Food Refusal

A large part of my work is help frustrated caregivers – parents and educators – to understand the reasons young children may refuse to eat their meal. Old-fashioned practices and lack of education lead many adults to engage in battles with little eaters at the table. But, trust me, many times, addressing it is easier than you think once you know what you’re up against…

NOT HUNGRY

I’ve been working in ECEC centres for more than ten years now. The meals timetable is one of the things that still stands out to me in all the efforts that dedicated cooks and educators put in to making sure children eat well.

In long-day care centres, for example, it’s common that children are offered a meal every hour-and-a-half to two hours. Some meals are just one hour apart. And this has its merits when you’re feeding a diverse, large group of children because 1) it provides many opportunities for children to eat or to at least explore foods and 2) it caters for many different eating patterns, like children who eat very quickly, also caters for children who prefer to eat small portions, many times a day, it also allows those who like to fill up well in a meal and then skip the next and so on.

Now, try to imagine the inconvenience of this pattern out of daycare/preschool setting: if families offered foods at the same rate, children would eat 8 to 12 times during their wake time! Plus, if we’re talking about fussy eaters, it’s 8 to 12 daily chances for battles, tantrums and power struggles. Who has the energy for that?

The human body is wired to signal hunger around 3 hours after the last meal – that’s the time the body needs to digest foods and absorb nutrients before it realises it needs to restart the process (1, 2, 3). So, in the early learning setting, we must be prepared to accept “No thanks” to some meals. The child’s refusal to eat could be simply because they haven’t had enough time to feel hungry again. And that’s totally fine. It's actually what we want children to do: to listen to their natural hunger-fulness signals.

HEALTH AND ABILITY ISSUES

I’ve written about Bruce before. He was three years old and, at mealtimes, would cry, block his mouth with both hands, keep his head down, and not eat the whole day at daycare, unless he was offered milk or sweet biscuits or Jatz crackers, which he would nibble on, slowly and carefully.

Bruce had his tonsils removed. More fussy eaters than you think will present some sort of health problem that prevents them from enjoying foods and mealtimes. Tonsillitis is a common one. It makes it painful to swallow the softest of foods and the child will often develop an aversion to eating.

The struggle may persist for some time after the surgery because the child will need to learn to trust food, and adults offering it, all over again! In many cases, with the help of feeding professionals. Bruce is now seven years old and is still struggling to enjoy a variety of foods.

Chronic diseases and other conditions that curb a child’s ability to feed can go unnoticed for a long time. The longer it takes to be addressed, the longer and harder it is for a child to overcome their issues with eating.

Overuse of liquid foods can hinder children’s ability to chew (image: Anna Kraynova)

INNAPROPRIATE FOOD

Mealtimes with four-year-old Baileigh are often challenging. He refuses to eat most foods, he can’t use cutlery and only eats pureed foods, mostly straight from a pouch, or finger foods – he uses his hands to eat his pasta, usually sent for lunch in his lunchbox.

Baileigh has been offered baby food for most of his life and given very little encouragement to use cutlery and eat foods of appropriate textures for his age. So, he finds it challenging to eat certain foods, and rejects them.

This behaviour compels his caregivers – parents and educators – to only offer foods that don’t present a challenge and that he will accept. This creates a vicious cycle that limits Baileigh’s opportunities to learn to feed himself independently. The older he gets, the harder it will be for him to catch-up with his peers and to develop into enjoying a wide variety of foods.

INAPPROPRIATE TOOLS

On the other end of the cutlery mastery spectrum, Leila – also 4 years old – showed how important cutlery was for her.

She refused lunch on her first day attending daycare – the day before we met – and her mother had warned the room leader that she was fussy at mealtimes. So, she was introduced to me as “a fussy eater”.

I was curious about lunchtime and I wasn’t disappointed: we had spaghetti Bolognese that day and, as usual – I roll my eyes as I say this and I’ll explain why in a minute –, children were given silver teaspoons to eat lunch.

Leila was at the table, looking down, her bowl about 30cm away from her. For a few minutes I only watched that from across the room. I noticed her looking around a few times, frowning.

I went to the kitchen, made myself a bowl of spaghetti, took a fork for me – adult size fork – and a smaller fork which I put in Leila’s bowl, pushing it a little closer to her.

I didn’t say anything, sat next to her and started eating ‘my lunch’. Leila raised her head, looked at me then stretched her neck to check inside her bowl. Then, she took the fork and started eating her spaghetti. In fact, she had two portions! That was a beautiful day!

I didn’t have much time to observe Leila’s eating habits as she moved houses, to a further location, soon after that – I don’t really know that story –, but I think she was proficient with a fork and was upset to have been given a spoon to eat spaghetti. If that’s the case, I don’t blame her. I too get upset when I’m given a spoon to eat spaghetti! You should try that when you’re hungry. Not fun.

I chose these to illustrate the different reasons children may refuse their meal. There are many many more. Whatever the reason for food refusal is, it is the adults’ job to find it out. It’s not only fuss. It’s not the food either. That behaviour is communication of something being not quite right and our job as carers is to find it out and support the child to overcome it.

Note: I made up all children’s names, but their stories are very much real.

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References

1.       Chemical Messengers: How Hormones Make Us Feel Hungry and Full (Article, 2015, Australia). Prof Joseph Proietto for The Conversation.

2.      Food & Nutrition Throughout Life (Book, 2015, Australia). Ch 7, pg 145.

3.      Secrets of Feeding a Healthy Family (Book, 2008, USA). Ch 6, pg 65.