by Parker Ellison, M.D.

A common complaint that I hear from parents in the clinic is, “My child won’t eat.” These children are often very picky with long lists of foods that they dislike, or can seem to have very poor appetites, especially at family mealtimes. They are almost always growing acceptably when we plot them on the pediatric growth charts, but they are oCen thin-appearing and don’t have a lot of “insulation.”

A child’s refusal to eat well can lead to several dynamics at family mealtimes. Sometimes, a parent feels they need to become a “short-order chef” in order to find something that the child WILL eat. Too, mealtimes can consist of non-stop talking about food and the child’s eating becomes the main topic of conversation at every meal. At times, parents can feel as though they are negotiating with a child over every bite of food. Under these circumstances, mealtimes become stressful for everyone involved.

Over the years, I’ve counseled the parents of these difficult eaters that mealtime struggles are often about a natural tendency of children to want to assert some independent will about something they can control (namely, what they swallow). After reviewing a child’s growth chart to assure that he or she is growing acceptably, and making sure that a child does not have a metabolic or developmental disorder that may be underlying a refusal to eat, I recommend that parents adopt the following strategy to help with mealtime struggles:

First, I counsel parents to adopt an “I-don’t-care” attitude in front of the child. This attitude is not callous or dismissive, just neutral and nonchalant. If a child feels less pushed to eat something, he or she will often be less likely to resist.

Next, if a child is old enough to understand, I suggest that parents talk to their children about new rules for mealtimes, explaining only ONCE that they, as parents, will decide what food is prepared at mealtimes. Children should be told that they don’t have to eat the food that is served, but they will not be given any other food until the next mealtime and they may not prepare any other food for themselves or snack between meals. If children then want to fight the new rules and begin the old incessant talking about food, they can be dismissed from the table and told that conversation about eating is over.

A difficult eater’s first tendency will be to resist. He or she will want to discuss the situation and try to negotiate. When that doesn’t work, the child may think, “Great! I don’t have to eat what I don’t like!” In my experience, however, hunger proves to be a good teacher and I counsel parents to remind themselves that they are not withholding food—the child is choosing not to eat. With these new rules in place, a difficult eater’s resistance is oCen short-lived and parents can expect less stress and more enjoyment at family mealtimes.

At the yearly well-child check at Children’s Medical Group, we review of our patients’ progress on the pediatric growth charts and discuss nutrition and physical development. We can screen for nutrition-related issues such as anemia and high cholesterol and address any further concerns parents may have regarding feeding and growth. Parents can call our offices at 601-362-8776 to schedule a visit, or go to our website at childrensmedicalgroup.net to choose an appointment time online.

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