Nutrition part 2

This page deals with how to get your children to eat healthy foods. For more on what to feed them, please see Nutrition part 1.

People tend to think of kids as being picky eaters by nature; with healthy habits being something we need to train into them. I like to think of kids as being good eaters by nature, something we want to avoid training out of them.

How does picky eating arise? From an early age, most infants tend to enjoy a pretty broad selection of wholesome vegetables, fruits, and meats without difficulty. Then, one day they might not be in the mood for something they're offered, such as broccoli, so they choose not to eat it. At a time when humans had more limited resources, this wouldn't have been a big deal – they might skip a meal and simply eat more at the next meal. The natural consequence of refusing food was going hungry for a short stretch, and the natural benefit of eating a broad diet was being fed. In our current climate of food abundance, when a child refuses food they are instead given something else that they want more; something tastier/sweeter/starchier. In essence, we are inadvertently rewarding children for refusing food; training them to become picky eaters without realizing it.

With this phenomenon in mind, it is much easier to prevent picky eating than it is to change it once it's set in. If you already have a picky eater on your hands, it may be harder to jump right in to this preventive strategy, but do not despair, we will get you there. Start by reading the strategies to get a handle on them, then I'll include some tips at the end for how to transition towards this for families that are already struggling.

Preventing picky eating habits from developing.

From a very early age with your child, try to mimic nature by providing a broad variety of foods. The food nature would provide is not based upon any child's taste preference, but rather the climate, the seasons, the location, etc. This gives the child an opportunity to match their taste preferences to the healthy variety of foods available, instead of expecting foods to match their taste preferences.

What to do when your child refuses to eat those foods? This is the million dollar question. Here are some highly effective strategies that will help make healthy eating a reality.

Firstly, and most importantly, be supportive. When your child is upset because they don't want what you've given them, and you know you could easily give them something else they would eat, it's hard to hold back. This is the moment where most families break down. Many parents feel guilty not giving their child something they want to eat, others feel worried they won't get enough to eat and will be starving, or suffer behavior consequences or sleep problems, all common consequences. What to do?

Put that loving, kind, compassionate energy to good use: empathy goes a long way here. "I'm sorry you didn't get to eat what you wanted tonight, sweetie. Sometimes it's hard when you don't get the things you want, isn't it? It's okay if you don't want to eat this, I'll just save it for you for later in case you get hungry."

Keep mealtimes positive. Try to avoid showing frustration or anger, it's normal for your child to be upset. It is not useful to have a punishing tone or show disappointment, that only leads to more negative associations with mealtime that we'd like to avoid. It's also counterproductive to label them as a picky eater, they will only assume that role more.

  • Instead of "well, if you'd just eat your broccoli, we wouldn't be having this problem," say "that's okay, you're getting better and better at making good choices, and I'm really proud of you for trying!"
  • Instead of your child overhearing you say "yeah, Charlie is a real picky eater" he could overhear you saying "he's learning how to eat more and more things, and I can tell he'll figure it out really soon, because he learns so quickly!"
  • Note that we are not being dismissive of picky eating habits, we are merely focusing on the resolution rather than ruminating on the problem. If we label them as a lost cause, they'll be the first to believe that they're a lost cause, and simply give up trying.

Don't expect your child to make appropriate nutrition choices when they are young. It is unrealistic to expect a child to choose brussels sprouts over mac & cheese – that is a choice you'll need to make for them until they are old enough and mature enough to make that decision for themselves. However, it is helpful to give them a choice between two healthy options, like brussels sprouts vs. green beans. To visualize this in a more dramatic way, you wouldn't let a child play with a knife instead of a toy if that's what they wanted, nor ride down the street alone on their bicycle without a helmet, etc. But you would let them choose between riding their bike with a helmet or playing with their toy, both appropriate choices. You are not being cruel by eliminating the dangerous (unhealthy) options, you are applying appropriate limits out of love and care for their health and well-being.

Provide options from the start, rather than after the child refuses. By this I mean offer both brussels sprouts and green beans during the meal, so the child can pick between the two if they want. This is preferable to providing brussels sprouts alone, then only if the child refuses, getting up and preparing green beans instead. This avoids the unintended consequence of rewarding picky eating.

Keep fewer unhealthy options around in the house. It is much harder to withhold a particular food if it is available in your home. Filling your house with only healthy options makes it easier to pick from within those options. Likewise, if you do provide a small serving of something less healthy, don't leave a big bowl of refills on the table while you're eating. Have it out of sight, with seconds not an available option.

Many children learn by observation. If they are eating in isolation they have no frame of reference for what healthy eating behaviors should look like. Witnessing other children and adults consistently eating healthy foods, preferably with them at the same family meal, is a valuable tool for setting the norm and expectation. You have the same thing on your plate that they do. Modeling a thorough enjoyment of healthy eating is one of the best tools for teaching your children about food.

Keep fit! If you’ve ever had dehydrated camping food when you’re not camping, you’ll know that it’s not the most prized culinary delight. And yet, after a day of intense physical activity, like hiking all day and setting up camp, when you finally sit down to eat somehow it tastes amazing. The body is set up to crave and appreciate food more when it is needed. We want to take advantage of this phenomenon by getting kids to a state where they are fit and happy and hungry and open to experiencing food in a positive light.

Grow and prepare food together. A child will be more likely to try something if they are involved in its planting, harvesting, and cooking.

A common question and closing thoughts

Isn't it harmful for my child to go hungry if they refuse food? Not at all. In fact, it is quite healthy for our metabolism to fast periodically (with the exception of a few rare diseases). In all my years of pediatrics I have yet to see a child fail to grow because they were only offered healthy foods, even when they have skipped several meals. It is not harmful emotionally, either, as long as there is a kind, loving parent supporting them and guiding them through it with the suggestions above. Truthfully, it's harder on the parents than it is on the kids — that parental instinct to feed your children is incredibly difficult to set aside! It's also unpleasant to deal with the behavior challenges you can face in a hungry child, or fear of sleep sacrifice that evening.

With this in mind, it's great to have some support for yourselves built in to your plan. Here are some tips for managing the challenging emotions that come up, and maintaining a positive mindset:

  • If you're ever worried about them getting enough to eat, simply repeat this mantra to yourself over and over: "if she truly needs this food, she will eat it."
  • Remember that you are responsible for providing nourishing food for your children, it is their responsibility to eat it. Trying to remove that challenge from them won't ultimately help them, they need that opportunity to learn healthy eating independence. Supporting them and guiding them, however, are great places to invest that energy and keep things positive.
  • Allow yourself to have a hard time with it. Know that you providing nourishing food and them choosing not to eat it is a very different scenario from you simply denying them food, a common guilt felt by parents. The only thing you're denying them are things that are bad for their health, and that's not cruel by any means. Kids ultimately know that it's your job as a parent to do so, and they may even thank you some day. As a matter of fact, thanking your own parents may even help you feel better. I'll thank mine too.
  • If you are struggling with your own feelings as you witness your child become upset from not getting the food they want, use those feelings for good! Rather than respond to their frustrations with unhealthy foods, offer them extra support, love, compassion, empathy, one-on-one time, etc.
  • Pretend to yourself that unhealthy foods were suddenly unavailable, as if the nation's white flour reserve was destroyed and the choice is simply out of your hands. You are on your child's side, not against them. How can you help them through the loss of white pasta? Offer to try and help make their meal more palatable. Would they like some grated cheese on top? Salt or pepper? Make it into the shape of a sailboat? Take a break and try again later? Etc.

Imparting healthy eating habits in children is one of the all time most challenging tasks of parenting. It helps to keep in mind that these struggles are common but temporary, and the advantages are immeasurable. If you stick with it, you will find that your child is not only a healthier eater, but most importantly a happier one too! They will ultimately approach eating with more of a sense of gratitude than entitlement, as well as have a broader range of foods that bring them joy throughout life. And for that, some day, they'll thank you.

If you already have a picky eater, see addendum below for tips on how to manage more challenging cases.

More resources:

Ellyn Satter >  An influential nutritionist who writes about how to get kids to eat. Some useful snippets of info on her website, but her books are best:

Here are some helpful books by other authors on the topic as well:

Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child’s Diet (Paperback). By Cheri Fraker, Mark Fishbein, Sibyl Cox, Laura Walbert.

Just Take a Bite: Easy, Effective Answers to Food Aversions and Eating Challenges! (Paperback) by Lori Ernsperger, Tania Stegen-Hanson.


Addendum: what if I already have a picky eater, or a special circumstance?

If you've been struggling with a picky eater for years before coming to this page, or have a special circumstance such as a child with sensory processing difficulties, some modifications to these strategies may be necessary. Both children with sensory processing difficulties and children who have been picky eaters for years have already developed strong negative associations with many foods. Changing overnight to an expectation for them to suddenly eat nothing but healthy foods can be too drastic a step and may backfire. What we want to do is gradually transition towards healthier eating.

One good method is called food chaining. This book describes the technique of introducing a new food by way of other similar foods, rather than jumping right into it. For example, if you give a child cubes of rutabaga, they may not eat it. But they will eat spaghetti with meatballs. So, one day you make the spaghetti with meatballs identical except you replace the pasta with spaghetti squash. Then, on a future date, you replace the spaghetti squash with cubed squash, but still with the sauce and meatballs. Next, they're eating the cubed squash as a side dish with some olive oil, salt and pepper. Eventually, they're actually eating cubed rutabaga with olive oil, salt and pepper.

Pick appropriate times for experimentation. When a child is hungry and cranky, they will be less open to trying foreign things. Sometimes experimenting outside of mealtime can be both effective and fun. Make it like a cooking class, where you experiment and prepare the food in three different ways and let your child pick which one they like the best. Boiled, roasted, or sautéed with garlic?

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Be mindful of textures, visual appeal, etc. For some kids, it's the texture more than the taste that they're averse to. For others, it's how the food looks. Sure, we do eventually want them to be able to tolerate foods of different textures and appearances. But just like food chaining, we may want to get there more gradually. Let's first focus on getting healthy foods into their diet enjoyably, and worry about its shape or form down the road. Try things in different textures and forms, and try to make them fun and appealing! Gradually transition the textures and forms down the road to encompass a broader variety.

Bribing. This is a double-edged sword. For some children, bribing them to eat their vegetables can actually be effective, but can have consequences to be aware of. Example: "if you eat your broccoli, you can have more mac & cheese." The downside to this approach is that the broccoli is essentially holding hostage the mac & cheese. While they might begrudgingly eat it, it makes them see the broccoli as a negative food, something standing in the way of what they really want. To minimize this effect, try putting small amounts of both on their plate, letting them eat in any order, and when they finish the whole plate they can have a refill of the whole plate. Here, we're emphasizing that eating should be balanced; when they finish a balanced plate they can have another balanced plate. Also, keep the amounts small — making it through a mountain of broccoli to get a treat will leave a bad taste in their mouth, but a single floret may not. A small amount followed by a reward may even leave a positive memory of it for some kids, making it easier for them to eat it in the future.

Focus on habits first, success and balance will come later. I'd rather your child were in the habit of eating the equivalent of a single bud from a floret of broccoli at every meal than bypassing vegetables entirely. It gives them the expectation that eating vegetables is a part of every meal, and is not negotiable. With that habit in place, over time we can work on increasing that amount, eventually getting to a more balanced place.

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Healthy Schedule

  • After birth (within 24 hours)
  • Newborn visit (day 3-5 of age, home visits encouraged)
  • 2 weeks
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 2 years
  • Yearly thereafter