Feeding Help for Kids Starting School & Childcare

It’s that time of year again! Back-to-school or the start of childcare...Many of the parents I have been meeting with this week are understandably worried...

"How will my little one with feeding difficulties do when eating at school or childcare?"

When kids don't eat well at school or childcare this can be very stressful for everyone - the parent, the school/childcare staff, and of course the child.

Here’s the positive news!

Most of the children I see with feeding challenges benefit from attending school or childcare. Eating with other kids and following a structured meal/snack routine can help with their feeding development and can sometimes reduce picky eating. Often kids’ feeding skills begin to improve when they start school or daycare! 

The childcare environment provides exposure to new foods on a daily basis and usually follows the recommended schedule of 2.5 hours between feedings to promote appetite. Food is offered for a limited time, which usually aligns with little attention spans (15-20 minutes) and thus eliminates grazing. Peer-modelling happens every day, at every meal and snack. Kids are provided with multiple repeated opportunities to learn about how other kids eat new foods, feed themselves, and drink from an open cup.

Many parents express anxiety and fear about sending their child with feeding issues to school/childcare; however, I always reassure them that the school/daycare routine, peer-modelling, and daily food exposure will likely benefit their child over time. Some of the kids I see eat extremely well at childcare, but not so well at home. This break in pattern from learned eating patterns at home can really help some kids with feeding difficulties.

Benefits of School/Daycare for Kids with Feeding Challenges:

1. Peer modelling – kids eating a variety of foods that they may not see at home which may help reduce picky eating
2. Self-feeding – staff typically encourage self-feeding to promote autonomy and child-led feeding
3. Cup drinking – most childcares introduce cup drinking from an early age
4. Regular Schedule – schools/daycares follow a schedule vs allowing grazing which helps with appetite development
5. Shorter mealtimes – schools/daycares tend to limit mealtimes to the recommended 20 minutes
6. New feeders – a new face/person/feeder can create a change in a child's feeding behaviour and break learned food refusal patterns

Feeding Tips for Back-to-School Kids!

Prepare Your Child in Advance:

For school-aged kids, take your child shopping and let them choose their own cool lunchbox. During the weeks leading up to school, engage your child in helping to pack their lunch with you. Do a couple of “school lunches” at home each week: Ask your child to go and get their lunch box, bring it to the table, and practice opening the containers inside. 

I also find for that for picky eaters it helps to prepare them in advance for what will be in their lunch to avoid any sensory surprises – “Today I have packed your bread slices and a cheese string in your lunch.” This reduces anxiety about what they will find when opening their lunchbox.

Always Offer Safe/Preferred Foods:

Most of your child’s school lunch should be foods that your child likes and can eat successfully, but you can include one learning food in the lunchbox. Try cutting foods into fun shapes with a cookie cutter and using small colourful containers to make the food more fun! 

Whenever possible, engage your child in packing their lunch so they feel involved, in control, and prepared for lunch in the school environment.

Feeding Tips for Little Ones Starting Childcare!

Brace Yourself for Bumps at the Beginning:

If your child demonstrates extreme food selectivity (picky eating) there may be an initial period of time where they do not eat well at childcare. I find that most of the kids with feeding issues that I work with take about 4-6 weeks to adjust to eating at childcare, so parents should brace themselves for a bit of a bumpy road at the beginning. Good news again! With repeated exposure and a routine, many kids gradually begin to eat some of the new foods offered at childcare.

Your Feeding Therapist Can Help:

In more severe cases, where a child is not eating at childcare over long periods of time, a Feeding Therapist can work/consult with the childcare staff to develop a feeding program to support the child’s feeding development and goals. This sometimes involves making exceptions (especially for children with special needs) where parents are permitted to send a familiar food from home to ensure that the child receives some form of "safe food" for nutrition during the day. This food could be presented along with foods that the other kids are eating for ongoing daily food exposure.

As a Feeding Therapist, I work with the childcare staff to provide strategies to introduce new foods in a positive, responsive way. This involves giving the child “helping” jobs like serving foods or scraping their plate at the end of the mealtime. It may also include training childcare staff to engage the child in sensory-based food acceptance steps or food play! A child may begin with just looking at new foods on their plate for the first few weeks, then progress to touching foods while clearing their plate, or learning to smell the foods ("Does it have a BIG smell or a little smell?"), or eventually kiss/lick the foods as they feel ready.

Feeding Tips for Childcare Providers and Teachers!

• Kids benefit from following a mealtime schedule with approximately 2.5 hours between feedings, so they come to the table with appetite.
• Mealtimes should be limited to around 20 minutes and snacks to 10 minutes. Some kids with special needs may benefit from more time to eat.
• Childcares can help kids by providing a preferred or “safe” food that a child can successfully eat. This lets them fill their tummy and get some nutrition during the day. Safe foods can be offered along with foods that the other kids are eating to provide repeated exposure.
• Kids benefit from being able to choose which foods they want to eat. Some childcare centres that I have visited are practicing family-style serving where foods are offered in bowls in the centre of the table and children can use tongs to choose foods to put on their own plate.
• Kids should not be pressured, pushed, or forced to eat foods. Research has demonstrated that this leads to negative feeding patterns and increased food refusal. When kids become anxious, their stress level goes up, which immediately reduces their appetite. Mealtimes should be fun, positive. and child-led.
• Food should not be rewarded with food (e.g., “You can have your fruit if you finish your chicken.” ) This sends a message that some foods are better than others - You have to eat the bad food to get to the good food. These tactics feel like pressure to little ones and can reduce their intake.
• The adults’ job is to decide where, when, and what is being offered to eat and the child’s job is to decide how much to eat or whether to eat at all. This is called the Division of Responsibility (Ellyn Satter).
• Kids do best when they control their eating and how much they eat. Let kids eat as much or as little as they choose. Food amounts should not be restricted or controlled. Kids should not be expected to finish their food due to concerns about “wasting food.”

For extreme picky eaters with restricted diets due to motor/sensory difficulties and children with special needs and medical issues, parents may consider enlisting their child’s Feeding Therapist to work in collaboration with the childcare to develop strategies to support the child's feeding outside of the home. I encourage parents to speak with the childcare supervisor/staff or their child’s teacher to foster a team approach to promote their child’s feeding development. A feeding plan always works best when everyone is on the same page supporting a child with the same feeding approach.

Want more feeding tips and resources to help your child? Want to connect with other parents facing feeding challenges? Join the FeedingPlus Community Waitlist below.

References:

Satter, Ellyn: The Division of Responsibility in Feeding: https://www.ellynsatterinstitute.org/how-to-feed/the-division-of-responsibility-in-feeding/