Many six or seven year olds don’t eat their vegetables. They may eat cereal and milk for breakfast, maybe with some fruit juice and toast. They may eat snacks and drinks throughout the day and have sandwiches for lunch and so the problem seems to be only at dinner at night. But is it? Is this a usual six year old pattern or does it remind you more of a two or three year old, except that a baby food dinner would have been eaten in the evening.
WHY DOES IT HAPPEN?
Most children progress reasonably well from baby food to finger food to family food. But others seem immature and progress is very slow. They prefer to stay with smooth baby food, are not happy with new tastes. They take longer to move from milk and fruit juice to a variety of solid foods.
This delay can seem to be fussiness as we expect children to be eating certain foods by different ages. Rather, we can accept that a food that is not managed one year may be managed the next, so it is reasonable to try again.
Children will usually only try new foods if they are hungry. The normal drop in appetite that occurs in the second year, added to the preference for milk or drinks, means that foods like whole fruit, vegetables or meats may be rejected. Or appetite may be good but is satisfied with drinks and snacks.
Perhaps the child is food intolerant. A tummy ache after some food may mean the child is cautious about any new foods. It is interesting to note that many food sensitive children have speech, motor or other delays.
The above lags can be gradually overcome but the patterns once began often become habits and habits are very hard to change. Girls can have these delays too.
Add to that the emotional part of growth – terrible tantrums at two and the development of an individual who may not be easy to deal with. He may be babyish but stubborn or tearful and wingy, with emotional-game playing techniques that would rival soap opera stars! Some children seem to want to remain a baby or maybe have got a message that it’s okay to be a baby.
NORMAL EATING IS ABNORMAL
Just as we expect speech and motor development to progress almost automatically we expect eating to gradually mature. Often it is by learning about those with problems we understand how complex normal development is. Intellectually handicapped children develop eating patterns very slowly. Baby’s first introduction to food used to be called “The Educational Diet” in recognition of the idea of teaching baby in a very gradual way about food. Early foods are usually bland, not extreme in temperature and very smooth in texture. They also require little effort to eat
Baby first learns about solids as cereal, then learns about a variety of tastes in solids and drinks while the food is kept bland and smooth. Fruit juice is dilute, sweet and no effort to eat. Potatoes are bland and smooth and small amounts of other vegetables can be added as long as they are quite smooth at first. Egg yolk is a new taste but the texture is smooth and we take care that the temperature is just right.
As baby grows and can hold things, rusks are enjoyed and wise parents also present raw fruit and other foods to chew on under supervision. Baby meals also add new tastes of meats etc but the taste is kept bland and the texture smooth at first. A variety of breads can be encouraged. Cold drinks and ice-cream are tried and also warm meals and desserts. Later while the taste of baby food is kept the same, he or she learns to cope with lumps in mashed vegies, junior baby food and various breakfast cereals. Gradually baby learns to enjoy many new tastes, bit-by-bit coping with more texture in food and managing a widening range of temperature in food presented.
Children vary in the rate they manage all this change. Development is often delayed when two changes are made together e.g. a new vegetable with a different texture will often be rejected. As chewing is an effort and a skill some children are slowed at that point. Those who are not adventurous about new tastes, or make a fuss about the temperature or presentation, look fussy. If this immaturity is added to the “terrible-two’s” behaviour it is easier to see how habits can be formed and progress in the following years can be slow.
MUDDLES CAN BE SOLVED
This is done in two parts:
1. changing the food and
2. managing the child.
GIVING MORE FOOD MAY NOT BE THE FIRST THING
Allow an appetite to develop at meal times. This usually means becoming aware how much food is being eaten between meals, often as drinks. Limit milk to the necessary 600ml/day. This includes milk on cereal, in ice-cream and desserts and note that one cheese single equals 200ml milk. Do not fall into the trap of feeling it is OK to have a glass of milk if the meal is not eaten. Save the meal. Half a small glass of fruit juice equals one piece of fruit so limit intake. Provide pieces of fresh fruit as snacks. Replace flavoured drinks with water. If less fluid seems to be taken don’t worry, one mouthful of water goes a long way. Do offer water often and always at meals. Where children gag on food ensure they have a sip of water before eating and between mouthfuls of food. Check the preferred temperature and drinking cup. Children do not have the right to run the household but it is wise to listen to their preferences about where they like to eat and what bowls and cutlery they prefer.
Most children need a snack between meals. This is important in lighter children. Where no definite morning or afternoon tea is eaten children often ask for drinks, bread, biscuits or snack foods. If a main meal is not eaten the snacks before may be too much. Most children need no more than the equivalent of one slice of bread and one small glass of milk. If they are hungry they can be encouraged to chew on some fruit or raw vegetables. They may not eat much but they help combat the requests for biscuits!
Do not serve a large meal. Serve normal amounts of accepted foods and very small amounts of the food you want the child to try. Put all leftovers in the fridge and present them when the child is hungry and asks for food. If rejected put back in fridge and do not give dessert or give only a very small dessert. Children who are not hungry at 6 pm are often hungry at 8 pm. Provide water to quench thirst. Ensure the meal leftovers are not thrown out until later than the child’s sleep time but do not same them until the next day.
EACH CHILD IS DIFFERENT
The theory above is of little use if the child is not managed at the same time. Most children can help themselves to food and drinks and expect to continue their babyish habits. Be aware that the child needs parent help. If your child runs off to football but cannot catch a ball, you gently but firmly help him catch a ball first. You may even seek out professional help from a physiotherapist if you cannot solve the problem. Changing the habits of a problem eater also needs your intervention.
Explain that since he is 5 or 6 it is a shame that his tummy seems to be managing only as well as a preschooler. That means that he needs supervision like a preschooler. As soon as he is eating normally you will treat him like a 5 or 6 year old again.
Of course he will not like the changes. He enjoys the drinks and snacks, and maybe even the fuss made of him not eating at dinner. But do you want this pattern to continue for years?
If you make some new rules it will take at least a week before they will be accepted. He will create a fuss, cry, bargain with you, or make you feel guilty. He may make the most of any visitors, especially grandparents, to convince you to go back to old rules “just this time”! Don’t be surprised if he says you don’t love him, or if he complains of hunger two hours after dinner when he hopes for ice-cream and topping or at least flavoured milk! If he was an easy child to manage you would have solved the problem when he was three. Keep persisting. One mum said she aimed to stand her ground just ten minutes longer than her stubborn child, and he eventually learnt that loving mothers can be firm.
OLDER CHILDREN LIKE TO BE “GROWING UP”
In infancy children first make food choices by crying when they are hungry or by saying “No” to some of the wide variety of food parents present. Later they tell us clearly when they are hungry and demand drinks or snacks. It is good that children tell us when they are hungry, but it is parents, not children, who decide what food is appropriate at that time. This is how children learn about nutrients needed for health, and why normal meals are important, and that wants for biscuits or cordial are secondary. Fortunately there is information available on the fun and enjoyment that can be had providing nutritious tasty food.
The next stage occurs when the child begins to take responsibility for ensuring that he is feeding himself well. If the problems are occurring in a 10 or 11 year old you can handle them a different way. You can use basic nutritional information on needs for protein, vitamins and minerals. Since he will resent being treated “like a baby” you can help him grow up by asking “How are you going to fed yourself”, and “What foods are you choosing to get your needs for iron, fibre and trace elements?”
These guidelines are made to help parents understand eating problems and to be some help in solving them. If you have difficulty on your own seek out professional help from a dietitian, just as you would seek help from other therapists for other developmental delays. Solutions often take time but it is very rewarding to see 7 or 8 year olds with fairly normal eating patterns.