During the holiday season, gathering around the dinner table is an especially meaningful time for parents, children, relatives, and friends. It’s also a good opportunity to focus on helping a child who refuses to eat, or one who doesn’t want to stop eating.
Some children often don’t feel hungry and would rather play than eat, or they may be so picky that they eat a very limited number of foods. There are other children who love to overeat because it’s simply a pleasurable experience and they don’t know when to stop. Irene Chatoor, MD
, Vice Chair of Children’s National Health System’s Department of Psychiatry and Behavioral Sciences
and Director of the Infant and Toddler Mental Health Program
, counsels parents of children with eating problems and disorders.
“Eating as a family is at the center of celebrations,” Dr. Chatoor said. “It is a particularly trying time for parents when a child won’t eat or eats too much.”
Counseling is important for children as young as 9- or 18–months old because that’s when they become more mobile, develop a sense of self, and begin self-feeding. They also start to exhibit oppositional behavior. Children may have ongoing difficulties unless there are early interventions, Dr. Chatoor said.
Whether they eat too much or too little, Dr. Chatoor urges parents that they shouldn’t praise or criticize children, or use food as a reward or expression of affection.When Children Don’t Want to Eat
Some children are so excited about playing that they don’t seem to notice when they are hungry, Dr. Chatoor said. Toddlers may not want to get in the highchair to eat, prompting their parents to try all kinds of things to encourage them to eat.
Children also may use food refusal to gain control over their parents. Dr. Chatoor said one mother put it so well, saying, “I have a two year old executive in my house.”
By not understanding these different eating issues, parents may try to distract and coax their children to eat. Some parents get so desperate that they hover over them or even force feed them. “That can make matters worse,” Dr. Chatoor explains. How to Encourage Children to Eat
Here are some of Dr. Chatoor’s suggestions to help alleviate some of these concerns:
- Have three regular meals and a mid-afternoon snack to allow children to experience feeling hungry and feeling full, so they learn how to eat accordingly.
When Kids Eat Too Much
- If your child gags or vomits upon trying a new food, keep your mood neutral, but make a mental note and do not to serve that food again. Children with strong sensory reactions consistently refuse the same foods, and forcing them to eat those foods makes them more aversive and distrustful of trying new foods.
On the other hand, some children want to continue eating and don’t feel they are finished, even when it seems obvious to parents they shouldn’t have more. These children have “poor awareness of fullness and don’t know when to stop,” Dr. Chatoor said. “When they see palatable food they want to eat it, just by seeing it, regardless of whether they just ate and should be full.”
Dr. Chatoor offers these tips for parents:
Research on Eating Disorders
- Since overweight children tend to eat too fast, help your child to “slow down,” by offering small portions of food. Offering small portions will also help the child recognize when he or she is full.
- Never restrict the child at mealtimes, and only offer another small portion once they have eaten what was on their plate. Ask the child whether he is still hungry and or whether he is full.Prepare three regular meals, which should be at least three or four hours apart, and a mid-afternoon snack. There should be no eating or drinking between except water.
- Do not keep snack foods and sweets around the house to tempt children. Occasionally, offer small portions of candy or their favorite dessert and allow the child to eat the snack food first if that is what he or she prefers.
- A trick of the trade: Use celery or a child’s “non-preferred” food. Offer some celery with food, and gradually increase the size of the celery piece while reducing other foods. At that point, the child stops eating “without the pleasurable experience” of food in their mouth, Dr. Chatoor said.
Dr. Chatoor is an expert in childhood eating disorders and has authored many studies on specific eating problems. In fact, Dr. Chatoor presented some of her latest research last fall at the Academy of Child and Adolescent Psychiatry workshops in San Diego.
She noted in her research that several eating disorders could occur simultaneously in children, including apparent lack of interest in eating or even feeling ill, which Dr. Chatoor has described as “post-traumatic feeding disorder.”
Dr. Chatoor also described findings in a study of 7 to 13 year olds, noting that while two-thirds of children had outgrown their eating problems, one-third continued to show “poor appetite and growth, lack of interest in eating,” coupled with sleep and anxiety disorders. Lack of regular family meals and not eating lunch at school separated a “poor growth group from those who had outgrown their problems,” Dr. Chatoor reported.
For more information on feeding disorders and case studies on feeding disorders, read Dr. Chatoor’s e-book When You Child Won’t Eat or Eats Too Much