I have tried everything! My child does not like to eat!

Do you dread feeding your adorable little child? Has feeding caused you and your household stress and anxiety lately? If you answered yes, you are not alone. More than half of parents are having the same trouble with feeding difficulty reported to be as high as 50-58.9% (1,2)

Parents hope that picky eating will be outgrown in time but it is discovered that the times of feeding struggles impart consequences for the health of the child. Vitamin and mineral deficiency, poor weight gain, and poorer performance in school have been reported (3,4). Apart from this the relationship between the child and the feeders suffers and impacts the psychosocial health of the developing child in a negative way (5.) This proves that you are right to be concerned.

Fortunately, there is hope for the difficult to feed child. And the hope lies not in changing the child’s behavior, but in changing the feeder! You read it right, it is us adults who have to make changes. And the child is sure to follow through with much better feeding behavior. This should be good news since we can readily rely on ourselves to make changes. As you may know from experience, instructing your child to change his or her behavior is easier said than done. So what simple steps can you take? Here are the changes for you to make that are sure to make your child eat and feed better without you having to tell them:

If you have tried to bribe or threaten your child to eat or finish his or her food, I am sure you know it does not help at all in the long run. Force-feeding may have allowed an extra spoon to be eaten. But after force-feeding, a child learns to shut his mouth or pocket the food in her cheeks, or refuse to feed altogether. Some even become afraid to eat or cry at the sight of food or the high-chair. Persecutory feeding is when we feed whether the child is hungry or not, like when yaya follows the child everywhere with a bowl in hand and slips the spoon in his mouth any chance she can get. Prolonged feeding is also commonly done but not helpful. We can pack up the meal after 20 minutes, or sooner if we recognize that the child is full. Prolonged feeding, bribing, threatening, force-feeding, and persecutory feeding are behaviors by the feeder that are proven to make the feeding difficulty worse, and in most cases even cause the feeding disorder (6,7.) A lot of times a normal child will be misperceived as not eating enough, so a well-meaning parent will bribe or force-feed, which becomes the start of the feeding refusal.

All regular, healthy children will eat when hungry and stop when full because their body’s neurohormonal signals are intact. When a child does not eat much of the yummy lunch you prepared with love, there is always an explanation. Perhaps, he just finished a big bottle of milk an hour ago, or he ate a lot of biscuits in the past 2 hours. Children can fast for 3-4 hours before they feel hunger. Trust them when they are not hungry, and believe them when they say they are full. As parents, we can make sure we avoid over-snacking and that we maintain a schedule that allows fasting in between meals.

Since steps 1 and 2 asks you to hold back on the urge to force-feed or to make your child finish the whole bowl of food you prepared, you can now focus on what matters which is to make sure that all meals are healthy for your family, that the family all eat at the dining table for bonding, and that no other unnecessary food or milk is given in between 3 meals and 2 snacks. It has been reported that if the mother was very worried about picky eating, the child is likely to remain picky (8.)

Remember that with these changes you are setting a different environment that will encourage your child to behave differently at mealtimes. The new environment has to be maintained all the time for your child to be comfortable with it. Challenge yourself to be consistent and for sure you will find your efforts will be rewarded.

1. Taylor C.M., Wernimont S., Northstone K., Emmett P. Picky/fussy eating in children: A review of definitions and assessment measures, and prevalence in a UK longitudinal cohort. Appetite. 2015;95:349–359.

2. Pavan Kumar K., Srikrishna, S., Pavan I., Chary E. Prevalence of picky eating behavior and its impact on growth in preschool children. International Journal of Contemporary Pediatrics. 2018; Vol 5, No 3.

3. Kerzner B. Clinical investigation of feeding difficulties in young

children: a practical approach. Clin Pediatr (Phila) 2009;48:960-5.

4. Kerzner B., Milano K, MacLean, W.C., Berall G., Stuart S., Chatoor I. A Practical Approach to Classifying and Managing Feeding Difficulties. Pediatrics 2015, 135 (2) 344-353.

5. Lucarelli L., Sechi C., Cimino S., Chatoor I. Avoidant/Restrictive Food Intake Disorder: A Longitudinal Study of Malnutrition and Psychopathological Risk Factors From 2 to 11 Years of Age. Front Psychol. 2018; 9: 1608.

6. Levine, A, et al. Screening Criteria for Diagnosis of Infantile Feeding Disorders as a Cause of Poor Feeding or Food Refusal. Journal of Pediatric Gastroenterology and Nutrition 2011;52(5):563-8

7. Levy Y, et al. Diagnostic Clues for Identification of Nonorganic vs Organic Causes of Food Refusal and Poor Feeding. Journal of Pediatric Gastroenterology and Nutrition. 2009; 48(3):355-62.

8. Emmett P.M., Hays N.P., Taylor C.M. Antecedents of picky eating behaviour in young children. Appetite. 2018; 130: 163–173.