology and tell them this is not kids' food, it's what grown-ups eat, and they'll probably show interest in trying it. Instead of fighting with them over eating their vegetables, be creative- grate carrot and zucchini very finely and toss them into the rissole mix and the pasta sauce, make 'chips' out of sweet potato, pumpkin and parsnip and oven-baked crisps out of thin slices of beetroot, give them whole raw beans as crunchy 'swords' on their plate and raw carrot sticks with their cheese and biscuits. Don't get too fussy about how they get the good foods into them- many kids won't eat raw tomato, but nearly all of them love a freshly made tomato sauce on pasta with cheese sprinkled on top. Avocado makes a good substitute for margarine and is oh so good for them; mashed up with lemon juice and garlic, it makes a yummy dip for the corn chips you've included as a treat food.
Let them help with the cooking, and not just of sweet treats; they might enjoy arranging a salad, or turning meat in a marinade, or mixing up the salmon cakes.  Why is it that the only cooking experiences ever undertaken at the childcare centres I've been to are biscuits, pancakes and cupcakes?  What about mini-pizzas, quiches and do-it-yourself sandwiches?
If your child won't eat at mealtimes, then wants a million snacks later, don't panic and don't make a fuss. Your child will not starve! Offer them the choice of eating later on, cover their food and put it in the fridge. Even childcare workers can be flexible if they change their attitude. What's more important- that children eat at the conventional times, or that they don't unlearn their own hunger signals?
And watch that you haven't made the meals boring and the snacks exciting- include small amounts of snack-type food in their meals, and provide interesting but healthy snacks in between.
To avoid giving food emotional value, you need to examine your own attitudes to food and work on them, so you don't pass dodgy values on. You also need to think of other ways of rewarding your child; praise and your time are actually the most effective rewards, and cost nothing.
Instead of refusing a child a food treat when they've been naughty, work out another penalty, like going home early from a party, restricting computer time or confiscating a toy- it seems a natural instinct to use the 'party food', but it's a taught response which is quite destructive; it gives that food an extra emotional value- and if you do it all the time, it can make a child more likely to seek out high-kilojoule food later in life when something goes wrong or they're in trouble, on the reverse-psychology basis of 'I wasn't allowed to have it before, and damn them all; it'll make me feel more in control of my life to let myself have it now.'  I see childcare workers using birthday food treats as bribes all the time, and it's completely counter-productive.
To take the emotion out of junk food, it helps to sometimes offer treat foods WITH the meal- a mini cupcake, a few jelly beans, a handful of potato crisps or corn chips.  And don't tell them when to eat it!- what does it matter if they eat that part first? Don't make it more special than it is; don't put reward value on it by saving it for last or making supply conditional on having the 'good stuff' first.  Let them choose when to eat it, and it loses some of its power.  If you supply a small amount and they scoff that first, they'll still have room for the other food on their plate and they'll have time and space to recognise the body signals telling them they're still hungry.
I tested this on a class of preschoolers once by giving them their share of the birthday mini-cupcakes (one!) and their fruit together, on the same plate. (This was totally in opposition to centre practice, I might add, but I just did it without commenting on the change and the kids didn't bat an eyelid.) The same kids as usual ate all their fruit, the same kids as usual didn't, with no apparent relationship to the cupcake (which most, but not ALL, ate at least part of first); a few kids even ate the fruit but not the cupcake- and we had no drama, and no stress.  (Of course it helped that I made sure that there was only one cupcake each on the serving plate- so no second helpings, either!)
If they constantly ask for refills of the junk food at home, first ask them which part of them is hungry.  Is it their tummy saying 'I need more food' or their tongue saying 'that's a nice taste'? This is the time to explain that listening to their tongue instead of their tummy is not such a good idea, because tummies only have a certain amount of space inside- and filling up empty tummies with lots and lots of 'sometimes foods' can make your insides sick from too much salt or sugar or fat.
You can also explain that if you have too much of your favourite food, you can wear it out and it's not special any more.  I remember my own mother telling me about how much she used to love Arnott's Orange Slice biscuits when she was a little girl; she saved up her pocket money until she could buy a whole pound bag of them, then took them home and ate the lot.  She was, of course, violently ill- and to the day she died couldn't LOOK at an Orange Slice biscuit without feeling sick.  Feel free to use that story as an example!
If they still nag you, you might need to change your storage strategy to help you stand firm- cupcakes hard as rocks in the freezer, one snack pack of little biscuits or crisps taken out of the pantry at a time- and explain that this is all you have for today (remember to allocate some for you- that's part of teaching them to share- and you're bigger, so you need more food. Logical!). If they start to whine, apply the anti-whining strategy I've outlined in another blog column, talking honestly and more in depth to them about food that makes you sick inside (where you can't even see you're getting sick) and too big for your favourite clothes if you eat too much of it. Try Googling up some pictures of internal organs covered in fat, and you will probably get comments like 'Eugh, gross!'. Mention your responsibility as a parent to keep them healthy. (And stay firm!)
To avoid teaching your child to eat when they're not hungry, RELAX about when and how much they eat.  Lots of children are grazers; they'd rather eat a little and often. Have a choice of snacks in the fridge and offer tiny meals.  They can always ask for more!  Some kids find a huge plate of food off-putting. A smorgasbord approach may go down better- little bowls of this and that so they can pick what their body wants right now. There's plenty of time for them to learn about eating timetables when they go to school.
This is much harder in a childcare centre unless there's a fridge in the room, but if a child rejects their lunch you can always bring it out again at afternoon tea time if they complain of hunger (and you've had the wit to cover it and ask the kitchen staff to store it).  You're resourceful- think of ways to be more flexible in your unique setting. If a child doesn't want lunch, why can't they sit down with a book? Have YOU ever had to sit at a table smelling food you really don't want? It can be quite a nauseating experience.
Meanwhile at home, you can help them learn the social value of food, and the joys of eating a meal together. If your adult meal is appealing enough, they'll join in, so welcome them when they do.  You can give them a tiny dinner meal at 5pm and then let them sit with you and sample other food when you eat with your partner, if they're still awake.
It might sound like a lot of trouble to go through for a little kid, and it's probably completely counter-intuitive to change your attitude to your children's food routines like this.  That's because it's not what you were brought up with.  But we have a plague of eating disorders amongst our adolescents, and a huge eating-related health problem in the adult community- we have to change something- and this is a lot LESS trouble than dealing with a teenager with bulimia, anorexia or obesity later on.  Think about it.

10 comments:

  1. This is something I've worked hard on with my son. I wasn't raised with a healthy concept of food. I did a lot of reading on this and talking to my super supportive pediatrician. My son just turned 3- all of a sudden, he eats. He spent the last year just grazing and probably experimenting with foods, finding out what he liked and didn't like. Overnight, he kind of turned from a "picky eater" to an amazing eater. The biggest problem I had was other family members (mostly grandmas) who in front of me would insist that he "finish" his plate, bribe him with desserts, and lie to him about what he was eating. My father in law cooked some fish last summer and my MIL told him, those are chicken nuggets. When I asked her why she lied to him she said, "Well, he wouldn't like fish." I try to be kind when addressing these family members but I also have to tell myself that I'm my kids advocate!

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  2. Oh good grief! He wouldn't like fish?

    !!!!!
    Sounds like you handled it perfectly :)

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  3. Thanks for the great post! I think it is very helpful and makes me more conscious of my modelling for my daughter. I also like the 2 options when giving choices.

    Can you please change one part of it?
    >>"Both mothers and childcare workers need to MAKE time to sit down at meal times and do this."
    Please do not leave out FATHERS!

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  4. Thank you so much, Beth- that one slipped through without me noticing it. You're absolutely right! I've changed it to 'parents'.

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  5. Thanks for this Aunt Annie. A great post, and makes me feel a lot better about the position I want to take with my own son (who only eats "party food"). It has been a struggle for us for a few years now. I appreciate you sharing this.

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  6. another wonderful post!

    I read the book Baby Led Weaning which was a really enjoyable and lovely read.. we have implemented this philosphy with our daughter and it is going brilliantly. It works around the principal that although it is up to you to offer your child a broad variety of foods, it is up to them to chose how much/what/the order the eat.. and when to stop.

    I have book marked this post as it builds on those trust principles for the older children.

    I really really really want my daughter to be free from all the dieting and food cr@p that plague her mother!

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  7. Thank you both for your kind words!

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  8. Hi Aunt Annie, since i saw this posted on my facebook news feed a while back, i've really tried to change the way i feed my son. it's resonated with me bc everything you say is SO true. i've always dealt with eating issues bc my mom made me eat as a skinny infant. then i got chubby bc i probably never developed my own internal meter to detect when i'm full. i always listen to others to tell me when to eat and when to stop. i've also made eating and food an emotional issue. it's been a lifelong struggle and one which i think my son can avoid or at least not be such a big issue if we as parents deal with this in a healthy manner. anyway, sorry for being so longwinded but i have a question. my son who is now 3.5 has never been too picky with eating. however, now he's reached 3.5 he's suddenly become pickier. the other issue is that he LOVES sugar. so now he'll pretend to eat his meal, then an hour later ask for candy. or he'll have a few bites of dinner and want dessert. i usually keep dessert to fruit or flavored yogurt but sometimes he wants ice cream. if i serve dessert with his main meal he'll only eat the sweet portion and skip the savory and vegetables. if i were to have him decide his menu for the day it would consist of candy, yogurt and some fruit. the other issue is that he has food allergies (egg, peanut and tree nuts) which means most commercial candies and bakery items are off limits due to cross contamination. so when we find a candy he can eat we end up sort of going overboard which is entirely our fault. so usually now i end up telling him that if he doesn't eat his main meal then there's no dessert. this is something i've wanted not to do and i'm not sure how to set limits on him with this one. it inevitably turns into me forcing him to eat his main meal. ugh!

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    1. Michi, thanks for your feedback!

      As to your son- this sounds like food's becoming a power issue, which is understandable given that the poor kid has so many restrictions already. You need to decided where your fences are, point them out calmly and then step back.

      Basic Principle 1 is that no child will starve while there's food available, so you need to be clever about quantities. Make your dessert portions smaller- and I mean SMALL- you are trying to replicate the healthy eating pyramid and sugar is at the very tiny tip of that. Offer dessert plus the normal meal together, and make no comment about what he eats and doesn't eat. When he turns the normal food down, take it away and cover it and put it in the fridge. If he complains he's hungry between meals, that's what he gets offered. Put up with the screaming. He will eat it if he's hungry enough. STAY CALM.

      When he asks for more sugary stuff, say calmly "I won't let you eat ONLY sugary food. It will make you sick." Brace for the screams. Another useful calm statement: "If you are hungry, there is food right here for you to eat."

      As an activity, draw the food pyramid and let him stick pictures of the foods you normally feed him onto the pyramid, so he has a visual cue as to relative amounts. Explain that more food eaten from the bottom of the pyramid will equal more dessert at the top of the pyramid. STAY CALM.

      The next meal time, you calmly serve a meal in the same way, but if he didn't eat his main course last time you give even smaller portions of everything, including dessert, without comment. Explain to him, if he protests, that your job as his mum is to make sure he is healthy, and so because you love him and want him to feel well, you will give him more dessert only when he eats more main course. Point to the pyramid. Talk about it.

      (A smaller quantity of healthy food will be less daunting, too.)

      Repeat until he is hungry enough to eat normal food. When he is hungry enough, he WILL eat what's offered. He may complain and cry, but humans are designed to survive and he won't hold out for long. He is testing your boundaries and you must show him CALMLY where they are- the boundary is his health.

      Your biggest enemy here is your own emotions, which will tell you are being cruel and starving your child! Actually if you have ever had to take a small child to the dentist or stick a child every day with a needle due to diabetes, you would know that you are being a good parent by refusing to be manipulated into giving him a diet of sugar.

      Make sure you explain the food quantities using the pyramid, stay calm, and try to let him work it out for himself.

      GOOD LUCK! It will probably be noisy!

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  9. Hi aunt Annie,my 20 month old has feeding issues.she don't eat any thing whole day and even dont drink any fluids or water.she is active and happy. but recently I have noticed that her urine has become very concentrated.Now i force-feed her. Even water I need to force her to drink.Meal time has really become a struggle time for us.This is even causing problems in our family.kindly give some suggestions

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