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Feeding problems In children

WHat should you do if you have a picky eater? Dr Dana Elliott Srither advices.

How to handle kids eating problems How to handle kids eating problems

Question 1

Dear doctor My 15.5 month son takes a long time to chew and he does not like to swallow his food. Now he is also spitting out the food. What should I do to get him to enjoy his food and stop spitting?

Question 2

Hi, my son, 3 1/2 years old is a very slow eater. He hardly chews and swallows his food during meal times; even when we serve him his favourite food, noodle. This makes it very frustrating. Pls advise if there's any help available in this respect. Thanks.


“Feeding” problems among our children is a common occurrence. One reason may be that the problem is based on the parent’s perception, rather than a real problem. For example, my 3 month old son is now giving my wife problems in taking his milk via the bottle, something that he has done for the past 3 months till about a week ago. This can be perceived as a problem, even though he is at the 90th percentile in weight for his age! So the solution that we are trying is to start him on plain rice cereal, which he is starting to consume. Notice that I used the word trying, because we never know when he will start refusing that too!

Fussiness about food is a normal part of a child’s development. Young children are naturally neophobic — they have a distrust of the new. Even the most determined parents can be cowed by a child’s resolve to eat nothing rather than try something new.

There are several steps that we can follow to make us more reassured that our children will not become undernourished (hardly the case here in Singapore).

Eat with Your Child as Often as Possible.

Kids are tuned into their parents’ eating preferences and are far more likely to try foods if they see their mother or father eating them. A Rutgers study of parent and child food preferences found that preschoolers tended to like or reject the same fruits and vegetables their parents liked or didn’t like. And other research has shown girls are more likely to be picky eaters if their mothers don’t like vegetables.

Given this powerful effect, parents who are trying to lose weight should be aware of how their dieting habits can influence a child’s perceptions about food and healthful eating. In one study of 5-year-old girls, one child noted that dieting involved drinking “low-calorie” chocolate milkshakes, which her mother was drinking as part of her weight-loss regime. Another child said dieting meant “you fix food but you don’t eat it.”

A 2005 report in the journal Health Psychology found that mothers who were preoccupied with their weight and eating were more likely to restrict foods for their daughters or encourage them to lose weight. Daughters of dieters were also more likely to try diets as well. By exposing young children to erratic dieting habits, parents may be putting them at risk for eating disorders or a lifetime of chronic dieting.

Involve your toddler in simple cooking and food preparation

With hot stoves, boiling water and sharp knives at hand, it is understandable that parents don’t want children in the kitchen when they’re making dinner. But studies suggest that involving children in meal preparation is an important first step in getting them to try new foods.

Researchers at Teachers College at Columbia University studied how cooking with a child affects the child’s eating habits. In one study, nearly 600 children from kindergarten to sixth grade took part in a nutrition curriculum intended to get them to eat more vegetables and whole grains. Some children, in addition to having lessons about healthful eating, took part in cooking workshops. The researchers found that children who had cooked their own foods were more likely to eat those foods in the cafeteria, and even ask for seconds, than children who had not had the cooking class.

Give small portions. Do not rush their meals. Limit mealtimes to about 20 - 30 minutes. Never insist she finishes everything on her plate.

Studies show that children react negatively when parents pressure them to eat foods, even if the pressure offers a reward. In one study at Pennsylvania State University, researchers asked children to eat vegetables and drink milk, offering them stickers and television time if they did. Later in the study, the children expressed dislike for the foods they had been rewarded for eating.

The better approach is to put the food on the table and encourage a child to try it. But don’t complain if she refuses, and don’t offer praise if she tastes it. Just ask her if she wants some more or take seconds yourself, but try to stay neutral.

Praise your toddler when she eats well because toddlers respond positively to praise. If you only give her attention when she is not eating, she may refuse food just to get some attention from you. Toddlers like attention, even if it is negative. If she doesn't eat well, take the uneaten food away without commenting and accept that she has had enough. Don’t worry. They will make a fuss when they are hungry.

Stocking up “restricted foods” at home

In a Penn State study, researchers experimented to determine whether forbidden foods were more desirable. Children were seated at tables and given unlimited access to plates of apple or peach cookie bars — two foods the youngsters had rated as “just O.K.” in earlier taste tests. With another group, some bars were served on plates, while some were placed in a clear cookie jar in the middle of the table. The children were told that after 10 minutes, they could snack on cookies from the jar. The researchers found that restricting the cookies had a profound effect: consumption more than tripled compared with when the cookies were served on plates. So buy healthful snacks and give children free access to the food cabinets.

Don’t give up too soon. Don't assume that because your toddler has refused a food she will never eat it again.

While it may be true right now, she noted that eating preferences often change. So parents should keep preparing a variety of healthful foods and putting them on the table, even if a child refuses to take a bite. In young children, it may take 10 or more attempts over several months to introduce a food.

Where vegetables are concerned, nutritionists say parents shouldn’t be afraid to dress up the vegetables. Adding a little butter, ranch dressing, cheese sauce or brown sugar to a vegetable dish can significantly improve its kid appeal. And adding a little fat to vegetables helps unlock their fat-soluble nutrients. The few extra calories you’re adding are a worthwhile tradeoff for the nutritional boost and the chance to introduce a child to a vegetable.

Finally, don't feel guilty if one meal turns into a disaster

Put it behind you and approach the next meal positively. Parents also learn by making mistakes.

Answered by:

Dr Dana Elliott Srither MBBS (S'pore), Grad Dip Family Medicine, is a certified Family Physician who believes in the principles of "Get Well" and "Stay Well".

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