Parent question: Why won’t my child eat like other kids his age?

Nicola says:

Feeding issues are extremely distressing for parents. It’s normal for parents to want to know why their child is having feeding issues, when they are often surrounded by other kids that are eating well. Seeing other kids eat well is frustrating and painful for parents and they often tell me that they wish their child would eat like their friends’ kids. I find it’s helpful for parents to understand the “Why” of their child’s feeding challenges. In my 20-years of experience as a feeding therapist, these are the 7 main reasons children have feeding issues. Many kids have more than one contributing factor, which can make feeding even more challenging for little ones and their families:

1. Gastroesophageal Reflux (GERD): If your child has or previously had reflux (heartburn), he may have learned to associate eating with pain or vomiting. This can lead to food refusal. He thinks, “I eat and it hurts, so I don’t want to eat.” Children that refuse to eat due to reflux are often pushed or forced to eat by well-intentioned caregivers who fear their child is not eating and growing. In turn, eating becomes a negative experience.
2. Feeding Relationships: Force-feeding, coercing, tricking, or bribing your child to eat can lead to feeding issues. Good feeding relationships are based on trust. When kids feel stressed during meals, they have reduced appetite and are less likely to eat well. The happier and more relaxed kids feel at mealtimes, the better they will eat.
3. Sensory Differences: Your child uses his senses to take in information about the world (sight, sound, smell, taste, touch, and movement). Feeding involves all of his senses! For your child, tastes and smells may seem stronger, noises might be louder, and wet/sticky foods on his hands may be overwhelming. By limiting the food and textures he will accept, your child can control or reduce sensory overload and may feel safer at meals.
4. Early Oral Experiences: When babies are born early or have medical issues, they are often required to have invasive procedures that involve their face and mouth. Sometimes children need breathing support, suctioning, and feeding tubes to keep them alive and/or help them grow. These are necessary measures; however, these early experiences sometimes contribute to feeding and oral aversion.
5. Meal Scheduling: Many kids do not eat well if they are grazing on food throughout the day. Kids eat more volume, grow better, and are more willing to try new foods when they are on a schedule with 3-4 hours between feedings. One of the first steps I take with families, is creating an appropriate mealtime schedule to allow adequate hunger at mealtimes.
6. Milk and Juice: After age 1, if you child is drinking more than 2 cups (16 ounces) of milk or more than 6 ounces of juice per day, this will impact his appetite at mealtimes. Kids that drink too much milk and/or juice tend not to grow as well and do not demonstrate good appetite at mealtimes.
7. Constipation: If your child is having difficulty with bowel movements, this will impact his appetite at meals. Constipation can lead to nausea, pain, increased reflux, and poor appetite. It's very important to work with your child's physician or Registered Dietitian to address constipation, as this often helps with feeding progress.

Please don’t despair! Regardless of the cause of your child’s feeding issues, there is help available. There are many strategies that can be implemented at home immediately that will have a significant impact on your child’s feeding. I will further discuss each of the 7 topics above in my upcoming blog posts.

Stay tuned.