Food refusal

Posted by Barbara F. Meltz  May 20, 2009 06:00 AM

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When a preschooler refuses to eat, it sets up a powerful reaction in parents. Our job is to sustain our child, and yet we have no way to control what she will or won't put in her mouth. Or do we?

Question: My 4-year old daughter recently started complaining that she cannot swallow her food. I'm not sure if this is a real physical problem, a psychological one, or if it's just an excuse so she doesn't have to eat her meals. What should we do? No amount of withholdings nor offer of rewards has had any impact. She's never been a big eater, but we could usually get in 2 - 3 meals a day. She has a new baby sister (now almost 7 months old.) Could this be some delayed reaction to her new sibling? Thanks.
From: Ladywxbee, Hudson

Hi Ladywxbee,

Yes, I'd put my money on that. But first, call your peds office and get her checked out. Even if it's not medical, she needs to trust that you take her complaints seriously and you need to rule medical possibilities out, just to be sure.

My guess, however, is that this is indeed related to her baby sister. It's not unusual for reactions to be delayed: She"s likely hit a new level of cognition and it's dawned on her, "Uh oh, this baby is not going away!" There are also other developmental reasons why a 4-year-old might refuse to eat: a way to assert independence, or a way to signal she's conflicted about her independence.

Either way, I would consider her refusal to eat as an attention-grabber. And boy, has she got your attention. Stop the swinging between withholding food and offering rewards. Stop talking about what she's eating and what she's not. Make it a non-issue between you. Caveat: That assumes she is getting minimal nourishment; your pediatrician can tell you what that is for her.

Let her know the rule in the family is that food happens at specified times: three meals a day and two snacks (or whatever) that happen at set times. I recommend the snacks coincide with two of the baby's feedings. Be clear and firm, but also kind and gentle. Don't force, don't tie the food to your love. Offer what's available. Make the meals a pleasant time, where there is conversation that involves her and a good family feeling of being together. If you can, involve her in the preparation in some way, for instance, it's her job to put the napkins on the table: "The baby can't help, she's just a baby. But you can!" At the same time, tell her explictly that you will always be there to take care of her and play with her. Repeat those words often. Also, make special time for each parent to do something fun with her each day even just for five minutes. If it's attention she's wanting, you want to find ways to give it to her without her needing to act out to get it.


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4 comments so far...
  1. When we had our second daughter, the oldest was just starting to not want to eat for whatever reason. I implemented a rule, that it's OK not to have to eat dinner, but the next meal is breakfast. It was her choice. That's it. It was not said with the fear the child was going to "starve" because she wasn't and there was no substitution such as cereal (I'm not a restaurant.) Only once did she "miss" a meal.

    This rule applied to everyone in the family - including my husband, but it also included the choice of watching TV vs. sitting down to eat. (I worked full-time & you get 3 chances to come to the table.) He and the oldest both missed a dinner (because of a TV program), while the youngest (around age 6 or 7) ate. The table was cleared and we went our way. That only happened once also.

    The bottom line is - don't worry about it. If everything is OK, she in not going to starve to death, just don't cater to it. Tell her fine, next meal is . . . . (what ever the next meal would be.)

    Posted by g05 May 20, 09 09:58 AM
  1. I have two nephews who are adults but when they were that age, ugh ugh ugh for food. One doesn't have any siblings and the other has a sister. However, the one without siblings, my sister always hovered. That nephew insisted he hated mustard as a child and adult, but I have made recipes with mustard that he absolutely loves. I think it is just a phase, of course have your child examined by the doctor to rule out anything physical and then maybe have some discussions with your child. some down time, just the two of you. Good luck. Children, if given the chance, always want to confide. My late husband was great as getting the kids to confide in him...

    Posted by sophie08 May 20, 09 11:51 AM
  1. I'm with g05. I still do that with my kids - if they choose not to eat what's offered, it's their choice, but they don't get an alternate meal or an extra snack. I don't think it's a coincidence that my older child has become an extremely adventurous eater, and the younger one, although somewhat picky at times, is still far more adventurous than many of her peers. It also works well with the kids who flit back and forth from the table - when you get up, meal's over, nothing until the next regular meal/snack. That cures the wandering quickly. It even works with little ones who throw stuff out of their highchair - "ok, meal's over!". They learn quite quickly that mealtime is for eating and socializing, not games. It's definitely no coincidence that I have children with great table manners, who carry on pleasant conversation with their dining companions.

    Posted by akmom May 20, 09 12:12 PM
  1. Kids will eat if they are hungry. Offer food at regular intervals and make it clear that's what is available. Also, make it clear that when a meal is over, it's over. We have used a timer set to a reasonable amount of time (30-40 minutes) to underline this point. It typically only takes once for them to get the picture, although it may involve some drama. We also make sure to offer a "safe" course with every meal that we know is generally acceptable, as well as offering something like fruit in whatever quantity is desired. Dessert may or may not be served dependent on how dinner has gone, but we don't let the kids skip dinner and gobble down a gallon of ice cream.

    We've also involved the kids in meal preparation and table setting. When they have something to do with the meal, they seem to get into it more than if it's just put on the table.

    Rewards (aka bribes) only have a way of getting bigger. While they may be appropriate for occasional or exceptional circumstances, something as routine as eating a meal shouldn't require them.

    Posted by K May 20, 09 12:36 PM
 
4 comments so far...
  1. When we had our second daughter, the oldest was just starting to not want to eat for whatever reason. I implemented a rule, that it's OK not to have to eat dinner, but the next meal is breakfast. It was her choice. That's it. It was not said with the fear the child was going to "starve" because she wasn't and there was no substitution such as cereal (I'm not a restaurant.) Only once did she "miss" a meal.

    This rule applied to everyone in the family - including my husband, but it also included the choice of watching TV vs. sitting down to eat. (I worked full-time & you get 3 chances to come to the table.) He and the oldest both missed a dinner (because of a TV program), while the youngest (around age 6 or 7) ate. The table was cleared and we went our way. That only happened once also.

    The bottom line is - don't worry about it. If everything is OK, she in not going to starve to death, just don't cater to it. Tell her fine, next meal is . . . . (what ever the next meal would be.)

    Posted by g05 May 20, 09 09:58 AM
  1. I have two nephews who are adults but when they were that age, ugh ugh ugh for food. One doesn't have any siblings and the other has a sister. However, the one without siblings, my sister always hovered. That nephew insisted he hated mustard as a child and adult, but I have made recipes with mustard that he absolutely loves. I think it is just a phase, of course have your child examined by the doctor to rule out anything physical and then maybe have some discussions with your child. some down time, just the two of you. Good luck. Children, if given the chance, always want to confide. My late husband was great as getting the kids to confide in him...

    Posted by sophie08 May 20, 09 11:51 AM
  1. I'm with g05. I still do that with my kids - if they choose not to eat what's offered, it's their choice, but they don't get an alternate meal or an extra snack. I don't think it's a coincidence that my older child has become an extremely adventurous eater, and the younger one, although somewhat picky at times, is still far more adventurous than many of her peers. It also works well with the kids who flit back and forth from the table - when you get up, meal's over, nothing until the next regular meal/snack. That cures the wandering quickly. It even works with little ones who throw stuff out of their highchair - "ok, meal's over!". They learn quite quickly that mealtime is for eating and socializing, not games. It's definitely no coincidence that I have children with great table manners, who carry on pleasant conversation with their dining companions.

    Posted by akmom May 20, 09 12:12 PM
  1. Kids will eat if they are hungry. Offer food at regular intervals and make it clear that's what is available. Also, make it clear that when a meal is over, it's over. We have used a timer set to a reasonable amount of time (30-40 minutes) to underline this point. It typically only takes once for them to get the picture, although it may involve some drama. We also make sure to offer a "safe" course with every meal that we know is generally acceptable, as well as offering something like fruit in whatever quantity is desired. Dessert may or may not be served dependent on how dinner has gone, but we don't let the kids skip dinner and gobble down a gallon of ice cream.

    We've also involved the kids in meal preparation and table setting. When they have something to do with the meal, they seem to get into it more than if it's just put on the table.

    Rewards (aka bribes) only have a way of getting bigger. While they may be appropriate for occasional or exceptional circumstances, something as routine as eating a meal shouldn't require them.

    Posted by K May 20, 09 12:36 PM
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Barbara F. Meltz is a freelance writer, parenting consultant, and author of "Put Yourself in Their Shoes: Understanding How Your Children See the World." She won several awards for her weekly "Child Caring" column in the Globe, including the 2008 American Psychological Association Print Excellence award. Barbara is available as a speaker for parent groups.

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