Food Strike!

A recent facebook question: Any articles out there about what to do when your child goes on an eating strike? My son, who's five (soon), has these occasionally, and he's already thin as a rail to begin with :)

My answer became much too long, as this is a very common concern and there are so many aspects, so it turned into this blog.

This question (very common) always reminds me of the Judy Blume book, Tales of a Fourth Grade Nothing.  (One of my favorite books growing up.)  The younger brother in the book, Fudge, refuses to eat.  After many failed trials of forcing food, and bribing, his Dad finally loses patience and says "eat it or wear it."  Needless to say, Fudge ends up with the bowl of cereal on his head and goes around for days saying "eat it or wear it!"

Food Strike!  This is a common concern of parents.  But kids are smart, they won't let themselves starve.

Of course there are some instances that are cause for concern.  Red Flags include kids who are sick, recurrently vomit or ruminate, seem dehydrated, have problems with food allergies, are very limited in foods over an extended time, experience swallowing problems or choking, or who are not following their growth curve.  Red flags are another topic entirely!  Work with your physician in these cases.

If hungry, he will eat.  Just don't let him fill up on things that aren't giving a nutritious balance. Even just milk all day can be harmful because it lacks many vitamins and minerals, so a little milk with other foods is better!

• Offer veggies, fruits, cheese, nuts, etc at scheduled snack times. 
• Limit pre-packaged foods and snacks.
• Limit drinks other than water and low calorie milks.  These fill kids up and don't offer balanced nutrition.
• Put only a small amount on his plate... it might be overwhelming to have a full plate.
• Turn off the tv.  Have a dinner conversation with the family.  This not only sets up healthy eating habits, but also healthy family dynamics. Teens who eat with their families are less likely to have risky behaviors!
• Set a good example!  Talk about how much you are enjoying the healthy foods at the table. (Not how healthy they are, but rather how good they taste.)
• Keep foods separate on the plate... they might eat one food if not touching another.
• Set a time for meals and stick to it.  If your child doesn't eat, still clear the table.  When they complain of being hungry, don't be condescending.  Simply say, "I know how you feel.  I'm hungry too when I don't eat.  Dinner is coming up soon. I'm sure you'll be ready!"  Don't offer filler foods. Don't yell.  Don't over-discuss.  Kids are smart, they'll pick up on the fact that they need to eat at meal time or be hungry.  (They won't starve to death!)
• Hide healthy foods in casseroles, sauces, etc.  I love my blender... the food processor was too much for me to clean, but my blender works just as well!  Many vegetables have little flavor, which makes it easy to "hide" them in things.

• I put a can of beets in with the spaghetti sauce --makes a cool color without changing the flavor.    

• I put carrots, spinach, or cabbage in my smoothies without changing the flavor.  Strawberries, bananas, kiwi, and other fruits are much more flavorful than many veggies and kids tend to like their tastes.  I just try to match color to hide the vegetable. 

•  Puree onions, carrots, zucchini, spinach, and other vegetables in recipes rather than chopping them... kids won't pick them out!  Chances are they won't even know they're there.

• Try foods in different forms: 

• frozen peas are crunchy-- maybe they don't like the squishy texture of cooked peas
• raw broccoli is much different in taste and texture than cooked broccoli
• many kids love cheese over vegetables or foods dunked in catsup or yogurt
• it is fun to eat with fingers for a change... let them get messy!
• try cutting things into pieces and serve with toothpicks
• make a kabob of fruit and cheese pieces... it's always more fun to eat off a stick! 
• cut sandwiches with a large cookie cutter for fun shapes
• use small cookie cutters for bite sized sandwiches or fruit pieces 

• Try not to use food as a reward. This can set up unhealthy eating habits.
• Don't reward for eating.  Most kids will get the intrinsic reward of satiety.  They don't need stickers or dessert for eating a meal.
• Praise small steps.  If kids try a new food (whether they like it or not) praise the fact that they tried!

Set your expectations realistically.  Don't expect kids to eat as much as infants/toddlers or teens/adults.  Calorie needs go down when not in growth spurts.  Just make the nutrition needs balance.  Don't worry as much about volume as variety of healthy foods!  Most kids don't need supplemental meals in a can (Pediasure and other brands) ~ they are getting the nutrition and calories they need, there is just an imbalance of perception of what they need.  I always prefer a healthy, active, thin child over a child who is overweight and not active (and often undernourished due to poor quality foods).

Vitamin supplement use and need is debated (except Vitamin D, which is recommended for all).  In general, I think it is a good idea to give a multivitamin with iron if kids aren't eating well.  Iron deficiency actually causes anorexia-- increasing the problem!   Just be sure to lock up vitamins as if they are medications, so kids don't accidentally ingest too much. 

Most kids grow well during their picky eating and food strike phases!  Just be patient and aware of any red flags that need to be evaluated.  If you are concerned, schedule an appointment to discuss foods, growth, nutrition, and concerns.  Bring a typical food log of foods and drinks (with approximate volumes) for at least one week.  We can either identify a concern and develop a plan of action, or reassure you that your child is normal!