Following is info that I use in my presentations for CF family education days. I hope this helps give you more ideas about handling food issues. They are so very common with our kids with CF. Go easy on yourself if you are struggling- many of us do. Good luck! Lisa
Avoiding Food Fights: Tools and Tips for Motivating Picky Eaters
by Lisa C. Greene
One of the earliest power struggles for every parent is around food. Being picky about food is a typical toddler behavior. And when a child has CF, it's an even bigger battle because the stakes are so high. Having a good parenting tool kit around dealing with food issues is essential. There are definitely things that we should, and shouldn't, be doing when faced with a food standoff.
The bottom line is that we can’t make a kid eat! Of course we try to and we do everything under the sun to "make" our child eat. But a basic rule of human nature- especially for toddlers (and teenagers!)- is that when one demands, the other resists. So the more you try to make your child eat certain foods or a certain amount, the more your child will naturally resist.
Kids love emotion so the key is to show lots of emotion when they do things right and very little emotion when they don’t. It's easy to do the opposite. We don’t even notice when our kids do things right and then we show all kinds of emotion when they goof up! So we have to be thoughtful and clever about how we motivate our kids to eat and one way is with choices. The earlier you start with sharing control around food choices, the better. Here's how it works:
Parent: "It's time for breakfast! Do you want pancakes or waffles?” Kid: "Waffles." Parent: "Great! Would you like one or two?" "Two." "Okay. Do you want maple syrup or strawberry?" "Maple." Good! Do you feel like having bacon or sausage?" "Apples or bananas?" "White milk or chocolate milk? You get the idea...
By using choices, our preschoolers are more likely to actually eat what we prepare because they are involved in the decision-making process.
Parents often ask, "What if my child just won't eat?" That's a great question. In fact, it was that very question that led me to Love and Logic! This was me before Love and Logic:
“Jacob, eat your food.” “Please eat your food.” “It’s getting cold, eat!” “Don’t you know there are starving kids in China?” And finally, the ultimate, “You are not leaving this table until you eat your breakfast.”
Now, has any parent ever existed that could make a three- year- old sit at the table until he has eaten a bowl of cold, hard oatmeal? What was I thinking?! But I didn’t know what else to do. And, in the back of my mind, I was afraid. Afraid that he wouldn’t eat. Afraid that he wouldn’t gain weight and afraid that he’d get sick. I thought it was my job, as his mom, to make him eat. And I was afraid I wasn’t doing a good enough job. Talk about pressure! And this was what happened after I learned just a little Love and Logic:
We were getting ready for preschool and, as usual, Jacob didn’t want to eat his breakfast. But, unlike the old days, I didn’t get all worked up. Instead, I said, “Well, it’s your choice not to eat breakfast but you’ll probably be hungry at school.” Jacob said, with a sassy little attitude, “I’ll just eat a snack at school if I get hungry.” So I said, “Okay. I hope it works out for ya.”
Then, I put a banana in his backpack and had a little conversation with his teacher about only allowing him to have the banana for snack. As luck would have it, the school snack that day was birthday cupcakes! And… Jacob had a banana. Let's just say he was not a happy camper!
We never fought over breakfast again. To this day, years later, he’ll still ask, “Mom, can I have treats today?” And I say, “Of course, sweetheart! Kids who eat their healthy foods are welcome to have treats.” This stuff really sticks with them for a long time!
Here are some more tips for avoiding food fights that I've picked up since those early years:
- Do not show anger and frustration over food issues. Show encouragement when they eat well and empathy when they don’t. Encouragement sounds like, “Way to go eating up all your food. You must feel really good about taking such good care of your body.” Or: “I’ll bet you can’t wait to get dessert- it’s a good one!”
And empathy sounds like: “Oh, that’s too bad you didn’t eat dinner. I guess you won’t be joining us for that special, yummydessert I made. Ohh bummer.” (Remember to be truly empathetic- not sarcastic or snippy).
- As in the banana story, use dessert and treats as a positive consequence for eating properly. Our kids are not allowed to drink soda pop or eat junk food unless they eat their healthy food first. Here's another example:
I was packing my daughter’s lunch recently and had put in an oatmeal cream pie which she just loves. She was dawdling over breakfast and I could see that if she didn’t hurry it up, she’d run out of time. I was so tempted to nag!
But instead, I simply took the oatmeal pie out of her lunchbox and set it on the counter. And I said, “Looks like you might not finish your breakfast in time so I’m not sure that you’ll be having this today. But I’ll set it right here just in case you finish.” And you should have seen that little mouth move. And she did it! And, we were both happy about it. I said: “Yayyy Kasey! You get your cream pie!”
- Regularly involve your kids in the food planning and preparation. When they help you plan and cook the meals, they are a lot more excited about eating it!
- When you go grocery shopping, let your little ones help pick out some of the food items they want to try. Try to buy in small quantities in case they don't like it.
- Use the power of example. You be excited about trying new foods and eating properly. Say things out loud like “I feel so good when I take good care of my body with good food!” or "I've never had this food before but I really like it!"
- When your child gets a little older and is resistant around eating, problem solve together. You might be surprised at the reasons why your kid is struggling but unless you explore it, you won’t know how to solve it. I was surprised to find that the reason my daughter wasn’t eating some of her school lunches was because she had a loose tooth and couldn’t eat some of the things I had packed for her like apples and sandwiches. Once we figured this out, I cut them up for her and it really helped.
- Along these lines, be aware that teething can affect appetite. Teeth come in for most children from around 12 months of age to three years. I remember getting worried about Jacob's lack of appetite and runny nose, thinking that maybe he had a lung infection, and then Pop! out came a new tooth. I learned to watch for the signs: drooling, runny nose, fussiness, chewing on things, reduced appetite, possible fever, and maybe diarrhea. Of course, these might also be signs of your child getting sick so if in doubt, call your doctor. I found that as soon as I started treating the symptoms of teething, he did better. I made sure I fed him things that would help: softer foods, milkshakes, homemade popsicles, etc.
- Encourage trying new things without pressure to eat it. One mom shared how she gets her 4 and 7 year olds with CF to try new foods. They don’t have to eat it, just take a tiny taste. And she sneaks special toys into her CF clinic visits so when her kids report on all of the new foods they tried, the doctor gives lots of praise and the special treats.
And another mom shared that their family calls this “No thank you bites.” Once the child takes a little taste, they have the option of saying, “No thank you. I prefer not to eat this.” And, this smart mom makes sure that she always has at least two other items on the plate that her child likes.
- Kids commonly take about five or six tries of seeing a new food on their plate before they accept it. Parents generally give up on the new food way before then. For our family, I introduce new foods that my husband and I like and make sure there are other side items the kids like. It took about seven tries to get meatloaf down the hatch but both of our kids now love it- as well as a wide variety of different foods including Japanese, Chinese, Mexican, Thai, Indian, etc.
- Kids tend to like "pure" foods rather than mixtures. So for example, they are more likely to eat meat, potatoes and a vegetable rather than a casserole that mixes the three. I'm honestly not sure why. But a lot of kids don't like their foods to "touch" either. Go figure...
- Children taste foods differently than adults; some flavors are stronger and others more blan. If something tastes good to you it doesn't necessarily mean it will to your child. Also, kids are very sensitive to texture.
- Presentation matters. Make the food "look good" on the plate. Gourmet chefs know that even for adults, presentation matters. It does for your child, too. In a study done by Stanford University, researchers presented two identical meals to a group of children. One was in a plain wrapper and the other in a package from a popular fast-food chain. Even young children liked the name-brand food better. This suggests that marketing and expectation have an impact on perceived taste even in kids.
- Be creative and fun! Make food in fun shapes or colors. Even my older kids still like Mickey Mouse shaped pancakes. Make the food look like a funny face on the plate. And sometimes just adding a new flavor will help like nutella or peanut butter. Or maybe you can have backwards day and serve pizza for breakfast and waffles for dinner! Our kids love that!
- Don't become a short order cook. Cook one meal for the family but stay flexible. For example: With spaghetti, my son likes sauce and my daughter doesn't. So I serve the sauce on the side as well as butter and cheese for my daughter. Then they can make their plate how they like it. Don't pre-mix in salad dressings. Let them pick. Choices, choices, choices. If my kids don't like what I've made, they have the option of making a peanut butter and jelly sandwich instead- as long as they do all the work including cleaning up the mess.
- My husband and I really “talk-it-up” how lucky our kids are that they get to eat all of the kinds of foods that everyone else wants to eat but can’t! In mock frustration, we'd complain about how they get to have brownies and ice cream with hot fudge for dessert but mommy and daddy get grapes. We'd say, “Oh you lucky kids!!” And they'd laugh and tease us with their brownies.
- How do you tell if it's the child who has the problem or the parent? Generally speaking, if your child eats pretty well for other people like Grandma, your partner, or at preschool but continually battles you at home, then it's likely that your child has figured out that food is your hot button and isn't hesitating to push it! Ineffective parenting responses can turn a typical toddler stage into a perpetual battle. Showing anger and frustration is the top one.
Lori J. Stark, PhD, a Professor of Pediatrics at the University of Cincinnati College of Medicine has done some great research on motivating kids to eat and here are a few of her suggestions:
- Limit mealtime to about twenty minutes. Dr. Stark says that this because there is a biological response that all humans have in which the stomach tells the brain it is full after 20 minutes of eating. Therefore little eating is likely to occur after 20 minutes.
- So she says to focus on helping your child get as much food as possible within the first 20 minutes by paying attention to behaviors that support eating such as loading food on a fork, taking bite after bite, chewing quickly, swallowing quickly, trying foods, and finishing foods. Give compliments and praise; be enthusiastic and specific: “Kate, I love how you took three big bites of your hamburger!”; “Sam, smart idea to load your fork while you are chewing that bite.”
- She also tells us to ignore the behaviors that interfere with eating, like dawdling, chewing excessively, talking excessively, complaining about food, and complaints about not being hungry. So be picky about where you give your attention and do not give it when the child is not eating. The trick is, that as soon as the child starts to eat or even picks up their fork, you need to compliment this behavior.
- And Dr. Stark suggests using rewards to motivate good eating habits. By saying things like: “If you eat all your chicken and potatoes and drink your milk you can play 15 minutes of videogames tonight” we are teaching children that positive things come from getting more energy. Thank you, Dr. Stark, for your great ideas.
Here’s an important final point about kids who don’t want to eat: Be sure to rule out medically based reasons before just assuming that it’s a behavioral problem. Resistance to eating can be cause by many things including acid reflux, sinus or lung infections, pancreatic insufficiency, food allergies, or medications which might cause stomach upset or decreased appetite.
Be sure to discuss food challenges with your doctor- good nutrition is so important with CF. The good news about using effective parenting strategies at mealtime is that you, and your CF Team, will be more quickly able to figure out if the problem is a medical issue versus a behavioral issue and respond accordingly.
Lisa C. Greene is the mother of two children with cystic fibrosis, a certified parent coach and public speaker. She is also the co-author with Foster Cline MD of the award-winning Love and Logic book “Parenting Children with Health Issues.” For more information, see www.ParentingChildrenWithHealthIssues.com.
Copyright by Lisa C. Greene. All Rights Reserved.