How to Get Your Child to Eat When They Refuse

If you’re struggling with how to get your child to eat when they refuse – you’re not alone.  Picky eating, food refusal, and power struggles over meals are an endless source of frustration for many parents.

Today, I’ve brought in my amazing intern, Roseanne Walsh, to share a TON of helpful information about this topic!  Roseanne is not only a mom of two girls, but also a certified health coach who is currently pursuing a Master’s in Nutrition – so she’s got the knowledge and personal experience to help us out on this.

What’s the Deal with a Child Refusing Food?

Whether you are a stay at home mom with children who are toddler age, a working mom with older school aged children, or somewhere in between, one thing shared in common among all moms is the fact we downright struggle with getting healthy foods into the mouths of our kids.

Who hasn’t tried the “sneak the sweet potato into the pancake mix” approach, and the “no dessert unless you finish your peas” threats to no avail, but who are we kidding? Certainly not our picky eaters!

They know better. They can’t be tricked into appreciating and adopting an “eat the rainbow” mentality through coercion, (no matter how covert the tactic)! It happens on their terms, when they are ready, after repetitive exposure and modeling at home.

There. I said it. They are in control and we are powerless!

I am not suggesting we are victims here in this daily drama, wasting countless hours and dollars attempting to feed our kids vegetables they have not acquired a taste or appreciation for yet. Instead I am suggesting we interrupt the power struggle pattern, give it another go with an open mind, renewed focus, optimism, and creativity.

We also need to understand what we are truly up against in the daily food fight, no small task due to scientific matters completely outside of our control.

Reason #1 for Food Refusal:  The Science Behind What Kids Crave

Let’s take a science-based look at why our kids turn their noses up at kale and cauliflower but can overdose so easily on candy.  First and most importantly, we must acknowledge that we are hardwired to have a positive response to foods that are high in sugar and salt, and a negative response to foods that have a bitter taste.

According to Daniel Lieberman, an evolutionary biologist at Harvard University and author of “The Story the Human Body: Evolution, Health, and Disease,” we have evolved to crave sugar since our ancestors relied on ripe, sweet fruit as a primary source of energy. The negative response to vegetables that have a slightly bitter taste, such as greens and cruciferous vegetables happens because in nature, bitterness is the default sign of poison and potential toxicity.

Essentially, one of the reasons a child refuses to eat is simply because kids naturally reject bitter flavors initially out of evolutionary survival instincts. However this bitterness is caused by the very beneficial compounds we want to ingest, such as phenols, flavonoids, isoflavones and terpenes. So until their taste buds are exposed more routinely repetitively to these flavors, they will not be trained to accept them as “safe.”

What are phenols, flavonoids, isoflavones and terpenes?

As a parent, you may be interested in knowing why some of those bitter components are healthy for your family!  Here’s a breakdown:

• Phenols refer to an extensive group of protective chemical compounds that can be found in a variety of plant based foods. These chemicals make up the active substances that are responsible for protecting the plant from bacterial and fungal infections as well as UV radiation damage. With their protective properties, researchers in recent years have come to understand and document that many phenolic compounds in foods have cancer fighting properties.
• Flavonoids are considered a classification of phenols, and are viewed as the most important single group of phenolics in food. They can be broken down into catechins (found in apples, apricots, cherries), proanthocyanins (found in blueberries, cranberries, and black currant), anthocyanidins (found in oranges, elderberry, olives, red onion)and flavonols (found inonions and tea.)
• Isoflavones are considered to be a class of organic compounds and biomolecules related to the flavonoids which act as phytoestrogens and are thought of by some as useful in treating cancer due to their strong antioxidant content. Examples include chick peas (biochanin A), alfalfa (formononetin), and peanuts (genistein).
• Terpenes are organic compounds made of hydrogen and carbon that can be found in citrus fruit rinds, black pepper, and pine needles or pine tree sap. Terpenes may help to produce anti-inflammatory, antibacterial and anti-depressant effects on the body.

Remember, just because these are perceived as bitter initially doesn’t mean that kids (and adults) can’t develop a tolerance or preference for them over time.  Think about your own habits – I’m sure there are some foods you disliked as a child but that you now include regularly.

Reason #2 for Food Refusal:  Power Struggle

Remember the 19th time you tried to feed little John roasted beets and he looked at you like you just served him a pair of stinky socks for dinner? How did you react?

Did you get upset, that food was being wasted, as one would expect – those beets take a sold hour to cook in the oven, not to mention the scrubbing and peeling!)

Or did you allow him to decide whether he was ready to taste them and detach from the outcome, quietly going about enjoying the serving on your plate while sharing a meal together?

It is easy to get sucked into the first scenario; we are merely mortal moms and yes automatic that we would react this way. We may get anxious, fixating on how we are wasting lots of food (insert deep yoga breathe here…and remember, those uneaten leftover vegetables can be frozen, juiced, put into soup, etc.)

When we get emotional about food, our kids can sense that. It can become easy for this to be an ongoing power struggle. When John wants to exert his independence or when he’s feeling frustrated, he may revert back to refusing his food again.

Release the attachment to the outcome, the need to control, and find comfort in knowing that repetition is scientifically proven to be an effective strategy in encouraging trial. As long as we continue to eat the beets and model healthy choices, maintain a positive attitude, and create a safe space for our children to feel that they have some choices and control over their little worlds where so much is already scheduled and planned for them, they will likely surprise us.

What if the 20th time you offered the beets resulted in little John trying them, and even liking them? And asking for them next time?

A lifetime of healthy habits can not be formed overnight. They will take time, patience, perseverance, consistent positive role modeling- after all studies suggest that children need to be exposed to a novel food between 6 and 20 times before increases in intake and preferences are seen.

Reason #3 for Food Refusal: Oral-Motor Issues and Sensitivities

Despite all the best attempts you might be making to feed your children healthy choices, a few often overlooked challenges that could be causing your child to refuse to eat are oral motor and sensory based issues. If either of these issues is suspected, a conversation with your child’s pediatrician can help to either rule them out or confirm whether further evaluation is needed, in which case referrals to a speech language pathologists and an occupational therapist would be advised for in an person evaluation.

Oral Motor Issues

There are a few tell tale signs that a child is suffering from oral motor issues which you can look out for. In addition to flat out refusing to eat certain foods, behaviors such as eating and then spitting food out, vomiting, or gagging are indications that oral motor skills may be delayed and therefore causing discomfort at mealtimes.

Ultimately, when a child is refusing to eat on account of oral motor challenges, they are in essence acting to protect themselves from a potential choking hazard. There are two main steps that must be mastered before chewing and breaking down food is a safe process for your child:

• The jaw must move in a circular motion while the tongue moves food side to side and up and down in order to aid in breaking it down
• Rhythmic chewing and coordination is needed in order to convert the food particles into a bolus in preparation for swallowing

Sensory Issues

The two most common sensory issues that lead to children having food aversions are hypo-sensitivities, (little to no oral awareness), and hyper-sensitivities (too much oral awareness).

Hypo-sensitivities

• If your child seems to “overstuff” their mouth with food, also known as pocketing, this is an indication that oral awareness is limited and in order to feel the sensation of the food in their mouth they must fully stuff it with food
• Leftover food on your child’s tongue, lips, inside cheeks, etc. it could be a sign they are simply not able to detect that it is there due to hypo-sensitivity
• If your child is unable to feel the food in their mouth, this will make swallowing it a big challenge and the food will become a choking hazard.
• Excessive drool could also be a sign that there is a lack of sensation (children must be able to feel the saliva pooling in order signal the need to swallow).

Hyper-sensitivities

• Consistent crying, screaming, gagging, vomiting, spitting food out, turning away from the foods at meal times can be a sign of a child having too much oral awareness
• Gum massages are thought to help treat issues with sensory hyper-sensitivity

All in all, we must remember there are going to be foods our children will flat out reject, regardless of whether it’s due to oral motor or sensory issues or just a matter of personal preferences, and that’s ok.  The goal to keep in mind is continue to offer a well-rounded menu of foods from all of the food groups and work towards a balanced nutritional intake.

But if you are sensing extreme picky eating or noticing any of the symptoms above, having professional support from a speech therapist as well as a dietitian who can ensure your child is meeting their nutritional needs is beneficial and tremendously helpful.

Overcoming These Challenges

Oral-motor issues or sensitivities certainly benefit from expert guidance.  But assuming you’re dealing with one of the first two issues – disliking bitter tastes, or engaging in a power struggle – here are some suggestions on ways to overcome these challenges.

• Remember that it may take many times of seeing, playing with, and tasting a food before a child develops enjoyment for it.  Continue to repeat exposure to foods, even if they don’t eat them.  It’s that old motto – if at first you don’t succeed, try try again!
• Model positive behaviors for your child – eat your vegetables; try new foods that you are unsure about.
• Avoid forcing kids to “clear their plate” of foods they dislike, as this can usually backfire into continued power struggles.
• Keep in mind the role of parenting styles and the division of responsibility.
• Offer a variety of foods to your children – and think outside the box.  Not only can you do different fruits and vegetables and other new foods, but you can also consider different preparation and presentation methods too.

Let’s dive into those last two bullet points…

How Parenting Style Plays into Eating Habits

According to the Satter Division of Responsibility in feeding (sDOR), it has been well documented and researched that healthful child eating habits are typically associated with a balanced relationship between child autonomy and parental leadership defined by authoritative parental feeding behavior.

The theory here is that the parent owns their responsibilities, and the child owns theirs:

Parent responsibilities:

• What food is offered (fresh, quality tasty options)
• When food is offered (consistently and on schedule)
• Where food is offered (no distractions, at the kitchen or dining table)
• No forcing, bribing, coercing, nudging, applauding, rewarding, explaining, talking about food, or restricting

Child responsibilities:

• How much to eat (as many servings as they want)
• If they will eat (they may choose not to eat)

When this approach is embraced and followed over time, a bi-directional trust is established where parents trust that their children will ultimately grow up to eat the food that they serve and grow predictably, and children grow to trust the parent that enjoyable food will be available at structured meal and snack times.

Quick & Creative Strategies for Food Variety

Admittedly, time is definitely not something we have much of these days for preparing multi course gourmet meals for our families, as much as we might wish we could.

But we sure have food envy don’t we! We have all seen the pinterest posts and instagram feeds featuring beautifully presented colorful foods, you know, like those roasted veggies in the shape of a rainbow!  Most of these meals look like they probably took an hour to prepare, and meanwhile we are feeling relief if we have time to get to the store to buy hummus and manage to serve it with a bag of baby carrots.

So making the most of those trips to the store when you can get there, and picking up quick ingredients that can save you time and add to your toolbox of creative quick meal prep is key. Try some of these ideas that have worked in our home and the question of “how to get your child to eat when they refuse” may start to feel less daunting:

Keep us posted on how you make out, and feel free to share some your own short cuts and strategies with us in the comments section below.

• Kale Chips:  No luck getting your kids to eat kale? Try Kale Chips! Bagged kale is easily converted into kale chips. The prep work is done – just drizzle the chopped greens with olive oil, season with salt and roast at 350 for 15 minutes. Have your child help out by sprinkling on toppings such as fresh grated parmesan cheese or nutritional yeast.
• Veggies & Balsamic:  Stuck in a hummus & carrot rut? Stop by the supermarket salad bar and pick up an array of colorful and crunchy veggies – kids love color and texture! And the washing and chopping is done for you, so you will save time on prep work. Instead of hummus, pair with a balsamic glaze. This is a fun and delicious alternative to a hummus dip. This often comes in a squeezable bottle that your child can hold and make “design drizzles” on their dish and then dip away. Encourage them to “draw” hearts, their initials, or spell out their favorite word
• Pesto:  Tired of the same old Pasta? I bet they are too! Add variety and a dose of nutrient dense greens with a premade basil or olive pesto. You can swirl pestos into basic pasta dishes, soups – even mix into yesterday’s hummus that seemed boring and bring it to life with new color and flavor
• Add Spices:  Spice things up, literally, with every meal. Spices are potent sources of antioxidants that are often overlooked when we prepare meals for kids. Let your child sprinkle some cinnamon onto their apples or oatmeal. Add cumin to some roasted sweet potato. Sprinkle raw cacoa powder into oatmeal (or check out this post with 10 ways to use cacao powder!).  Allowing them a chance to get involved in flavoring their own foods will give them a sense of empowerment and creative license to make a meal their own. And they will get some added nutrition to boot!
• Kebabs and Skewers:  Put a stick in it! Little toothpicks or long wood skewers, either work amazingly well to get your child to eat foods when they refuse. Not sandwich eaters? Deconstruct a sandwich into bite size pieces of bread, cheese, lettuce, tomato olives cucumbers and turkey with a skewer through it all and they will see the sandwich served in a totally new light! Little toothpicks are perfect to serve up mini fruit salads – try grapes with strawberries, banana and blueberry, or any combination of fruits you have on hand.
• Taco Bar: Kids love it when they get to be involved in making their own meal. Heat up some taco shells and serve them along bowls of assorted beans (black, kidney, pinto), salsa, shredded lettuce, corn, cheese, wedges of lime, even chopped cilantro. You will be pleasantly surprised at how much more likely they will be to try something new in their taco shell when its on their terms, and presented alongside a bunch of other colorful and familiar options.
• Mini Pizzas: Pita rounds, English muffins, tortillas and bagels all make for great pizzas. Give your child a chance to make their own pizza by offering traditional tomato sauce and cheese as toppings, but also keep it fun and colorful by offering combinations like basil pesto with sun dried tomato, ricotta with a fig jam mixed in. They can also make their pizzas fun by adding pepperoni “eyes”, some “spinach hair” or a slice of pepper for a mouth.
• Oatmeal Porridge: Many kids eat a quick bowl of cereal and milk for breakfast when short on time. Since many cereals are high in added sugar, this is a missed opportunity to get some higher quality nutrition into our children in the morning when they need energy and balanced blood sugar to power them through their day. Make a big batch of oatmeal in the slow cooker on Sunday night and you will have the basis for a healthy high fiber breakfast all week long. Give the kids a chance to add their own toppings – additions like flax, chia, and hemp seeds are fiber and nutrient dense options that pair well with fruits like banana and blueberry.  Or you can swirl in some of our crockpot pear butter!  Finish with a dash of cinnamon to add to their mix and they will be gobbling it up their little concoctions in no time.

References:

De Cosmi V, Scaglioni S, Agostoni C. Early Taste Experiences and Later Food Choices. Nutrients. 2017;9(2):107. Published 2017 Feb 4. doi:10.3390/nu9020107

Leiberman, D. The Story of the Human Body: Evolution, Health, and Disease. 2014.

Lowsky, D. Food Refusal – Is It Oral Motor or Sensory Related? 2014.

About the Author: 

Rosanne Walsh is an AADP board certified health coach living in Charlestown MA with her two daughters. After losing her husband to Glioblastoma, an aggressive form of brain cancer, she left her successful marketing career to pursue her passion in the nutrition and wellness space. Through her practice she offers health education seminars, as well as private nutrition coaching and cooking classes geared towards women and families in the Boston area. She also established the non profit CAPE (Cancer Awareness Prevention and Education),  a 501c3 organization which is dedicated to advocating for the benefits of lifestyle medicine for disease prevention. Over the past 4 years, generous support from Whole Foods and MGH/Spaulding has enabled funding for hundreds of “edible art” classes at Boston based schools such as the Kennedy Center as well as the Eliot, which are uniquely designed to encourage children to eat more fruits and vegetables. Rosanne is currently pursuing a masters certification in Nutrition at Simmons College – you can find her on her website or over on Instagram!

Share:  Do you find yourself struggling with how to get a child to eat when they refuse?  Which of the three reasons mentioned in this post tend to be an issue for you?  Are there any other tips and tricks you have that we didn’t mention?

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