Food Strike! What can I do when my child won't eat anything anymore?

May 01, 2018

"What can I do to help little Sally eat? She used to eat everything, but now she hardly eats anything at all." I call this a food strike, and it's very common. But kids are smart, they won't let themselves starve. The way you handle it as a parent can either encourage unhealthy eating or healthy eating.

Eat it or wear it.

This question always reminds me of the Judy Blume book, Tales of a Fourth Grade Nothing, one of my favorite books growing up. The younger brother in the book, Fudge, refuses to eat. After many failed trials of bribing and forcing food, his father finally loses patience and says "eat it or wear it." Needless to say, Fudge ends up with the bowl of cereal on his head and goes around for days saying "eat it or wear it!" I would not advise this approach.

When is a food strike a real concern?

Most of the time picky eating is a normal phase. Sometimes it's simply that toddlers and young children don't need as many calories because they're not growing as fast as during infancy. Or it could be that they're filling up with empty calories due to inappropriate snacking. Of course there are some instances that are cause for concern.

Red Flags include:

  • Recurrent or persistent illness

  • Frequent vomiting or diarrhea

  • Food allergies

  • Very limited food types over an extended period of time

  • Problems swallowing or choking

  • Falling off growth curve

  • Sensory issues (trouble with textures, tastes, smells, and more)

  • Anxiety about eating or around foods

  • Body image problems

There is a great series of posts covering picky eating on a dietitian's blog. Some articles are authored by a nutrition therapist. I will include some of my favorites below, but you can find them all on the site.

If you notice one or more of the red flags above, be sure to talk with your child's pediatrician.

Encouraging healthy eating

If hungry, kids will eat. Don't let them fill up on things that aren't giving a nutritious balance. Even just milk all day can be harmful because it lacks many vitamins and minerals. A little milk with other foods is better!

Healthy food choices

Offer veggies, fruits, cheese, nuts, etc at scheduled snack times. Think of snacks as mini-meals. If kids are offered healthy foods at meals and snacks, they will eat them when they're hungry.

Limit pre-packaged foods

Many prepackaged foods are preferred over fruits, vegetables, dairy products, nuts, and other healthier options. If kids have a choice between cucumbers and hummus or a bag of chips, what do you think they'll pick?

Healthy drinks

Limit drinks other than water and milk. Drinks fill kids up and don't offer balanced nutrition. Limit milk to no more than 24 ounces per 24 hours.

Too much is overwhelming

Put only a small amount of each food on the plate. It might be overwhelming to have a full plate. Different personality types can even respond differently to different plate sizes. See Children's Personalities & Bowl Bias: Extravert and Introvert Children Are Not Equally Influenced by Plate Size!

Turn off the tv and put down the screens

Have a dinner conversation with the family. This not only sets up healthy eating habits, but also healthy family dynamics. Teens who eat with their families are less likely to have risky behaviors!

Set a good example!

Talk about how much you are enjoying the healthy foods at the table. (Not how healthy they are, but rather how good they taste.)

Keep foods separate on the plate

Kids might eat a food if it's not touching another but refuse it if it's contaminated.

Scheduled eating

Set a time for meals and stick to it. If your child doesn't eat, clear the table. When they complain of being hungry, don't be condescending. Simply say, "I know how you feel. I'm hungry too when I don't eat. Dinner is coming up soon. I'm sure you'll be ready!" Don't offer filler foods. Keep the discussion calm and without blame or judgement. Kids are smart, they'll pick up on the fact that they need to eat at meal time or be hungry.  They won't starve to death!

Hide healthy foods

Puree a can of beets into spaghetti sauce. It makes a cool color without changing the flavor much at all. Blend carrots, spinach, kale, or cauliflower into smoothies. I've even used frozen peas when there was nothing else. Strawberries, bananas, kiwi, and other fruits are much more flavorful than many veggies and kids tend to like their tastes. If your kids balk at the color, try to match the fruit and vegetable colors to hide the vegetable. Puree onions, carrots, zucchini, spinach, and other vegetables in recipes rather than chopping them... kids won't pick them out! With all of these hidden foods, chances are they won't even know they're there.

Try foods in different forms

Frozen peas are crunchy-- maybe they don't like the squishy texture of cooked peas. Raw broccoli is much different in taste and texture than cooked broccoli. Many kids love cheese over vegetables or foods dunked in ketchup or yogurt. It's fun to eat with fingers for a change. Let them get messy! Try cutting things into pieces and serve with toothpicks. Everything's more fun on a stick! Cut sandwiches with a large cookie cutter for fun shapes. Use small cookie cutters for bite sized sandwiches or fruit pieces. Take a look at Pinterest to find ideas on how to make foods fun if you really have a lot of time on your hands.

Rewards?

Try not to use food as a reward. This can set up unhealthy eating habits. Don't reward for eating. Most kids will get the intrinsic reward of satiety. They don't need stickers or dessert for eating a meal.

Praise small steps

If kids try a new food (whether they like it or not) praise the fact that they tried!

Set realistic expectations 

Don't expect kids to eat as much as infants/toddlers or teens/adults. Calorie needs go down when not in growth spurts. Just make the nutrition needs balance. Don't worry as much about volume as variety of healthy foods! Parents can decide what kids eat, but kids should decide how much to eat. Most kids don't need supplemental meals in a can (Pediasure and other brands) ~ they are getting the nutrition and calories they need, there is just an imbalance of perception of what they need. I always prefer a healthy, active, thin child over a child who is overweight and not active (and often undernourished due to poor quality foods).

Will they get enough vitamins?

Vitamin supplement use and need is debated. It's very difficult to study vitamin supplements. Baseline diet variations could make a big difference as to whether or not the supplement is needed. The time that needs to be studied is very long, because many health issues develop over many years. This means we need to wait a long time to see results and there's a bigger potential that study participants are lost to follow up. Vitamin D is one vitamin that I believe should be supplemented by all. Very few foods have vitamin D. Milk and a few other foods have been supplemented, but that alone will not give sufficient levels. Sunlight is a great way to raise vitamin D levels. But sunlight availability is unreliable and amounts needed vary based on skin type and quality of the light. Not to mention that sunlight can damage our skin. In general I think it's a good idea to give a multivitamin with iron if kids aren't eating well. I prefer for them to get nutrients from foods, but if they refuse, then there's no need for them to become deficient in nutrients. Iron deficiency actually causes anorexia, which increases the problem by not eating well! If your family uses vitamins, be sure to lock them up as if they're medications so kids don't accidentally ingest too much.

Last thoughts

Most kids grow well during their picky eating and food strike phases. Just be patient and aware of any red flags that need to be evaluated. If you are concerned, schedule an appointment to discuss foods, growth, nutrition, and concerns. Bring a typical food log of foods and drinks (with approximate volumes) for at least one week. Your physician can either identify a concern and develop a plan of action or reassure you that your child is normal!

Resources:

How to Handle Picky Eaters (Zero to Three)

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