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Picky Problems


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May 23rd, 2006, 01:47 AM
Rusha's Avatar Platinum Supermommy
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"Vitamins and prayer," a schoolyard acquaintance confesses, summing up how she and her husband deal with their son's picky eating habits. "He'll hardly touch fruits and vegetables."

In a culture where food is equated with love, parenting ability is almost measured by the gram, at least until kids emerge from the preschool years. And while that may be satisfying when your baby's weight rapidly multiplies in the first two years of life, it can be downright discouraging when you're the parent of a toddler who seems to be subsisting on a daily handful of Cheerios - or a seven-year-old who eats nothing but cream cheese sandwiches and plain pasta. Add that to the anxiety that your child will develop beriberi, scurvy, rickets or other dire dietary deficiencies, and the kitchen table can easily become a battleground.

You're not alone in your frustration. Here are the pros' answers to some typical picky-eating questions.

Q: My 13-month-old is suddenly refusing to eat oatmeal for breakfast. I don't want to feed him toast because I don't think it's nutritious enough. What can I give him?

A: First of all, whole-grain toast is good food, especially eaten with a dairy product, such as yogurt or milk. Other favourite breakfast items include whole-grain pancakes, waffles, muffins, bagels and eggs. Branch out beyond standard items for the morning meal - try macaroni and cheese, rice pudding or pasta.

But before you warm the waffle iron, banish any bottles or sippy cups served ahead of breakfast. While it might be convenient to dole out drinks while you're getting the food ready, those fluids fill tiny tummies, replacing more nutritious fare.


Q: My daughter, who just turned two, used to be a great eater but now she only nibbles. How can I get her to eat more?

A: The short answer is, you can't. "Around age two, most kids seem to live on air for about six months," says Karen Cunningham, a family physician in London, Ontario. A child's growth rate drops dramatically around this age, and the corresponding drop in her need for calories causes the plummeting appetite that worries and puzzles parents.

"It's really rare for a toddler to eat three good meals a day," says Nancy Strange, paediatric clinical dietitian at Children's Hospital of Western Ontario. "If a toddler eats a good breakfast, you can count on him not eating much for lunch, but he'll probably do fairly well again by suppertime."

When your tot does sit down to eat, keep your expectations in proportion to your child's stomach - which isn't much bigger than his fist. "Parents are often reassured to discover that a portion size for a toddler may be only a tablespoon," notes Carolynn Mazuryk, a public health nurse in London, Ontario, who helps coordinate well-baby-and-child clinics. Serving sizes for children are about half the size of those listed in Canada's Food Guide to Healthy Eating. For example, a quarter to a half slice of bread constitutes one serving for a two-year-old; a slice equals one four-year-old-sized serving.

Small stomachs and pint-sized portions also mean toddlers and preschoolers need frequent feedings, so offer three meals and two or three daily snacks.

Remember, too, to listen when your child says, "I'm full," adds Shawna Berenbaum, head of the division of nutrition and dietetics at the University of Saskatchewan. "Children should follow their own internal cues so they do not overeat. Parents should not push, beg or plead to get children to eat."

If you still don't think your child is getting enough nutrients, try keeping a diet diary, suggests Denis Leduc, chair of the Canadian Paediatric Society's community paediatrics committee. Writing down everything your child eats and drinks for three or four days may reveal that one bite here and another there add up to a larger and more varied total than you suspected. This approach can also unmask a common culprit that sabotages little appetites - fruit juice.

"Even pure, unsweetened fruit juice contains a lot of natural sugar," explains Strange. This boosts blood glucose, thus switching off hunger.

Still stumped? Take your toddler - and the diet diary - to your doctor. Occasionally, a condition such as anemia (an inadequate supply of red blood cells) can masquerade as a depressed appetite.

Q: My three-year-old son eats almost no fruits and vegetables. Can vitamins take up the slack?

A: Vitamins are no substitute for a balanced diet, says Berenbaum. Plant-based foods contain many substances that can't be packed into a pill, including fibre and a variety of micronutrients.

Instead of immediately reaching for vitamins, first try perking up presentation. Serve raw veggies with dip for dunking - cheese sauce, low fat salad dressing or ketchup. If your son won't bite, sneak in nutrients using new recipes: Kids who won't eat a raw apple may clamour for oatmeal-topped apple crisp, or may overlook pureed pumpkin in muffin and pancake batter. Children whose diets are light on fruits and veggies may also need a helping hand to keep their bowels moving, so offer fibre-dense foods like bran bread, oatmeal muffins and whole-grain cereals.

The bottom line is that kids should be able to get most of their nutrients from food, barring allergies or other special circumstances, like food intolerance, that cut out entire food groups. A daily multivitamin probably offers more payoff in parental peace of mind than kids' health; on the other hand, a supplement geared especially for children probably won't hurt. Talk it over with your child's doctor.

Q: How can I encourage my four-year-old daughter to eat a variety of foods?

A: The best way to get a child to eat a variety of foods is not to push the issue, says Ginette Blake, a public health dietitian with the Middlesex-London Health Unit in Ontario. "The more pressure you exert, the more problems you're going to have."

Children have little control over their lives, other than what slips between their lips. As kids become more independent, it's natural that they lock horns with parents about what's on the menu.

Blake suggests shifting the way you think about food. "Feeding is a shared responsibility between the parent and the child. The parent is responsible for buying, preparing and offering healthy food. The child is going to decide what and how much she eats.

How can you coax in those calories? Blake suggests making food fun, involving children in some aspect of grocery shopping or meal preparation, and giving choices. For example, a child is more likely to eat something she's made herself, and even little fingers can assemble pita pizzas from grated cheese, chopped veggies and spaghetti sauce.

While offering open-ended choices ("what do you want for lunch?") is a recipe for disaster, asking, "Do you want a peanut butter sandwich or vegetable soup?" allows a child to assert some control, without undermining your efforts to teach her healthy habits.


Q: I've tried every trick in the book, but I end up having to make my seven-year-old things he likes, even when I've prepared something else. How can I get him to eat other things?

A: Food jags are as much a part of childhood as the two-year-old "No's!" - and just as annoying. The trick is to tread the line between accommodating your son's tastes and feeding his finicky eating habits. When possible, offer a number of different dishes at each meal, and try to incorporate some of his favourites. If he can't get through the day without pasta, serve macaroni and cheese alongside the broiled chicken and broccoli, or toss whole-wheat noodles into soup. For kids this age, try the one bite rule: Have your child take one bite, praise his willingness to try new things and don't insist on more.

On the other hand, catering to your son's food fixation by becoming a short-order cook may deepen his dietary rut. Some families cope with this dilemma by offering a single alternative, only when the meal is something the child finds especially offensive. If liver literally makes your son gag, you could ask him if he'd like a peanut butter sandwich instead.

Otherwise, suggests Strange, "just smile and say, 'OK, I guess you're not very hungry right now.'" Excuse him from the table and offer something nutritious at snack time.

Q: My two-year-old daughter will only eat five foods - at home, that is. At daycare, she eats everything! Why?

A: The first place to look for problems is your own plate. Do you and your partner eat a variety of foods? Children learn by copying their caregivers and even the other kids at daycare, says Strange. If you insist your daughter drink milk at suppertime while you sip on soda, it's not surprising if she pleads for pop. If your toddler's dietary habits don't mirror your own, she could be asserting her independence. Try some of the above suggestions for avoiding mealtime power struggles. Strange also points out that this behaviour may indicate too much attention is being focused on your child's eating habits at home. "I would say that this toddler is not a picky eater, but a child who is looking for attention," she says. "The best bet is to make it a non-issue and chances are it will die a natural death."


Q: My one-year-old son will only eat mushy foods. What can I do?

A: There's a window of opportunity between about seven and ten months of age when babies are eager to try new textures; introducing them afterward can be more problematic, says Blake. "Gradually increase the texture of foods," she advises. "Often that means a diet that's a mixture of baby food and table foods, while you slowly increase the proportion of table foods."

Q: My five-year-old daughter refuses to eat foods that are touching on the plate. Is this normal?

A: Yes. Kids often go through a phase when they can't bear to eat peas that have rolled into the mashed potatoes, says Blake.

Blake suggests an approach similar to the one she advocates for many common mealtime woes - make food fun and try not to let your daughter push your buttons. You could also buy partitioned picnic plates to prevent pea-potato contact, but keep in mind that when your daughter is 20, a blob of sauce on her broccoli probably won't bother her. Even if it does, you will have done your best to foster healthy habits - and you'll be free to enjoy paella and chicken pot pie once more.
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