When Are a Child's Food Issues Just a Phase vs. Something to Worry About?
No child is without their own food issues, and they each have different forms or timelines. While some will phase out, some may actually be cause for concern. We save parents potential stress by talking to experts about how to know if these things are temporary, or if they are something far more serious.
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No child is without their issues regarding food. They may take on different forms, or have differing timelines, depending on the child, but every parent has their own grievances. While most of these problems phase out over time, some can signal more serious conditions.
"Food issues that persist for years or grow worse over time may be a sign of an underlying condition," say Natalya Murakhver and Victoria Stein Feltman, RD, co-founders of Apple to Zucchini, a healthy eating resource for parents and families. "Some kids want to try new foods but have a physiological reaction (gagging, throwing up) when they do. This may be a sensory sensitivity (meaning they are very sensitive to certain smells, tastes or textures) or just extreme food aversion."
How can a parent tell the difference between the more traditional episodes, and conditions that are far more serious? And when should they consider contacting a medical professional to weigh in? We talk to parenting experts to learn more about the food issues parents face with children on a regular basis.
How can I identify real problems vs. phases?
Every parent should know that complications with food are perfectly normal for kids, especially at a young age. Identifying these early on can help parents work towards a solution before any of them become serious problems. That said, most will fade away with patience and support.
"If your kid refuses to eat vegetables, has aversions to textures, often spits out his chewed food, and doesn’t want to eat more than a few bites, relax, your kid is normal," assures Mitzi Dulan, Registered Dietitian and Founder of simplyFUEL. "However, there are still ways to combat these difficulties. Preparing foods in a new way, switching up presentation, leading by example and letting them have a say in their meals may help." There's nothing abnormal about picky eating with children, despite how frustrating it may be for parents.
So what are the signs of real issues that may require medical attention? "If your child is having a physiological reaction to trying new foods or going hungry or refusing to eat the meals you are providing, the issue may be more deep-rooted," say Murakhver and Feltman. Adds Dulan, "Signs that your child’s eating habits are serious issues may include them refusing food because they want to lose weight at a young age, obvious anxiety around mealtimes, and losing or gaining weight quickly."
Should I consult a doctor? If so, when?
The concern for many parents is figuring out when to get a medical professional involved in a situation around food struggles. Many are afraid they're being overdramatic, or aren't concerned enough.
"If your child is losing weight or no longer tracking on their growth curve, we recommend consulting your pediatrician or another medical professional," advise Murakhver and Feltman. Dulan agrees that if a child is losing or gaining weight very quickly, that's when it's time to contact a pediatrician or dietician. "Children are classified as underweight if they are below the 5th percentile and considered obese if they are at or above the 95th percentile," she says. "Both of these designations should definitely result in additional help, so your child can quickly get back on the right track."
It's important for parents to first try working through problems at home, because oftentimes, food issues can be worked out over time. "If you notice they do not like eating a category of foods, such as vegetables or dairy, incorporating them in a smoothie may be helpful," recommends Dulan. "Spinach is practically tasteless when added to a smoothie. If this fails, a gummy multivitamin might be a good choice just to ensure they are meeting all vitamin and mineral needs."
What resources are there if my child needs feeding therapy, occupational therapy other types of help?
If these issues are of the more serious kind for children, many parents aren't sure where to begin finding help. "History of reflux and/or slow speech are red flags for feeding difficulty," says Dulan. "Your pediatrician will be able to tell if your child needs additional assistance from feeding specialists, speech pathology, or occupational therapy."
It's imperative for parents to find a pediatrician they trust so that they can get proper help in situations like this. Your pediatrician is the perfect source to know what assistance is necessary and how to find it.
Murakhver and Feltman suggest starting with The Ellyn Satter Institute. "Ellyn Satter’s Division of Responsibility model allows the child to determine whether and how much they want to eat," they explain. "If you prefer a more conventional approach or you believe your child has a sensory sensitivity, your pediatrician will be able to direct you to a speech or occupational therapist who specializes in feeding therapy."
What if my child isn’t interested in eating breakfast?
Breakfast is the best way to start any morning, and has often been called the most important meal of the day. With mornings being such a time crunch for most families, it's also the meal many prioritize the least.
Dulan recommends first looking into why a child is showing disinterest in their AM nourishment. "Are you eating breakfast with them? They may see you rushing around in the morning and sacrificing your own breakfast and be confused about why they need to eat when you’re not," she says. "Eat breakfast alongside your child and be a good role model by showing that you value eating breakfast, too."
"They also may be tired of eating the same thing every day or not having a say in what is served to them," Dulan adds. "Try offering a couple of choices in the morning ('Would you like oatmeal, cereal, or yogurt today?'), so they are excited to eat what they chose. Another reason your child may refuse breakfast is that they are distracted. If the TV is on nearby or they have toys at the table, eating will fall to the wayside."
Murakhver and Feltman also stress the importance of not pressuring your child to eat when they are not hungry, as they may get hungry later in the day.
"That can ultimately lead to them losing touch with their hunger and satiety cues," they advise. "You may try offering a small serving of fruit, yogurt, nuts, or cereal in appealing small and colorful dishes, alongside water or milk." One tip Dulan has if your child rejects solid foods, or prefers a glass of milk or juice, is making them a smoothie. "A great breakfast smoothie recipe is half of a banana, a handful of ice, ½ cup of skim milk or non-dairy milk, 1 spoonful of nut butter, ⅓ cup of granola and dash of cinnamon."
What if my child is more interested in snacking than eating full meals?
It is common for children to be more excited about their snacks than the full meals you prepare for them. And while there is nothing wrong with the occasional nosh, it's important to be mindful of what's being given to kids, and how often.
"We recommend offering snacks (and meals!) on a set schedule and trying to make snacks as whole healthy and unprocessed/unboxed as possible," say Murakhver amd Feltman. "A good rule of thumb is to think of snacks as mini-meals. If your child is eating nutritionally dense snacks, it will remove some of the pressure to get them to eat at mealtime. Always offer water alongside — often thirst masks as hunger and kids should have access to fresh water all day long."
The key is making sure snacks don't get in the way of mealtime. "If your child consumes too many snacks throughout the day, they may have already consumed their daily caloric need," points out Dulan. "Therefore, they may be full by the time dinner rolls around, and eating more will make them physically uncomfortable."
It can be easy to forget how much smaller your child is and that they don't require the same amount of food as an adult. So while it may seem concerning they dread meals over snacks, they may just feel overwhelmed by the portion size of a full meal.
"It is important to note that a child grows extremely fast in the first 2 years of life, but growth begins to slow after that," reminds Dulan. "Your child may only need 1,000-1,500 calories, which doesn’t seem like a lot compared to the 2,200 that you consume every day. Just remember to serve kids smaller portions than you would eat."
What is the best way to help while being sensitive to my child’s potential needs?
Some dramas with kids around food may require attention, but some aren't worth making a fuss over. Children may be just as aware of these things as you are, and may have their own insecurities about them.
"A child may be upset or caught off guard if they are having fun playing and then immediately asked to eat food," says Dulan. "They might not be aware of the time and did not know a mealtime was coming up so soon. Routines can help children mentally prepare for what is next. Another helpful tip is instead of just repeating over and over again 'please just eat something!', talk to your child about why eating these foods are good for them."
"And finally, it's never a good idea to force a child to eat a meal," she adds. "You can provide healthy food choices, but it is up to your child to decide how much food they want to eat." Trusting a child to know their own body can be difficult for parents to accept, but figuring it out for themselves is integral to their relationship with food.
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"Never label a child, so they are not a 'picky' eater, though there may be selective phases," suggest Murakhver and Feltman. "Always encourage and take deep breaths when serving and sharing meals. The more stressed you are about the meal, the more your child will sense and react. Also, try not to talk about healthy eating or nutrition at mealtime."
There's no harm in making kids a bigger part of the meal, and their increased involvement may help build the excitement they have toward new foods. "Try to make mealtimes communal, pleasant and relaxed experiences," add Murakhver and Feltman.
"When kids seem picky, take them along with you to the grocery store," Dulan recommends. "Instead of telling them, you’ll be in and out in a minute and not to touch anything, let them explore. Let them pick out something new they would like to try for lunch or snack. They’ll feel much more included and understand that making food choices can be fun."
What if I’m seeing similar behaviors in their friends?
There's often an air of nerves when young kids are spending time with their friends —parents lose control over what they learn or what habits they might pick up. And while it might be relieving to discover some of these friends are experiencing the same frustrations as your child, you should try not to fixate on other kids. "You don’t know what foods someone else’s child is used to, how much they previously ate, who they eat meals with, etc.," says Dulan. "Relax knowing you’re not the only one who is frustrated with your child’s eating habits, but focus on your kiddo."
Your instinct may be to contact the other parents, if only to feel less alone in your situation, but it's important to tread lightly in case they are handling it differently. "This is a sensitive situation and one that must be attenuated to the relationship you have with the child’s parents," say Murakhver amd Feltman. "You could try to bring it up gently by talking about your child’s struggles and listening a lot to the other parent, taking their cues, or depending on your child’s age, you could also have a gentle and playful conversation about favorite foods and trying new things and see how they view their friends’ eating habits."
The most important rule of all? "Ask questions rather than offer opinions," conclude Murakhver and Feltman.