Thursday, January 10, 2013

5 Reasons Kids Refuse to Eat







People ask me all the time, "Why doesn't my kid eat?"  Most of you know how frustrating meal time can be when you try something new or worse when you serve something they've eaten before and then refuse to eat! Most kids will do this occasionally, but for some it is a way of life.  So, what gives? Well, a variety of factors can contribute and the reasons can evolve over time.  There is value in doing some detective work because getting to the root of the problem will then give you the tools to help them eat more food, more consistently.  In my experience and specialized feeding education,I believe there are 5 different reasons kids refuse to eat.  At the same time, it is common for several of these underlying issues to affect a child's ability to eat well at the same time.  Keeping that in mind, let me a explain in some more detail...


Medical

Although this may seem like the most obvious reason kids don't eat, it is often the most overlooked.  Well, at least it isn't always explored deeply enough.  When kids have a well documented medical condition or are visibly sick, it is obvious that their eating can be affected, but sometimes there are more subtle issues.  Two of the biggest culprits are acid reflux and constipation.  Both of these very common problems for kids can put a halt to eating.  Sarah Dees guest posted a few months back about reflux and it's effects on an infant, but it can also have an impact on kids much older- even if they weren't diagnosed as an infant.  My older son has struggled with constipation since he was about a year old.  I have to carefully watch his fiber intake and when he starts to get a little backed up,  his eating is greatly affected.  Every time he has a bad meal, I have to ask myself, "Does he need to go to the bathroom?"  The answer is usually, "Yes!"

If you read through the rest of this post and feel that none of the other categories fit with why your child isn't eating, I would strongly encourage you to think about any possible stomach issues.  Kids aren't always able to verbalize how they are feeling or realize it is part of the problem.  Definitely discuss it further with your doc, there are some really simple fixes for some of these problems.  By the way, teething, fatigue, and other common aliments fit into this category.  


Sensory

For many "picky eaters" sensory processing plays a big role in their refusal to eat foods. Simply put, if something feels gross in their mouth or on their hands, they aren't going to eat it.  The fancy therapeutic term we give for this is tactile defensive.  Clues that your child may be refusing foods because they are defensive are: gagging, squirming, or seeming frightened by the sight, smell, touch, or taste of a particular food. Oral aversion also fits into this category.  If your child has had medical testing, feeding tubes, or a physical incident in or around their mouth/throat (even from a infancy) they may be scared to have anything come toward their mouth and be overly sensitive in the area.  

On the other end of the sensory spectrum, a child may not be able to discriminate food in their mouth well and they will unsafely stuff a large amount of food into their cheeks like a chipmunk.  This helps give them some feedback as to where the food actually is.  These kids lose track of the food easily and can't chew it well.  Soft foods that aren't easily discriminated (think mashed potatoes, cheese, etc.) are usually refused because they can't manipulate them well in their mouth.  

I have written a lot about the sensory-food connection. Check out those posts here and here if you are looking for more info on this!


Mechanics

This one might be a little tricky for parents to figure out because you need to consider how well your child is chewing and swallowing their food.  You can probably rule this out if you have a child over 2.5 that safely and easily transitioned onto table foods.  Signs that your child may not be chewing well are: choking/gagging after the food is already in their mouth for a few seconds/minutes, spitting out half chewed food, or throwing up food that looks like it has hardly been chewed.  They also may have had difficulty breastfeeding and struggled with table foods when they were introduced.  Kids will start refusing to eat foods because they don't know how to chew it or they are scared they are going to gag/choke/throw up again on this food.  They will often stick to a limited diet because they know they can manage them safely.  

Routine

What do I mean by routine exactly?  Well, I strongly believe that structure and routine around food and meal time is critical to kids eating well.  I know there are a few kids out there that will manage to eat well with the lack thereof, but by in large most kids eating habits will suffer greatly without a regular routine.  This can be a touchy subject for parents, we all have our comfortable eating habits and routines that we have already established for ourselves as adults.  We often continue to do what is comfortable for us with our kids, but it isn't always what leads us to teaching them habits that we really want them to have. If you don't have regular meal times, pay attention to how frequently they are eating. Do you eat in front of the TV often, and/or mostly let your kids pick what they want to eat? If they aren't eating well or willing to try foods, lack of routine may be the reason for it... or at least part of it. 

I commonly see this compounded on top of one of the other 4 reasons kids don't eat.  When there is a problem with eating, we get overwhelmed and start grasping at straws just to get them to eat. This is another way the bad habits can begin and then play a role in poor eating.

Check out my Basic Strategies to Improve Eating and Easy Feeding Tips for a lot more info on the importance of routine and Easy Feeding Tips!


Behavior

I put behavior at the end of this list for a reason.  I want this to be the last thing that you consider. A lot of people advise parents that kids are being "bad" or that the reason they are refusing to eat well is behavior based.  Although, behavior plays a role, it is actually a small percentage of kids that actually refuse to eat based solely on behavior.  Now, please don't mistake me, even the youngest of tykes will learn quickly what they need to say or cry or throw to get what food they want.  All kids go through different stages of development when they are testing boundaries and you can bet they will test it at meal times, too.  After all, this is one of the few areas where they actually have some control.  But, these kinds of little phases are short lived and aren't severe.  For kids that have a history of being picky or poor eaters, behavior is a piece of the puzzle, but typically it has evolved from one of the legitimate reasons listed above.  


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So, I gave you a lot to think about!  If you are confused, overwhelmed, or still not sure why your kid is struggling with food, a consultation might be a good idea.  See the tab at the top or click here for more info!
        





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