My child is a very fussy eater, I keep having to chase him to eat. I am afraid he is not eating enough? Am I alone?
Many children have eating difficulties at some point between their second and sixth year. Although the fussy or picky eater is a real worry to parents, in most cases, the child doesn't truly even have an eating "problem." Instead, what often seems to the parent to be a problem may in fact be quite normal behavior for that child's age. Armed with the knowledge of what to look for and how to approach the difficult feeder, parents can relieve a lot of their worrying and mealtime tension.
The common types of feeding problems that children between two and six years old often have include:
- not eating enough or at all
- food jags in which the child becomes extremely picky, eating only certain foods and refusing most others
- snacking all day long, without really having "meals"
- often ending meals in tantrums without having eaten much
Young children tend to eat according to their own natural instincts about what, when, and how much they need to eat. Their appetite usually adjusts itself to the amount and type of food that provides the energy and nutrients they need to live and grow. And although parents tend to worry about their children's eating habits, their children's instincts are often correct. The fact that the child isn't eating according to the parents' expectations doesn't necessarily mean that there's a problem.
One of the most important indicators of whether there's a serious feeding problem is your child's overall growth pattern. Your child, like other healthy children, should follow a certain expected rate of growth in terms of length or stature and weight gain. If your child's growth rate is following the expected course, he/she is most likely in good health and does not have a serious feeding problem. But any change or interruption in the expected rate of growth may signal a more serious problem that needs medical attention.
How much is enough?
In order to maintain normal growth and good health, your child has two important needs: an adequate intake of calories, and a balanced diet that supplies a wide range of essential nutrients. Calories supply the energy needed for growth and keep you from feeling hungry. The number of calories a child needs varies according to the child's size, growth rate, and activity level. But in general, if you want to know approximately how many calories your child needs, a good rule of thumb for children up to five years of age is to begin with a base of 1,000 calories and add 100 calories for each year of your child's age. For example, a one-year-old would need approximately 1,000 plus 100 calories, or 1,100 calories. A two-year-old would need 1,000 plus 200 calories, or 1,200 calories
How can we ensure a balanced diet?
Besides getting enough calories, it's also very important for your child to have a balanced diet that includes a variety of nutrient-rich foods from each of the four main food groups. To ensure that your child is eating a balanced diet, offer some foods from each food group every day. And be sure to offer a wide range of foods from within each group, so that your child's diet has the variety needed to be nutritionally complete.
Should I see my doctor for this problem?
If you think your child has a feeding problem, be sure to have him or her examined by a doctor. Once the medical/dietary assessment has been completed, the doctor can determine whether or not your child has a serious feeding problem.
Fortunately, the majority of picky eaters grow normally and without nutritional deficiencies or imbalances. In these cases, the approach focuses on an individualized combination of practical measures and behavioral techniques.
My fussy eater is growing normally, are there are helpful practical tips?
- Children need to eat frequently to sustain their high energy levels and keep their bodies growing. As a general rule, they should have three meals daily and two well-spaced snacks.
- What's most important to the child's health and growth is not the quantity, but the quality of the food he/she eats. So be sure to put nutritious food in front of your child, without over-emphasizing portion sizes or how much he's eating.
- Because drinking too much liquid can lessen your child's appetite, limit liquid consumption to a total three to four cups daily. This will help ensure that your child is hungry enough to eat solid foods. Also, limit liquid intake in the hour or two before meals.
- If you're concerned that your child isn't getting enough calories, avoid giving your child "light" or "low-fat" varieties of food, and offer whole milk instead of skim or 2%.
- Satisfy your child's sweet tooth by serving foods that are naturally sweet but nutritious -- like fruit instead of candy or chocolates .
- Snacks can be as important as regular meals in obtaining needed nutrients but don't allow your child to snack all day. Stick firmly to three meals and two snacks. This encourages a regular feeding schedule, and avoids power struggles over when to eat. If your child doesn't eat much at one meal, he or she will probably eat more at the next.
Here are some helpful behavioral tips:
- Handle frustrating situations with patience, a positive attitude, and firmness without being aggressive or emotional.
- Avoid power struggles: don't force-feed, plead, bribe your child, or make her feel guilty.
- Try to present healthy foods in a positive light, so that they aren't associated with dullness or deprivation. Also, avoid placing foods into categories of "good" and "bad."
- Offer your child lots of opportunities to make her own food choices from a variety of balanced foods that you offer.
- Give small portions, so as not to overwhelm your child with too much food.
- Try preparing and presenting rejected foods separately from other dishes. For example, if your child doesn't like carrots, don't put them on her plate or in the main dish. Instead, place them in a separate bowl on the table, and allow your child the choice of whether or not to have them.
- Try serving foods your child doesn't like in new, original ways. For example, if your child insists that she hates spaghetti, try serving bow-tie pasta instead. Also, cutting vegetables in fun shapes may turn previously rejected vegetables into food that's fun to eat.
- Make the mealtime table a relaxed and positive environment, free of family conflict, tensions, and distractions (such as TV).