21 August 2018
Does the idea of meal time cause your heart to start beating fast and your palms to get sweaty? Do you know that the first words out of your child’s mouth will be “yuck”?
Is the thought of another meal time unpleasant? Do you have adult food and child food?
When you have a picky eater and the idea of meals is tricky because the sight or smell of food turns your child off or sends him running out of the room, then meal time tends to be a dreaded time of day.
Or have you found strategies that have allowed this process to be less stressful?
EATIng is a learned behaviour
Many people believe that once a child is hungry enough they will eat. But being a parent of a picky child, you know that is not true. They won’t just eat unless they have the food they like. Eating for them is not instinctual. Actually eating for anyone is not instinctual after the first 3-5 months of life. It is a learned behaviour, with skills that need to be mastered.
According to Dr. Kay Toomey from the Star Center, learning about food happens in three ways.
1. When a connection is made in time between two events.
Sometimes this connection is correct, e.g., my belly was rumbling and I was feeling grumpy, I ate yogurt then I felt better. However, connections can be negative too e.g. with Gastro-Oesophageal Reflux, I ate a food and then I was in pain. When this negative connection keeps happening, I learn not to eat.
2. Through reinforcement
When we eat and are praised then we received positive reinforcement. This can lead to more eating. However, if we refuse to eat, maybe due to pain, and then we get lots of attention and interaction from our parents, again this is positive reinforcement of our not eating. This can lead to more refusal which is then followed by more attention and a cycle is set. So positive reinforcement can lead to a desired outcome or an undesired outcome based on how we use it.
3. Through punishment
Punishment around food is very powerful and can lead to less eating. If you have reflux, you eat and have pain, then you feel as if you have been punished and this can lead to less eating. If you don’t have the oral motor skills to eat the food given to you and you choke or gag, again this feels like punishment and can lead to less eating. When a child refuses to eat and is yelled at, or punished for not eating, this will also lead to less eating.
Booth (1990) showed that if the learned reaction to food is negative, there is a physical effect of appetite suppression. That is, when learning about food is negative our bodies will turn off our appetite. With higher stress at mealtimes, your child’s appetite will decrease and lead to less eating.
What can we do about this?
Firstly, we have to figure out what are the contributing factors that have led to this difficulty with eating. Are there medical issues, such as reflux? Is there a difficulty with oral motor skills that have impacted the ability to eat?
Our goal is to be able to positively reinforce normal healthy eating patterns, which allow children to partake in mealtimes with their families while expanding their diets.
- Having a structure around mealtimes allows more predictability which will make it easier for your child to learn.
- Family meals are critical in providing your child with the opportunity to learn about food and to watch positive interactions with food. As well as to watch you eat and to be able to model your eating. Young children learn best through imitation, eating together provides them with positive models for trying new foods, chewing food, and eating a variety of foods. If you have a limited diet, it will be hard to expand your child’s diet.
- Meal times need to be pleasant. Work on interacting with food, which includes talking about it, smelling it, touching it, playing with it, licking it, and eating it. Positive reinforcement of any interaction with new foods is a must.
- Making food manageable for your child’s skill. Giving them small portions, if they have eating one kernel of corn then give them 2 kernels of corn instead of a whole serving.
- Teach them about the food. Talk about the properties of the food, this soup is watery, it has soft chunks of orange carrots, and white potatoes, it has small pieces of beef.
Remember it takes your child 10 positive experiences with a food to determine if they like it. So don’t give up when they won’t try a food the first go…try and try again. Keep it positive. If we ask them to “eat this or try this” their answer will be no. But if we ask them what colour it is, what shape it is, they might answer. Then they have interacted with the new food instead of immediately rejecting it. So try to stop asking them to eat new foods and ask them to explore new foods instead.
We would love to hear about your experiences of trying this approach with your picky eater.
Tricia has over 20 years of experience in paediatric Occupational Therapy, including working in the Neonatal Intensive Care Unit, Paediatric Intensive Care Unit, general hospital populations, private practice, schools, preschools and home based settings. She has also previously been the oral motor skills co-ordinator at a clinic in Boston.