Friday, March 07, 2008


Refusal to Eat

Q: Should a parent try to force a child to eat?

A: No. In fact, the dinner table is one potential battlefield where a parent can easily get ambushed. You can’t win there! A strong-willed child is like a good military general who constantly seeks an advantageous place to take on the enemy. He need look no farther than the dinner table. Of all the common points of conflict between generations—bedtime, hair, clothes, schoolwork, etc.—the advantages in a food fight are all in the child’s favor! Three times a day, a very tiny youngster can simply refuse to open his mouth. No amount of coercing can make him eat what he doesn’t want to eat.

I remember one three-year-old who was determined not to eat his green peas, despite the insistence of his father that the squishy little vegetables were going down. It was a classic confrontation between the irresistible force and an immovable object. Neither would yield. After an hour of haranguing, threatening, cajoling, and sweating, the father had not achieved his goal. The tearful toddler sat with a forkload of peas pointed ominously at his sealed lips.

Finally, through sheer intimidation, the dad managed to get one bite of peas in place. But the lad wouldn’t swallow them. I don’t know everything that went on afterward, but the mother told me they had no choice but to put the child to bed with the peas still in his mouth. They were amazed at the strength of his will.

The next morning, the mother found a little pile of mushy peas where they had been expelled at the foot of the bed! Score one for Junior, none for Dad. Tell me in what other arena a thirty-pound child could whip a grown man!

Not every toddler is this tough, of course. But many of them will gladly do battle over food. It is their ideal power game. Talk to any experienced parent or grandparent and they will tell you this is true. The sad thing is that these conflicts are unnecessary. Children will eat as much as they need if you keep them from indulging in the wrong stuff. They will not starve. I promise!

The way to deal with a poor eater is to set good food before him. If he claims to not be hungry, wrap the plate, put it in the refrigerator, and send him cheerfully on his way. He’ll be back in a few hours. God has put a funny little feeling in his tummy that says, “Gimme food!” When this occurs, do not put sweets, snacks, or confectionery food in front of him. Simply retrieve the earlier meal, warm it up, and serve it again. If he protests, send him out to play again. Even if twelve hours or more go by, continue this procedure until food—all food—begins to look and smell wonderful. From that time forward, the battle over the dinner table should be history.

— Dr. James Dobson

Ok, so apparently Dr. Dobson forgot the part where your hungry child becomes low blood sugar, despondent, cries himself to sleep on the floor at 10am, then wakes up and throws up the water he drank in the morning to try to alleviate his hunger. All so that he didn't have to try one bite of potato the size of a blueberry that he refused to try the night before. (we were trying to get him to try one bite of something new, no more food until he tries that bite.)

Do I just keep refusing food until he passes out? Which is practically what he was doing, he was all ready to just go back to sleep again (which he never does & definitely shouldn't be tired since he's had all his naps & gone to bed on time lately).

How is refusing him food until he eats what you want him to eat not "forcing" him to eat? It sure feels exactly like the battle Dobson describes before his brilliant solution. We were most certainly engaged in a battle of wills and stuborness.

I know we haven't done everything perfect in the food department, but where to go from here? I have a son who eats no vegetables, lots of fruit, lots of dairy & carbs, breaded chicken & occaisionally white fish. And refried beans, but only the ones at Taco Lobo that are pureed smooth. And will not try anything new unless its a condiment.

We've tried offering him new things & just letting him eat or not eat it as if we don't care. Doesn't seem to help. We've tried only giving him what we are eating for dinner and that led to:

1) Completely miserable meal & bedtimes for over 2 weeks with almost zero progress
2) Saben crying the instant I told him it was supper time. He dreaded & hated dinner.
3) Saben binging on 4 bowls of cereal every morning because he was so hungry.
4) Pregnant, tired mommy & daddy finally giving up.

What's nuts is that he actually eats fewer things these days because every now & then he'll get tired of something & drop it from his repitoire. (like cheese sticks) I tried blending some squash into his mac & cheese, and now he thinks he doesn't like mac & cheese either. Oh, and Saben LOVES to help me make food, he does it all the time. But contrary to stories you see everywhere, just because he helps me make a huge green salad does not mean he will try even one bite of it.

Ideas, weblinks, books, & encouragement welcome.


TheFiveDays said...

I can totally empathize. My son Jacob (4) has autism, and as part of that is a "selective eater". This means that he is picky beyond belief. He has to have a couple bottles of Pediasure every day to keep him from starving (and we are SOOOO thankful that he likes Pediasure, or he might have had to have a feeding tube put in my this point.) And just because he is starving does NOT mean he will eat. It is scary.

I can offer some ideas, because he has a whole staff trained in behavioralism who have been helping me out.

Obviously Saben doesn't have autism, but that means it should be a lot easier for some of the things we are trying/have tried to help you out.

There are many different approaches you can try, and it seems like you have done quite a bit already!

What we are trying is to approach it on two levels with Jacob:

One is just to get the nutrition IN to him. Because we have found the worse he eats, the less hungry he gets. Not to mention all the other stuff that comes along with poor nutrition. Also, the more frightened you are about the fact that your child isn't eating, the more you try to force food on them...which they then reject.

This means Pediasure, as well as some "Sneaky Chef" techniques. He drinks at least 2 Pediasure a day (recommended by a registered dietician we saw...she said he could have up to four if he weren't eating ANYTHING).

Then I try to cook as many of the things he does eat using some sly techniques to get extra nutrients in.

Jacob is the master of tasting ANYTHING off in his food. This is really common with autism. It is truly amazing what he can detect! But some of the things that have worked for us are:
- Putting 1-3 spoons of pureed fruit (usually some Gerber baby food pears, apples, or peaches) in his chocolate milk. He can detect it in his juice, but not in chocolate (or strawberry) flavored milk.
- Sneaky Chef milkshakes. They have a spinach/blueberry puree in them but they taste like regular chocolate milkshakes. My husband even loves them. You can't taste the puree at all. It would be awesome if I could get a smoothie in him, but that's a no-go.
- Sneaky Chef chocolate chip cookies. These taste really good and they have a white bean puree in them, not to mention her flour blend.
- Sneaky Chef grilled cheese sandwiches (you spread a little yam/carrot puree on the bread before you put the cheese on).

I'd have a bunch more if there were more things he'd eat but he is pretty limited! I am CONSTANTLY on the lookout for foods he might like that have even a tiny bit of nutritional value to them. He sometimes will eat chocolate z-bars (kids' Clif bars) and I feel so relieved on the days when he does. What a find! There are also some frozen muffins (Vita Muffin) he ate for awhile that I loved. Etc!

SO then we have the other side of the coin, which is to work on getting him to KNOWINGLY eat new foods. We have been diligently working on this for two years now and it is still touch and go, but I imagine once again that you'd have much better luck!

Some things that we have tried:

- Having two small plates. One with all the stuff from the meal that you know he likes. One with the one item he doesn't. The plate with the one item he doesn't has about a pea-sized portion of the "yucky" food. And it was recommended that we start this with foods he eats sometimes, not stuff that he absolutely hates. Then he has to eat the super-teeny-mini bite of yucky stuff to have access to all the other yummy stuff. There is no cajoling from you, no forcing, no attitude. Very black and white.

- Rewarding eating bite-for-bite. This is what works best for Jacob, and we have had to shape it for different foods. So for instance if we are working on a food he sometimes eats, we may require that he takes a regular bite of it in order to get a bite of a reinforcer food (for Jacob, this is a cookie, candy, chip, goldfish with squeeze cheese on it, etc). All we do is say, "take a bite!" and we hold the reinforcer right up so we can pop it in his mouth as SOON as he is ready for it. But if it is a totally new food or something he's had a lot of trouble with, we might start rewarding him for just touching it, picking it up, or touching the food to his lips. The reason we can have the patience with this technique and wait him out is because we know he is at least getting basic nutrition with the Pediasure and "sneaky chef" stuff. When we do this with him we are very relaxed, let him play with the food all he wants, etc.

I hope this helps a little bit. I think that getting your kids to eat healthily is one of the most difficult parts of parenting!! It is just so stressful.

shawn said...

It'll pass, Kari! :) I am pretty sure food 'jags' are quite normal. Even ones that last two years. When I was a nanny, I would do things like putting all different types of little foods into each hole of a muffin tin, and let them eat whatever they would. Or put things onto toothpicks. Really, it'll pass, just before scurvy sets in.

AndiMae said...

Oh, Kari! I am so sorry that this is still such a huge issue for you guys! As I have said before, I wish that you and my sister-in-law could talk about all of this together- I know that she can completely relate! Some of "thefivedays" suggestions sounded really good though, don't you think? If it makes you feel any better, even though Audrey eats pretty well, lately it has been like living with a 15 year old- the way she changes her clothes a million times a day and talks back to me...

P.S. I loved your random me list! All of it made me miss you so much-especially #1- you totally do that all the time and it is so cute :)