A mealtime is meant to be a positive experience; a time to take a break, come together, share our culture, and communicate. Mealtimes and food are about giving and receiving love. We show our love through food. It is central to our lives. We celebrate with food and bring food when someone is grieving or in need. When a child has feeding issues, mealtimes can become a source of stress and frustration for parents. Often parents tell me that they dread mealtimes with their child. They describe dramatic and lengthy meals along with exhausting power struggles over food intake.
Ongoing mealtime power struggles can actually contribute to picky eating and food refusal. Pressuring kids to eat is often unintentional, but it can lead to reducing a child’s likelihood to eat. Successful mealtimes are built on trust. If a child feels stressed and anxious at mealtimes, they may want to feel like they have some control…and this often comes in the form of food refusal. Your child may want to let you know that you can’t “make them” do something that wasn’t their idea. At age 3, my son Thomas would say, “You’re not the boss of me!”
Many research studies have demonstrated that pushing, coercing, and bribing kids to eat does not work. It actually reduces their willingness to eat. If kids feel stressed at mealtimes, their brain enters fight-or-flight mode and their appetite is reduced. If your child feels happy and calm at mealtimes, they will bring their appetite to the table and will be more likely to eat. Successful mealtimes are based on trust.
Under Pressure: Pressure to eat comes in many shapes and sizes.
Ellyn Satter is a renowned Registered Dietician who termed the “Division of Responsibility” or Golden Rule of feeding. I highly recommend her website and resources. I often share Ellyn’s golden rule as a handout with families I work with and I ask them to post-in on their fridge as a daily reminder:
This is a very difficult shift for many parents, especially for children with growth issues and extreme picky eating. It’s also important to consider that children with special needs often need parental help and prompting in order to be successful at mealtimes and maintain their growth and nutrition.
When there are power struggles at mealtimes, kids end up being reinforced for not eating. Yes, that’s right. Sometimes, they are getting attention and reward for not eating. Kids are often looking for a response from an adult…any response…negative or positive. When parents are constantly prompting their child to “take another bite”, “eat some vegetables”, “eat some more”, they are receiving constant attention for not eating. This evolves into a situation where the child has established control at mealtimes. By not eating, they earn a response from their parent. In time children become prompt-dependent and may not be able to self-regulate their hunger cues. When parents decide how much a child should eat, children lose their ability to decide when they are hungry and full.
In behavioural psychology in order to extinguish a behaviour, you ignore it. No reinforcement for non-target behaviour. In order to increase a behaviour, you reinforce it. I use a combination of approaches to address challenging behaviours at mealtimes.
Example at mealtime:
Thomas throws food: Ignore
Thomas licks a new food: Smile and talk to Thomas
Over time, Thomas will learn that he doesn’t get any response for throwing, but he receives a smile and communication when he is exploring food.
Thomas in this story is my son and he had Gastroesophageal Reflux Disease (GERD) and sensory processing issues as a toddler. As a mom, I often dreaded the drama at mealtimes. Thomas would throw food at the wall and spit food at me during feedings. In response, I would act nonchalant, turn away from Thomas, and remove my eye contact and attention when he was throwing or spitting. I would eat my own food. When he resumed eating, I would respond by talking to him, eating with him, and smiling. I was reinforcing or increasing target behaviours by responding and eliminating non-target behaviours by ignoring them. When changing any behaviour it’s important to be consistent. I know it's not easy, but it works.
Alternatively, I also recommend using re-direction for challenging behaviours. This involves telling your child what to do versus what not to do.
Example at mealtime:
Thomas throws the food: “Food stays on the table.” versus “Don’t throw your food.”
Thomas throws the food: “Food goes in the all-done bowl.” versus “Stop throwing!”
Here are 14 tips to reduce mealtime power struggles:
*Regarding tip number 9: How would you feel if you went out for lunch with a friend and the entire meal your friend constantly prompted you to eat your food: “You haven’t taken a bite of your soup.” or “Take another bite of your bread.” This would be a strange and stressful meal. Instead, you would talk about your kids, the weekend, or your summer plans. If your friend spent the entire lunch date prompting you to eat your food, you probably would pass the next time she invited you. It would feel like a lot of pressure and not much fun. This is how kids feel when we constantly prompt them to eat throughout mealtimes. Try talking about other things than eating. Talk to your child about their day, their favourite PAW Patrol character, or what you will do after dinner. If you reduce pressure to eat, and just model enjoyment of your own food, your child will gradually start eating more on their own.
Parents often ask “how much” their child should eat at mealtimes. Let’s go back to Ellyn Satter’s approach. Your job is to present foods on a schedule that allows appetite (WHEN), in a place WHERE you child can focus on eating, with foods from different food groups (WHAT). Your child’s job is to decide HOW MUCH or WHETHER they want to eat at all. Parents often pressure kids to eat at mealtimes when a doctor has indicated that there has been a dip in the growth curve or the child is at the low end of the curve. This creates a great deal of anxiety for parents and they resort to pushing their kids to eat. Parents feel scared and desperate. Trust me, I know…I was one of those parents. It doesn’t work.
As a parent, you may not feel comfortable taking a ‘all or none’ approach to this method. If your child has special needs or is a very picky eater it may take longer for him to progress and master these skills; but he will follow the same steps as other children that are learning to eat. The stages will look the same, they just may take longer and be harder work. It’s ok to start by making small changes. Perhaps you could try a bit less prompting and talk about other things at mealtimes. Perhaps you could observe your own behaviour and try not to respond when you child demonstrating challenging behaviours. Making small changes can gradually lead to big improvements at mealtimes. Maybe at your next mealtime, try putting some music on, talking to your child about their day or what you will do after dinner, and accepting that it’s ok if they don’t eat all of their food at every meal. Evidence shows that foods may need to be offered at mealtimes 15-20 times before your child decides if they like it or not…so keep trying. Relax and enjoy your own meal. Stop counting and measuring. Eventually your child will learn to eat too.
Ellyn Satter, RD: www.ellynsatterinstitute.org
“Ellyn is a Registered Dietitican who has devoted her career to uplifting the mealtime experience. She teaches parents how to transform family meals into joyful, healtful, struggle-free events, free from drama and conflict.