HELP My child won t eat! A guide for families
Help, my child won t eat! Many children go through phases of refusing to eat certain foods or at times refusing to eat anything at all. This is a normal stage in young children as they become wary of new foods. They need time to learn to like them. Food refusal is often a way of showing independence and is a normal part of growing up. Although it is very worrying, children will not harm themselves if they don t eat enough for a short while. They may need less to eat than you think. It may help to discuss the problem with other parents who have already gone through the same situation with their child. If the problem shows no sign of improving, or if you are worried about your child s weight and growth, you can contact your Health Visitor, GP, or Dietitian for further advice. 2
What can I do? Offer regular meals and snacks, as this is better than letting your child pick through the whole day. Young children often need 3 meals and 2-3 nutritious snacks. Always offer 2 courses at a meal, one savoury and one sweet. Eat at the same time as your child if possible, as he will learn from you. Try and make meals enjoyable social occasions. Keep offering your child new foods even if they refuse them at first. Many children will need to taste a new food well over a dozen times before they accept it. Eating new foods together with your child is important. Sit together at the table. Use brightly coloured plates and cups. Present food in fun and attractive ways. Try and eat in a calm, relaxed area, without the television or toys. Children are easily distracted! Try not to rush a meal as your child may be slow to eat. However don t let meals drag on for too long half an hour is about right. 3
How can I help? NEVER FORCE A CHILD TO EAT Your child is telling you he has had enough when: he turns his head away he pushes the bowl or plate away or onto the floor! he screams or shouts he spits food out repeatedly he holds his food in his mouth and refuses to swallow it. Although it is a very difficult thing to do, try not to show that you are worried or annoyed by your child not eating. If he does eat, show him you are pleased (for example, smile and say, good boy, well done! ). If he stops eating at a meal, try once to encourage him to eat a little more. If he doesn t want anymore, take the food away without any comment. It is a good idea for children to use their fingers to play with food. Do not worry if they make a mess! When your child eats well offer a reward such as taking him to the park or spending some special time playing together. Do not offer a reward of food. 4
Which foods do I give when? l Give small portions of food at meal times. If these are finished, praise your child and offer more. Do not take food away and offer a completely different meal if the first one is refused. l Finger foods are often easier to manage as a child can feed himself. Try sandwiches, sausages, cheese slices, cream cheese on crackers potato wedges, fish fingers, vegetable slices and pieces of fruit. l New foods need to be offered several times before children will even try them. It is a good idea to offer at least one thing you know your child will eat at each meal. l Giving children fizzy drinks, squash, milk, crisps, biscuits or cakes can fill them up. This means they may have a smaller appetite for food at meal times. Avoid giving snacks too close to meal times. Milk is a nutritious drink but should not replace meals. Be careful not to let your child drink more than 600ml of milk in total during the day/night. 5
Sensible eating for 1-5 year olds Suggestions to help you: 6 BREAKFAST Small bowl of breakfast cereal and milk or toast with butter/margarine and jam/honey. Cup of milk to drink. LIGHT MEAL Sandwich in bitesize shapes e.g. ham and tomato, cheese and cucumber, peanut butter or baked beans or cheese on toast. Small pot of yoghurt/fromage frais/fruit. Cup of water or diluted fruit juice. MAIN MEAL Pasta dishes e.g. macaroni cheese, Spaghetti Bolognese. Chapatti/rice and curry. Fish in white, cheese or parsley sauce. Roast meat or mince e.g. shepherd s pie. Fish fingers/chicken nuggets - Serve with vegetables e.g. broccoli, fingers of carrot and swede, peas and a scoop of mashed potato. Fruit segments/slices/shapes. Cup of water or diluted fruit juice. Also offer 2-3 small nutritious snacks each day. See back page for ideas
Try a variety of foods for a well balanced diet Milk and Dairy Foods: Aim for 3 servings a day. These can be given as full-fat milk, cheese, yoghurts, fromage frais, custard and milk puddings. Meat, Fish, Eggs, Dhals, Pulses and Nuts: Offer 2 servings a day. All types of meat and fish are suitable. Many children enjoy minced meat, sausages, chicken, fish fingers and fish in sauces (try to include an oily fish such as salmon, mackerel or sardines - once or twice a week). Chick peas, kidney beans and lentils make good casseroles. Hummus, dhal, eggs and baked beans are good too! Whole nuts, including peanuts, may cause choking in children under the age of five. Starchy Foods: Give these foods at each meal. Most children enjoy eating breakfast cereals and porridge. Other starchy foods to encourage include bread, potatoes, chapatti, yam and green bananas, pasta, tinned spaghetti, rice and couscous. Fruit and Vegetables: Offer fruit and vegetables with each meal every day. Try raw and cooked vegetables; raw, cooked, dried or tinned fruits or pure fruit juice. Encourage 5 small portions each day, but let your child eat as much as they choose to. Fats and Oils: Growing children need some butter/margarine and oils. Adding oils, butter and cream is a good way to increase calorie intake. Sugar and Salty Foods: Foods containing sugar are useful for adding extra calories. Offer them as a pudding and try not to give them between meals. Look after your child s teeth. Try and avoid giving too many salty snacks and salty processed foods. Vitamins: Children under the age of five should have vitamin drops containing vitamins A and D. This is particularly important for faddy eaters, and all children of Asian, African or Middle Eastern descent. Vitamin drops should be available at your NHS health centre and retail pharmacies. For information on NHS Healthy Start vitamins, see www.healthystart.nhs.uk. 7
Ideas for nutritious snacks Offer 2 or 3 each day l Cup of milk with a biscuit, cake or muffin. l Small bowl of cereal and milk. l Cheese and crackers. l Breadsticks, chapatti, pitta bread and cream cheese, peanut butter or hummus. l Small sandwich. l Small slice of pizza. l Apple slice with peanut butter or cream cheese. l Pancake with spreads such as fruit purée, jam or chocolate spread. l Milk shake or fruit smoothie made with milk. l Fruit pieces or vegetable sticks - for extra calories serve with yoghurt, cream cheese, peanut butter or hummus. This information was produced by the BDA Paediatric Specialist Group and has been reviewed for Nutrition and Diet Resources UK (NDR-UK) by the BDA Paediatric Specialist Group. At the time of publication the information contained within the leaflet was, to the best of our knowledge, correct and up-to-date. Always consult a suitably qualified dietitian and/or your GP on health problems. NDR-UK cannot be held responsible for how clients/patients interpret and use the information within this resource. NDR-UK Ref HCWE, First published: 04/08 Reviewed: 11/09, 03/11 To re-order visit www.ndr-uk.org and follow instructions The British Dietetic Association 5th Floor, Charles House, 148/9 Great Charles Street, Queensway, Birmingham B3 3HT. Fax: 0121 200 8081 e-mail: info@bda.uk.com www.bda.uk.com The BDA Paediatric Group is a Specialist Group of The British Dietetic Association