It’s easy to fall into a pattern of having cereal for breakfast, lunch, and dinner if that is all a child will eat. Child preferences are notoriously fickle; one day, they’ll only eat their favorite food, and the next, they may be flinging it to the floor. It can be frustrating to constantly worry about providing a child with the foods they need to be properly nourished. Still, it’s important to establish a healthy relationship with food early in a child’s life.
Refusing to eat is a normal child behavior and, in most cases, isn’t concerning. However, feeding struggles resulting from more serious causes, like disabilities or disorders, should be brought to your pediatrician.
Before finding solutions, it’s essential to understand why your child isn’t eating. In this article, we discuss the possible reasons for your child not eating, scenarios when you may need to call a doctor, and tips to follow when your child won’t eat.
Why is my child not eating?
While picky eating is normal among children, there might be other causes that might trigger it. Here are some possible reasons why your child isn't eating.
They are not hungry
If your child is not eating, perhaps they are simply not hungry or don’t have an appetite. As children grow, they tend to eat less. Children may eat less frequently than they did as babies since they are now developing much slower. As long as you maintain your feeding schedule, your child should control how much they eat, as their bodies will guide them.
Too many distractions
When they have screens or toys in front of them during meals, children may pay less attention to their meals or are likely not listening to their stomachs. They are likely to eat very little or eat too much when they have other things taking up their attention. You can enforce a “no distractions” rule during meal times. The rule should go for the adults, too, as children are more likely to emulate what they see.
Serving big portions
Perhaps you are serving big portions that overwhelm the child. Start with small portions and if they want more food, then encourage them to ask for more.
Over-snacking
If children have too much to eat or drink between meals, they might be too full to eat when it is time for lunch or dinner. Try reducing the snacks you give them or schedule snacks at specific times throughout the day, depending on your child’s appetite.
Pressure to eat
When children feel like they are under pressure to perform an action, they might lose the urge to do it. Persistently telling them to finish all their vegetables, watching their every move, or pushing their plates closer to them as they eat may induce anxiety. Instead of looming over them, allow them to enjoy their meal at their own pace.
Loss of appetite
It can be tough when you thoughtfully prepare a nutritious meal only to have it be tossed around on a child’s plate instead of being eaten. Bear in mind that there are various possible reasons for a loss of appetite. They could be ill, have a tummy ache, or be constipated. Developmental milestones may also lead to loss of appetite. For example, infants might prefer their newfound mobility over sitting in one place as they eat, and toddlers might refuse to eat to assert their independence.
Picky eating
A picky eater typically refuses to eat certain foods or only wants to eat the same thing repeatedly. Although the rest of the family might appreciate a variety of foods, the picky eater might prefer only chicken nuggets or cucumber sandwiches. Many times, their refusal is just a matter of preference.
Sensory issues
Some children choose food according to the information they gather in their senses. For instance, autistic children may reject certain food based on textures, smells, colors, or food temperatures. This greatly impacts the child’s decision to eat or not and can lead to food aversion.
Other times, children might have underdeveloped oral motor musculature and, as a result, prefer soft foods because they find it tedious to chew harder foods. A parent who may not know this might encourage the child to eat whatever they prefer, which is detrimental as they miss out on the foods that would strengthen those muscles.
Caregivers can help children with sensory food aversions with exercises to train and strengthen their mouth muscles. Have the child practice blowing bubbles, sucking from a straw, and making sounds that move their mouth in various ways. Purposeful play is another great way to help with sensory food aversions. For example, create a farmyard with toy animals like horses or cows and dry cereal as the hay. Can the child help the animals eat their hay? Have them try some and see how they respond.
Avoidant restrictive food intake disorder
Avoidant restrictive food intake disorder, previously referred to as selective eating disorder, is way more serious than simply picky eating. Children with avoidant restrictive food intake disorder sometimes display a phobia for certain foods and observe a severely restrictive diet. Others may have sensory aversions to specific tastes, textures, or smells, or a fear or hatred of swallowing.
Children with this disorder have a fear of food that might stem from knowing they must eat but have no interest in eating, may be afraid that the temperature of the food is not what they want it to be, or they might fear choking or getting sick from food they have not tried before.
Whereas most children go through picky or fussy eating phases that eventually wane, children with avoidant restrictive food intake disorders persist in their preferences. Individuals who suffer from avoidant restrictive food intake disorders often have trauma attached to their fear of particular foods. For example, if someone witnesses someone choking on some food, they might develop an aversion to it.
The anxiety they feel is the body’s way of protecting the system from a portion of food they associate with danger. Certain events like moving to a new home or parents divorcing may trigger selective eating in children as a way for them to exert some control over their lives. Other times, it comes down to the texture or feel of the food in the mouth.
Children with avoidant restrictive food intake disorder may prefer a particular texture of food, and might become emotional or show signs of distress around certain foods. Children with this disorder are likely to have anxiety, attention deficit disorder, autism spectrum, or be overweight, especially if they only eat junk food. If you suspect your child has an eating disorder, speak to your doctor.
What’s normal and when to call the doctor
When you have a child that is not eating, it is only natural to believe that they are underweight and not developing properly. Oftentimes, this is not the case as these children’s growth charts may indicate them at a normal weight.
It’s normal for children to refuse to eat or try new foods. Sometimes there is a disconnect between how much food is enough for the child and how much their parents think they should eat. As long as your child eats some food from each of the main food groups, then they are receiving the proper nutrition.
However, it’s time to call the doctor if your child displays any of the following:
- Rejects almost everything you give them. If you offer 20 items and only two are received, then there might be a bigger problem
- Weight loss
- Goes several days without eating anything at all
- Gets anxious in social situations because of food
- Completely rejects certain food types like grains or meats
- Fever, vomiting, diarrhea, and lack of appetite
What to do when a child won’t eat
As a caregiver, a few things are as frustrating as taking the time to prepare, cook, and serve your child a meal, only to have them refuse to eat. If you’re feeling defeated, don’t worry — there’s hope. Here are some tips to help your child develop an interest in food and start eating again:
Include your child’s favorite meal
When dealing with picky eaters, it is imperative that you include one meal you are sure your child will eat. However, do not give up on introducing new foods. Many times, children are just reluctant to try new foods. You might want to keep offering the same new foods, along with their favorite meal, so they get more familiar with them.
Encourage them to try new foods
Be persistent even if they do not like what has been provided. Some call this the “no thank you bite.” This is where a child takes just one bite of food and then says, “No thank you” if they don’t like it. This will help them develop their palates until they are comfortable with more variety.
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Remove distractions
Keep distractions like toys, books, and electronic gadgets away during meal times so everyone can focus on the food.
Involve children in meal preparations
Get children involved in the meal preparation process. When children are involved in activities like shopping for food, menu planning, and even cooking, they may have a more positive attitude toward meals. Yes, it might take longer to prepare the meal and clean up, but the benefits will be worth it.
Decline substitutions
Do not substitute other foods to replace what has been rejected, however tempting it is. If your child rejects the chicken, do not offer them a sandwich. Respect their decision not to eat what has been prepared. Later, they will have a natural consequence of hunger and learn to eat whatever is offered.
Have family-style meals
Place all the food on the table and allow children the choice to only put what they want on their plates. This gives you control over what is served and gives children the independence to decide what they will eat. This method works best for meals like tacos, homemade pizza, and stir-fries. Not only do children thrive on the social interactions that take place during meal times, but they also get to experience everyone eating and enjoying food together.
Prepare meals differently
Even if children love a certain meal, they might get bored if they have to eat it over and over again. However, if you switch up the cooking styles, they can remain enthusiastic about meal times. For instance, make sweet potato fries instead of steamed potatoes, steam vegetables instead of serving them raw and crunchy all the time, and bake chicken instead of making chicken nuggets.
Serve child-appropriate portions
Sometime it is not that your toddler refuses to eat at all, but rather, they refuse to eat all their food. Children require smaller portions than adults, and sometimes they are not being stubborn—they might simply be full.
Be patient
No matter how often your child refuses food, don’t give up. Keep trying. Keep serving the foods your child rejected before. It might take time, but eventually, they will come around. Also, limit snacks so that they are hungry by the time you are serving food.
Make it fun
Children like to play, and you can leverage this when serving food. Add color and interest to your child's plate by serving a colorful variety of vegetables like carrots, broccoli, and corn. Also, try serving finger foods on cute cartoon plates!
How to get your child to eat when they refuse
Refusal to eat is relatively normal in children. As a matter of fact, it might even be considered a rite of passage. Granted, this process can be a stressful time for families, but it usually goes away with time. However, this might not always be the case. Depending on how long the problem persists, or if there is suspicion that there could be another underlying cause, it would be wise to talk to your pediatrician to rule out other causes.
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