Reader question: “What do I do if my toddler refuses their dinner meal – let them go hungry? or give them another meal?

Reader question: “What do I do if my toddler refuses their dinner meal – let them go hungry? or give them another meal?

This question recently came up in a local mummy group that I am privileged to be a member of. What intrigued me with this question was that everyone had a slightly different answer. Which was confusing – what’s the right answer? Well at the end of the day – do what sits well with you – go on your gut feeling. But if you asked feeding experts around the world the same question, their answers hopefully would all be consistent…here is what I would have said….

alex, turning away

Toddlers are a really fun age – they cognitively have worked out that they are separate to you. And in the beautiful circle of security, they will explore, check in with you, test the limits and definitely use their favourite word – “no” – all of these changes can even occur overnight. Which leaves parents perplexed – their little baby ate most things but now this toddler is throwing foods and stating quite clearly what they like eating (biscuits and milk) and what they don’t (meat and vegetables).

Reach for your Nutella jar (well this is what I do when I need a “pause”) and then breathe out- this is a NORMAL PHASE and this too will pass.

So what do you do?

Remember the basic law of feeding:

Parents decide: what to serve, when to serve it and where to serve it

Eg chicken rice and beans at 5pm at the dinner table

Your child’s role is to decide how much they want to eat and if they want to eat it at all

Eg one try of the chicken – spit, no beans, 2 spoonfuls of rice and that’s it – thanks mum ?

using-tongs-to-serve-food

So why is this law of feeding so important to maintain?

Because if you let a toddler have open access to your kitchen and your choices of food – they will do what all toddlers do – they will test you and more often than not -say no.

This gold standard of feeding law is what us as feeding therapists preach because our biggest food goals for your child in life is to:

  1. Feel positive about eating (remember my rant about the American funniest video clip?)
  2. Learn to know when they are full and when they are hungry (grazing doesn’t help this)
  3. Rely on variations of appetite to know what to eat so one mealtime they might eat a lot, and other mealtimes, they might just graze (we as adults don’t always eat the same amounts at every meal right?)
  4. Maintain their natural interest in exploring new foods

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As Ellyn Satter, Dietitian in her book Child of Mine says, “your child does want to grow up with respect to eating and that’s what he is all about with his various quirky behaviours”. Your job? Is to trust them. Ellyn also goes on to describe the following in her book:

You are NOT trusting your child if you

  • Make them stay at the table to eat his vegetables
  • Clean his plate
  • Eat everything before he can have dessert
  • Get by on 3 main meals/day (ie no morning and afternoon tea)

You are NOT providing enough structure and limits if you

  • Give your child a snack whenever he wants
  • Let your child behave badly at the table
  • Regularly prepare special food for your child (that is separate to the family meal)
  • Short order cook – i.e. if he says no to your meal – you cook something else
  • Let your child have juice or milk whenever he wants

The battle of wills at meals is normal.

Your role is to stick to your foundations of positive trust based feeding.

5-month-old,-refusing-spoon

One of the suggestions that I commonly hear to this parent question is:-

Parent says: you must take one bite of everything on your plate

I disagree with this in establishing trust with toddlers. It’s a control tactic as Ellyn Satter explains in her book – she writes that by saying this, we don’t trust our child to learn and grow and the lack of trust takes away the joy of accomplishment. In the child’s mind – “if you make me eat this, then it must not be so good”.  I explain to parents that if you serve something often enough and enjoy eating it yourself, sooner or later, your child will start to taste it – and after possibly 20 times of tasting, they might actually decide that they like it.

Trust me – as a mum – it took my 5 year old many and many tries of capsicum, before one day he said to me “mum, I think I like eating capsicums now” (fist pump and joyous celebration on the inside of my head) – my outward response? (big smile) “They are yummy aren’t they, red capsicums are one of my favourite vegetables” (true and honest response to my son).

kid eating healthy food

So what would have been my answer to the mummy’s question?

Dear mummy

You are doing a wonderful job in feeding your toddler, I know it is worrying when they refuse their dinner, trust me – as a mum myself, sleep is important to me – and I always worry that if my child doesn’t eat their dinner, they will wake in the night and say they are hungry. Here is what you can do:

  1. Create 6 mini meals – breakfast, morning tea, lunch, afternoon tea, dinner and supper
  2. Space these mini meals out every 2 hours
  3. Offer a range of food at these meals – note how I didn’t refer to afternoon tea as a snack? I referred to it as a mini meal? Don’t offer “snack” foods – offer a fruit/vegetable with a protein (e.g. strips of meat, ½ egg or cheese) and a carbohydrate (e.g. crackers, ½ slice of wholegrain bread spread with a fat e.g. avocado, cream cheese, butter or peanut butter). This mini meal is nutritious and filling. Ellyn Satter refers to this as the “Mother Principle”.
  4. Make sure that the foods you offer for meals (including dinner) contain both foods you as a family would like to eat and foods that you know your toddler will eat. So meat, vegetable and bread/rice/pasta. That way if your child is tired (and they do get oh so tired at dinner), then they might eat something even if it’s bread. A child’s appetite will vary throughout the week – please offer food regularly and rotate these foods so they don’t always eat the same thing for specific meals.
  5. Don’t offer another alternative if they don’t eat e.g. cereal. Please don’t. I know you are worried. Stick to rule 4 (above) and chances are they will eat something at all of their mini meals.
  6. For fussy toddlers – I suggest the supper meal, this is a small mini-meal right before bed (see the difference – it’s not offered straight after a dinner meal which they refused, it’s later in the night – after their bath). Don’t offer snack food here either please – consider offering something that will fill their bellies up – yoghurt and chopped blueberries, cheese, sliced tomatoes and crackers, banana and peanut butter – good fats that will help them fill up for a good night’s sleep
  7. Some meals are great – and some meals are not. And remember this – you didn’t do anything wrong, it might have been an “off” night for your child and that’s okay. Chances are, they will catch up with their appetite tomorrow or the next night.

Good luck and hope that helps dear mummy – children often don’t need a lot of food to really fill their bellies. What you see as what they “should” eat, might not be what they actually “really” need. Big hug – Val from Lets Eat.

meal as 3

Hope that answers your questions as well, if your child has ongoing weight, nutrition and feeding concerns, please see a feeding Speech Pathologist, Dietitian and Occupational therapist, as a team, we can help you with working out why your child is not eating. Let’s Eat, Paediatric Speech Pathology works in Mayfield, Newcastle 3 days/week and we are more than happy to help you out if you need extra help or specific strategies.

food-play-1,-med-res

I have a peanut butter and honey sandwich to tell you..

I have walked your path – in fact I’m still walking your path but my boys are now in primary school and our toddler days are long gone. I have 2 boys and the gorgeous boy you see in that photo above was in the height of his “no” phase as a 2 year old. I had also gone back to work – the days were long and we were both so tired. When it came to dinner – he would refuse it on my work nights, so I offered him a peanut butter and honey sandwich (which he loved) but over time, the refusals increased and the PB and H sandwich requests increased. Suddenly the feeding therapist yelled in my head – wait – you are now in the trap you tell your patients not to get into!!!! What went wrong? My division of responsibility roles has mixed up – I had started short order cooking for him. So if this is you (and big hug, I really know the stress and anxiety this brings), go back to the first part of this post and re-read it – write it on your fridge and stick to it. The trap is that the hole gets wider and then the “accepted” foods get smaller and suddenly you find yourself where my new referrals are – “my primary school child is only accepting 5 foods”. Toddlers are still developing their likes and dislikes and whilst “no” is a favourite word, don’t get stuck into my PB and H sandwich hole. PS – Mr 8 year old now eats lots of different foods and whilst he still likes the odd PB&H sandwich, he would rather eat a whole wide variety of food instead.

There is a BIG EXCEPTION HERE – to all my clients with special needs, sensory needs, oral motor delays, high anxiety and Autism Spectrum Disorders. Sometimes your child may need extra help to get to the “gold standard” of eating as described above. I know you are trying your very best and your child may not be ready for this “gold standard” yet – that’s why we take smaller steps in feeding therapy. If you are worried or unsure, have a chat with me at your next session, we can problem solve what works and what doesn’t specifically for your child and your family.

Wishing you all positive and happy mealtimes

Val

Paediatric Feeding Speech Pathologist @ Let’s Eat! Paediatric Speech Pathology

This website and information on this blog post is provided for educational purposes. It is not meant or intended to replace Speech Pathology assessment and management nor medical or nutritional care for a child. It is recommended that you discuss any concerns or questions you might have with your Speech Pathologist and managing Doctor and develop an individualised team plan specifically for your child.

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About the author of this blog post

Valerie Gent is an Australian based Speech Pathologist with 14 years experience in Paediatric Feeding. She has recently opened a private practice called ‘Let’s Eat! Paediatric Speech Pathology’ that caters for Newcastle based babies and children with feeding difficulties. Valerie is passionate about working in the area of paediatric feeding and special needs and has been involved in the teaching and training of Australian Speech Pathology University students and allied health professionals. You can find out more about Valerie Gent and ‘Let’s Eat! Paediatric Speech Pathology’ via her website www.letseatspeech.com.au and Facebook page www.facebook.com/LetsEatPaediatric SpeechPathology or email her on valerie.gent@letseatspeech.com.au