Child Care: How to Tackle Feeding Problems in Children?

1. Child is thin

Check whether the child’s weight is really below the expected for his age (e.g. is a 1-year-old child weighing only 6 kilos?). Don’t be carried away by your subjective impressions or what others say. Don’t compare your child with other children’s built and weight. Parents, who harbour anxiety regarding the thinness of their child, invariably find some child amongst relatives or in the neighbourhood who is stouter than their child. Every child including yours is unique and comparisons are superfluous.

As long as his weight is within the normal range, relax. A healthy child may stay thin in spite of a good appetite, and probably he is meant to be that way by nature. Such children prefer low caloric food like fruits and vegetables to rich food like desserts and cakes. Don’t be worried if your child doesn’t have a good layer of fat. Excess fat is harmful. The current concept is that it is better to be thin (even for children) rather than being plump. However, if the weight is below the expected range or the child is not gaining weight at the expected rates (a child gains 1.5-2 kilos/year after the age of 1 year), it is best to consult a doctor.

If you are still obsessed that the child is thin, you can do 2 things. Firstly, you can increase the caloric density (obviously the child will not increase the intake of food to a significant extent; so what you can do is to modify the quality of food and make it calorie rich). Some ways of doing so are by adding ghee in dal, rice etc; giving the child high energy and rich foods like ice-creams, chocolates, cakes, pastries, halwa, puddings, custards etc.

The second thing to do is to view, without prejudice, whether the child is really a poor eater. If it is so, try to find out what is leading to this poor appetite (most likely it is your urging and pressures). For more details, kindly see below.

2. Child is fat

Definitely, it is a cause for more concern than being thin. Again, as mentioned before, if the weight is lying within the normal range, there is no need for worry or medical intervention. But if for example a 1-year-old child weighs 15 kilos, I will definitely be worried. Surprisingly, the parents seldom bring their child to the doctor complaining that their child is overweight. On the contrary, they may be proud of their child’s health.

The reason for this lies in the way the society perceives the concept of plumpness in the child. As of today the society views plump children with pleasure and find them attractive and desirable. The friends and relatives compliment the parents (as if it was evidence of their superior parental care, which it is not, as all parents care for their child to the best of their efforts). I don’t think the society’s way of looking at it will change in the near future because of the simple fact that a fat child (particularly till the age of 2-3 years) with chubby cheeks and dimple chins appear so cuddly.

Plump children have smooth and rounded contours which people love to feel and caress. But, from the health point of view, what about the baby? Scientists are of the opinion that babies who become fat during the first two years create in themselves more fat cells, which persist for the rest of the life. These fat cells will swell up with fat whenever the diet goes out of control. Worse, an increased number of fat cells increase the craving for food. As a result, this becomes a harbinger of adulthood obesity.

An overweight child should be of concern to the parents and instead of basking in the glory of the compliments showered upon the child by the friends and relatives; they should make efforts to keep the weight in check. Remember a fat child isn’t much interested in exercises, games and physical activities. This leads to more obesity and it becomes a vicious cycle. And finally, you should keep in mind that obesity may be due to a feeling of loneliness/depression in the child, where eating becomes a solace. So you should ensure that the child’s social and home life is satisfying and happy.

One way to reduce weight is by dieting (you don’t expect a 2-year-old child to do exercises to reduce obesity). Again, you can’t prevent a child from eating whatever amounts of food he routinely eats (even adults require a strong will power to do so). What you can do is make the child eat more of fruits, salads and soups (don’t make them rich). As children love these food items, they will satiate a major part of the appetite by eating them. Meanwhile you can gradually cut down on rich foods like cakes, pastries, ice creams, chocolates etc. You can also consult your doctor, who will tell the child what to eat and what not to eat. Children take such advice better from an outsider than the parents. No medicines should be given to the child to reduce weight.

3. Child is a poor eater

This is the commonest problem facing parents. Why do so many children eat poorly? Because parents try so hard to make them eat well, forcing them to feed by threats, cajoling, bribing, putting forth conditions like if you finish your plate, we will take you to zoo or tell you a story etc. You don’t see these problems in animal babies (who eat whatever they like whenever they are hungry, without their parents bothering). Even in the human race, the simple, uneducated people who live in villages hardly face this problem, because the mothers in such populations are hardly bothered about the amount of food consumed by their children. They do not pressurise the child to eat more and so they eat well.

Pressure makes an activity unenjoyable. Supposing, you enjoy reading novels. Now suppose there is pressure on you to finish the novel in 2 days and after that you will be asked 10 questions pertaining to the novel. You will lose all the enjoyment in reading that novel, because now it becomes a “task”. We cannot deny the fact that doing anything is pleasurable as long as there are no pressures. Same applies to the feeding of a child also. If he is urged to eat more, he is under pressure (i.e. eat what the parents expect of him). This takes the joy of eating away from the child who starts perceiving eating as a “task”, which has to be done.

Consider yourself in the child’s position. Suppose your stomach is full, but still someone forcibly puts more food onto your plate urging you to eat it (e.g. as happens in marriages and formal parties). Out of politeness and because you want to “finish” the plate so that it may not be considered indecent; you somehow eat it, though you don’t feel like it. And finally imagine it becoming a daily task. Day after day and meal after meal, someone is forcing you to consume against your will.

After some time you will become insolent and rebel against it by leaving the food unfinished. You will also start resenting “Mr. X”, the person that daily forces you to eat more. You will not want Mr. “X” to be present while you are eating and instead long to eat peacefully in a restaurant or a friend’s place or a neighbour’s place, where you can eat whatever you like and stop whenever you want.

So parents should not be like Mr. X! Let the child eat whatever he likes, and stop acting like a “watch guard.” Under*standably it is difficult for the parents to do so. When the chikd doesn’t eat well, the parents go through a lot of mental turmoil.

The first feeling is of anxiety that their child is not eating well and hence will become weak. They can take comfort from the fact that their problem is not an isolated one, but is a very common problem which most of the households face. The parents find it hard to relax as long as the child is eating poorly. Paradoxically, this concern is the main thing “shackling” the child’s appetite.

The second feeling is that of guilt that they are not able to make the child eat well and thus they blame themselves for it.

The third feeling may be of shame (ashamed of their child’s thin built in comparison to others and hence be obsessed to improve it). Parents are bothered by the comments of the relatives and friends “your child is thin.” The parents should ignore these thoughtless comments.

The fourth and a very uncomfortable and nagging feeling, is that of frustration and powerlessness. It seems that whatever they do and however hard they try, it is all in vain because the “little insolent child” of theirs, with complete disdain, spurns all the parental efforts to somehow make him eat. It appears that the child has developed an attitude, that come what may, he will always do the opposite of what the parents want him to do.

Obviously parents will be much relieved if somehow their child eats nicely without fuss. The treatment of such a malady lies primarily in changing the parental attitude towards their child’s eating (i.e. to resist the “irresistible” urge to make him eat). The main problem lies in the parent’s minds (rather than with the child); so all parents faced with this problem should consider the following points carefully:

i. They are not the only ones facing this problem. In fact it is so common that practically every household faces this dilemma. So the parents can relax knowing that they are not alone and that there are many others who are sailing in the same boat with them.

ii. Almost all children (if not prohibited by their parents) eat better at the neighbors rather than at home. Why? For the simple reason that over there, there is no one standing with “an eagle eye” on them monitoring their “eating performance.”

iii. The parents should keep on reminding themselves that all children have a remarkable natural mechanism that tells them how much food to eat for their normal growth and development.
Parents should not tamper with it, because what is natural cannot be wrong. They should also imprint in their minds that no child will ever starve himself.
iv. Parents should bear in mind that all human beings including children are born with a natural instinct to get balky if pushed too hard. So a child will dislike food items if forced upon them, mainly due to parental urging.
v. Why the parental urging becomes an almost reflex, monotonous and perpetual routine? The reason is that there are some short-term gains initially, like the child accepting a little bit more of food when cajoled, threatened, bribed etc. The parents unwittingly accept the “small extra morsel of food” eaten by their child as a reward and result of their constant trying and perseverance. This positively reinforces their behaviour and it becomes a cycle. If parents are advised to change their behaviour and let the child be free from all “pressures”, they may find it extremely hard to follow. This is because of their anxiety that the child is already eating less and if they stop urging him to eat, he will eat even less and thus starve. The parents also feel that their urging at least makes the child eat “a bit more.”

I can understand the parent’s dilemma and confusion. What the parents should understand is that their urging makes the child eat one or two spoons more and that too, not willingly, but because he is forced to do so by his parents. This extra one or two spoons hardly makes any positive difference to the child’s health in the long run. On top of that, after sometime, this urging stops having any effect on the child and doesn’t work. For e.g. if the mother says, “finish your plate, else I won’t take you to the party”, the child may reply, “I don’t want to go to the party.” In effect the child is indirectly saying that I don’t want to eat more (and that none of your threats or bribes is going to induce me to do so).

So, these types of urgings are of no value in the long term and in fact are counter-productive. The parents should not go for short term “gains” (the child reluctantly eats one or two spoons more), but rather focus on the long term “losses” of such an approach. And the “losses” are very obvious. The child will become a chronic problem eater, his appetite may be reduced permanently, and the pleasure of the child for eating will go. The parents also suffer a lot of mental agony and in the end are reduced to,a feeling of frustration and helplessness.

vi. Parents don’t want their child to eat more because he has been “beaten” in a fight with them. There is really no satisfaction in this for them. The parents’ real joy lies in the fact that they don’t have to force the child to eat, but to let the natural appetite of the child surface, so that he eats of his own accord and with pleasure. Also remember that in the “feeding battle”, initially the child may lose and eat a bit more; but in the long run a child can always outlast a parent when challenged to such a battle. And the child will feel joyous that at last he has “beaten” his parents and gains satisfaction out of it rather than out of eating. So ultimately you land up with a “poor eating child” whose attitude is just like the dog’s tail. However much you try to straighten it, it will again bend back.

Why I am stressing so much on all this is because the parents should be absolutely convinced that it is their attitude, which has to be rectified. Once they accept this fact, the first step and the most important step has been achieved towards the remedy. What is this remedy? Though theoretically simple (i.e. the parents should stop forcing the child to eat), in practice, once a feeding problem is established, the cure of it takes time and patience. The parents should possess a strong will power and curb their natural habit to pressurise their child to eat more and to make a big fuss out of it. With patience, you will gradually stop paying attention to the feeding of the child and remove the pressure on him. This is real progress.

It may take weeks for the child’s natural appetite to surface because he has to be given a genuine and long chance to forget the unpleasant associations with food. The appetite of the child is just like a mouse and the parents anxious urging just like a cat, which has been scaring it into its hole. And the cat must leave the mouse alone for a long time, before it becomes bold enough to venture out of its hiding. In between, parents may have the “itch” to urge the child to feed, as anxiety may gnaw at them (particularly if they perceive no real progress). In order to relieve this anxiety they may feel “compelled” to go back to the old habits. But, under all circumstances, resist this impulse; otherwise you will be taking a step backward. The key words are patience and perseverance.

The ideal parental approach should be to put the food before the child (small portions that the child can take; let him ask for more if he wants), then say nothing and think nothing about the eating of the child. Take the plate away after 30 minutes, without bothering or fussing about the amount eaten. In no way indicate; even indirectly by your body language or eyes that you are worried about his feeding (though internally you may be anxious). Start with the foods that the child likes the best. Be patient and go on sticking to this routine. Your patience will surely be rewarded; and gradually as the child feels relieved of pressures, his appetite will come back, and he will start eating spontaneously to his optimal capacity.
Key summary line: Try to make the child eat more, he won’t. Don’t try and he will eat well.

4. Child is choosy about food

Parents complain that their child doesn’t, for example, eat milk or green vegetables. This is of no concern, as everyone (including adults) has some food fads, some liking and disliking regarding food. As mentioned earlier, the child tends to eat a balanced diet over a period of time and being choosy about certain food items doesn’t make it “imbalanced.” The real problem is when the child eats only a few food items (like chocolates, toffees, ice creams, sweets etc.) and fills his stomach by them, so that he shuns the regular meals being prepared at home. In such cases, you have to be firm with the child and gradually cut down upon the excess sweets i.e. the marketed food items and offer him home made foods that he likes.

5. Child doesn’t feed himself

Another common problem, it usually starts when the parents take the onus of feeding the children on themselves and consider it their solemn duty. Some parents feel joy in feeding their child; others think it to be their responsibility. Whatever the reasons are, the end result is that of a hapless mother running around to feed the child with a spoon in her hand. In between she has also to talk to the child and cajole, coax, urge or threaten him to eat.

It is reasonable to feed a child up to 1 year, but after that the habit of self-feeding should be strongly inculcated in the child. The child should sit at the table with the adults during meal times and encouraged eating food with his own hands. Don’t worry about any mess he makes. Let him enjoy having fun with the food and trying out his own methods to “negotiate” the food into his mouth. The habit of “spoon feeding” makes the child dependent on you. He also starts taking it for granted his right to be fed by you, so much so that he won’t eat by himself. You, out of sheer habit, and not wanting to turn down the plea of the child will feed him, thus perpetuating the cycle; ultimately ending up running after him, pleading him to eat.

For the child, this feeding becomes an important indicator of his parents’love and affection towards him and so if you suddenly stop it, he will feel hurt. So don’t start this habit of spoonfeeding in the first place. If already established, you will have to be firm with yourself that you are not going to “spoonfeed” the child and also firm with the child that he has to feed himself. No child will willfully starve himself! Maybe, he won’t eat for a day or two and sulk. Just assure him that you love him a lot, and not feeding him doesn’t mean that you are angry with him or that your love towards him has lessened.

Keep the plate in front of him and tell him that you want to see whether he can feed himself. Tell him that you want to judge whether he has grown up and can do things by himself. These are just examples. The basic idea is to throw a challenge to the child in a way that the child accepts it!

A direct statement that he has grown up and it is high time he feeds himself or a comparison with others of his age group is not desirable. Instead if you say, “let’s see whether you have become big”, the child may accept the challenge and to prove that he is big, he may start feeding. Once he does so, encourage and praise him. Gradually the child will relish eating food by his own hands. Once in a while, if he demands that you feed him, do it casually. Tell him that you are going to feed him only say 5 spoons and after that he has to feed himself. If after having 5 spoons he still insists, firmly tell him that this is not what was decided upon. You have kept up your part of the “contract”, now the child should honour his part by self-feeding.

If the child wants to eat from the parent’s hands only, it is very difficult for the parents to resist it. And supposing the child goes without meals and that too, 2 times in a row, just because the parents are not feeding him, it requires a supreme will power not to feed the child. The parents feel guilty that the child is going hungry because of them not feeding him, and may feel uncomfortable.

Firstly, the parents have to decide firmly that the child has to be independently feeding. Remember self-reliance and independence are very important gifts that you, as parents, give to the child. The sooner the child is made independent, the better it is for him in the long run.

Secondly, parents must keep in mind that if they are not feeding the child, in spite of his asking for it, it is not because they don’t want to feed him, or that they are punishing him or have stopped loving him. It is because of a much greater and sublime love towards him (i.e. they want him not to be dependent on others). This type of thinking, which is rational, instead of being prejudiced by their emotions, strengthens their resolve to resist the urge to feed the child.

Finally once the child has started feeding himself, let it not relapse. Often what happens is that the parents feel tempted to feed him when he loses his appetite or falls sick. This should be resisted as the child may again start becoming dependent.

6. Fooling at the table

Some children indulge in mealtime misbehaviours like getting up and down from the table, playing with the food, fighting with the sibling etc. An effective management technique for such behaviour is to terminate the meal calmly when playing with the food exceeds the eating (regardless of how much the child has consumed). One hour later when the child becomes more agreeable and also hungry, food may be re-offered to him.

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