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Wednesday, October 6, 2021

How I got my picky toddler to finally eat - todaysparent.com

I remember the day I knew my daughter had an issue with food. I was out for a walk with a group of mom friends and we stopped for coffee. They all gave their babies a snack, and then all the babies ate their pouches and cut-up fruit and puffs. Except for mine, who ate nothing. 

“Huh,” I thought. “That’s weird.” 

It was part of a pattern of my baby just not being interested in eating much more than breastmilk, even as she neared her first birthday. And even though I kept telling myself that all babies develop at different rates, I knew she wasn’t eating enough. A few doctor appointments later, my suspicions were confirmed. In fact, her weight gain was levelling off, and blood tests showed she was becoming borderline anemic. Sometimes, “food before one” really isn’t “just for fun” (as the popular saying goes). 

My first child was a champion eater, so I had no expertise in how to make an older baby or toddler eat. My first step was meeting with a dietitian. Then, an occupational therapist (OT) came to our house for an assessment and advice on how to make my daughter eat. (This was all covered by OHIP.)

I kept logs of what she ate, changed our eating habits, and sleuthed out her sensory preferences—and some changes made a huge difference. Here’s what worked for us: 

I night weaned 

I had been breastfeeding 24/7—including nights, since we were co-sleeping and the baby nursed whenever she wanted. Because of that, my doctor suspected that she was getting too many calories at night, and that was making her disinterested in food during the day. So I night weaned (which required some sleep training) to see if that helped. And it did! She was noticeably hungrier.

I learned about “eating windows”  

One of the first things the dietitian had me do was write down when we ate on a typical day. She told me that kids generally need three meals and two snacks a day, each 2.5 to 3.5 hours apart. As a devotee of “sleep windows” and “wake windows” from all the reading I’d done on baby sleep and sleep training, “eating windows” or “feeding windows” made total sense to me. In the same way that a baby needs to be tired enough to nap well, kids need to be hungry enough to eat well. After they’ve been awake for a certain amount of time, they need a nap. If it’s been a certain number of hours between meals, they need a snack. I added a morning snack into our routine, and changed the timing of our afternoon snack and dinner. It helped get us off the “snacks all the time” habits we had fallen into, and it did seem to help her eat better. (We started this a little early because of her eating issues—many kids aren’t ready for timed meals until they’re closer to two years old.)

I served protein with every snack 

At first, I was convinced my kids couldn’t go for hours between snacks. But I learned that was because my snacks tended to be all carbs, which were quickly digested. The dietitian explained to me that adding protein to snacks was key to making them more filling. I tried thinking of snacks as mini-meals, following her rule of thumb of trying to serve at least two food groups for all snacks, and three for meals. My kids’ snacks transformed from a pack of Goldfish crackers into crackers, apple slices and cheese, and they stayed full longer. 

I improved our eating “hygiene”

Through my OT, I learned that just like there are things you can do to your bedroom to improve your sleep hygiene and make sleep more likely (like turning down the lights) there are things you can do to your environment that make kids more likely to eat. We started sitting down to eat at the table together, even for snacks. We ate without screens or toys, to help them focus on the food, and tried to socialize over meals, too—even if that meant playing peek-a-boo with the sandwiches. 

It helped that this was during COVID, so we were all at home and had nothing on the schedule. As a side benefit, I found it calming to take a break and sit and eat so often. 

I tracked her eating patterns  

For a few days, I charted how much both my kids ate. I discovered that my son woke up hungry, eating the most at breakfast—the most common pattern for little kids. My daughter actually ate the least at breakfast—but she was starving by snack and lunch. And, she was still well-rested enough to be in a good mood at that point. Lunch, I realized, was the sweet spot. 

I had been serving easy-to-make, kid-friendly convenience food for lunch, and more complicated new foods for dinner, and I was continually frustrated that she was only eating her lunch and refusing dinner. When I shifted to offering her those new and healthy foods at lunch instead—earlier in the day, before she got tired—she was way more likely to actually try them. 

I looked at textures, and sweet vs. salty foods

I looked at what she was eating and tried to look for patterns. Turns out, unlike me, my daughter didn’t delight in sweets, but she loves salty foods. And she likes sharp tastes—old cheese, mustard and garlic. 

Then I thought about texture. Lots of little kids prefer crunchy foods, and mine does, too. She wouldn’t eat cooked peas (too mushy), but when I offered frozen ones, which have a harder, more predictable texture, those were a hit. Once I figured that out, I discovered she would eat frozen pomegranates, too. I started cooking my pasta al dente, and steaming veggies just for a minute or two instead of boiling them, so they’d have more crunch. Now I know that for her, firmer textures always lead to a happier, more enthusiastic eater. 

I practiced the “division of responsibility”

The dietitian taught me about what’s called the Division of Responsibility, a research-backed method created by dietitian and family therapist Ellyn Satter. The idea is that arguing with kids and trying to get them to eat “three more peas” before leaving the table stops them from learning to tune into their own bodies to know when they’re hungry or full. 

Instead, parents are advised to control their side of things only. In the division of responsibility, grown-ups are in charge of what food is offered, where it’s offered, and when—and children are in charge of deciding what they will eat and how much they’ll eat. 

I liked the idea of having fewer power struggles at meals, but I was confused: I knew kids needed to taste foods a lot before they liked it. How were we ever going to make progress if my picky eater never tried anything new? 

Then I was introduced to something that made it all make sense for me: something called “food exposure.” Turns out, my kid didn’t have to eat food to get used to it. Just seeing the food on the table counted as a food exposure, as did her helping me wash the veggies before dinner, or seeing me eat foods and talk about them. (“Mmm, these carrots look good! Let’s hear if they make a big crunch when I bite them!”)

None of these new habits fixed her picky eating completely—but these seven changes did make a noticeable impact in how she ate. She’s three now and still the kind of kid who will eat just the icing off a piece of cake and leave the rest, but I’m OK with it, because now she also eats pepperoni sticks, pasta, carrot sticks, oatmeal and yogurt, too. I can work with this. 

When we went back for follow-up bloodwork a few months after this started, my doctor looked a little surprised at the results. “She’s back on her growth curve, and her iron levels look great!” she said. “Good job, Mom.” 

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How I got my picky toddler to finally eat - todaysparent.com
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