Little Lily, 3-years-old: Picky Eating & Mega Mealtime Meltdowns

A Real Client Story*

Where We Started:

Message from parents: “We are at the end of our rope and need help! Our 3-year-old daughter is only eating a few foods, and her safe foods seem to change all the time. Sometimes she likes a food and then the next day she refuses to eat it. She loves her milk! Mealtimes are a nightmare at our house and I’m starting to dread them because everyone is stressed and it’s affecting our younger son. We are VERY worried about her nutrition and want her to have a good relationship with food. She often refuses dinner then asks for snacks right away…not sure what to do anymore, we are so burned out and need some professional help!”

What We Did:

• Acknowledged that this is REALLY hard. We talked about the parents' fears about mistakes they may have made in the past, her nutrition, her future relationship with food. (Read more about Parent Mental Health When Kids Have Feeding Difficulties.)
• Implemented a meal/snack schedule and reduced milk and juice intake.
• Introduced transition activities to help prepare Lily for coming to the table for the mealtime.
• Family style serving where 2 safe foods are always available to Lily (e.g., bread, cheese). Parents stopped making alternatives.
• Asked Lily to be the server and serve food on family members’ plates. Let Lily serve her own plate with cool food tools like tongs and sand shovels and decide if she wants to have a “learning food” on her plate.
• Eliminated mealtime pressure by not talking about food/eating during mealtimes.
• Limited the length of mealtimes regardless of how much or what Lily ate.
• If Lily refused dinner and requested a snack immediately after the meal, parents remained neutral and responded, “It’s not snack time now. We are going for a walk and then we will have a snack before bed.”
• We talked about how to handle judgement and unsolicited advice from friends and family members. Particularly Lily's grandparents who said to "Just give her what everyone else is eating for dinner and let her "starve" until she eats something". (Read more about the judgement parents face when their child has feeding difficulties.) 

Where We Are Now:

• Lily is following an appropriate meal/snack schedule and milk and juice have been reduced.
• Mom said, “Since implementing a routine, just within a few days, I'm seeing huge improvements in her interest in eating. I really can't believe it!?”
• Parents report mealtimes have completely transformed. They have learned that it’s not their role to prompt/pressure Lily to eat. Lily is staying at the table longer because she enjoys the social time with her family and no longer feels pressured to eat.
• Mom also said, “This has been such a stress relief. Before my mealtimes struggles were 10/10, now they are 4/10. It’s been such a difference since we last met. I felt so out of control and at the end of my rope.”
• Initially Lily would only put her safe foods on her plate (e.g., bread, pasta, cheese). Recently she started putting learning foods (e.g., fruit) on her plate. 
• Lily has stopped asking for snacks after meals, as she is eating more at mealtimes. She has learned that snacks will not be immediately available if she does not eat at dinner.
• Parents have learned to respect Lily’s ability to listen to her own body and not push her to eat if she doesn’t want to and that kids will sometimes skip meals. If she refuses dinner, they use neutral language like, “It looks like you don’t want to eat right now, let’s clean-up and go outside.”
• Parents were able to explain to Lily's grandparents that they are working on a feeding program with a Feeding Therapist and they would appreciate everyone's support on their journey by respecting the approach they are using. 

What’s Next For Little Lily:

• I'm afraid there is no quick fix for picky eating. Kids learn to accept new foods through repeated exposure and by not being pressured to “try it.”
• Lily’s parents continue to model their own enjoyment of a variety of foods. They eat together as a family a few times per week, and they have fun at the table.
• Lily helps with cooking activities like stirring, sprinkling, and serving foods.
• She enjoys making funny food faces on plates as an arts and crafts activity. She recently took a bite of carrot while playing with foods :)
• Lily read “Dragons Love Tacos” with her Dad and asked to make tacos one night, which is a new food for her. She ate a taco shell with just cheese and helped make tacos for her little brother.
• She also asked to buy bagels (instead of bread) when grocery shopping and has added this to her diet. Lily saw her friend eating bagels and wanted to explore them. This is an example of "internal motivation" because Lily showed interest in this food.
• Parents report they feel more empowered and recognize that they are doing a great job of helping Lily to “meet new foods” and ultimately it’s up to Lily if she decides to “eat new foods.” 

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 *Names in this blog have been changed. Images are examples and are not of actual clients. Parents provided permission for their story to be shared.