Healthy eaters, happy mealtimes

Specialists from Children's Feeding Program at Children's Hospital share some their "top tips" for creating healthy eaters and happy mealtimes.

Feeding problems are a frequent issue for children and one that is often underrated by parents and pediatric professionals. Approximately 20% to 50% of toddler and pre-school age children are reported to have some mealtime problems or to be picky eaters. The percentage increases to 80% of children with identified special needs. These problems can range from a child who requests specific foods to the child who completely refuses to eat any foods/liquids and relies on tube-feedings for nutrition. While there are many causes of feeding problems, below are suggestions to encourage better eating habits with children who are developing strong opinions about what goes on their plate.

• Plan to serve at least one food your child likes as part of the family meal. The rest of the meal should include portions of what is being served to the entire family. Avoid becoming a short order cook and don't prepare extra dishes on demand. If you start making a separate meal for each child you will get frazzled and resentful, and your child won't expand their food preferences.
• Set an example by serving new foods to the entire family. Encourage tasting a bite and, if rejected, wait and try another time. Tasting has a more powerful effect on changing a food preference than just looking at a new food. Continue to have a variety of foods at meals and continue to try previously rejected foods. Often 10 or more tries are needed for the child to become willing to accept the new food. If you stop serving a food when your child says "no" to it you reinforce pickiness.
• Praise your child for good eating practices. Let your children know that you approve of their efforts when they try something new no matter how small the change. Celebrating changes such as trying a new flavor or brand of a preferred food can help children feel less anxious about branching out. Being rewarded with a special treat after trying a specified number of new foods can help motivate them to try something they would not otherwise be interested in.
• Serve kid-size portions. Big servings can be intimidating. Offer portions that are approximately ? the size of an adult's portion. If your child is still hungry, he or she can always ask for more.
• Be open to allowing children to add condiments or seasoning to help them feel a sense of control (ketchup on baked chicken, cinnamon sugar on carrots, for example). Suggest your child eat food in a sequence by taking a bite of each food and then a sip of a drink until all foods are gone. This helps keep a child from eating all their favorite foods first and then leaving the rest on their plate.
• To ensure your child is hungry when it is time to eat, make sure they haven't filled up on too many snacks or drinks in the late afternoon. Watch out for juice and soda. Sugary drinks don't offer the nutrition of milk and they fill kids up so they won't eat as much as they need to.
• Don't make the table a battleground. Fighting with your children over what they will and won't eat creates negative feelings about eating, which can lead to even more pickiness. Also, refusing to eat is a way to get attention. Stay calm when this happens; if a child learns he or she can push your buttons by rejecting foods, mealtime will turn into a battle.
• Don't pass your own food hang ups on to your kids. Be careful what/how you talk about foods. To ensure your child is hungry when it is time to eat, make sure they haven't filled up on too many snacks or drinks in the late afternoon.
• Watch out for juice and soda. Sugary drinks don't offer the nutrition of milk, can lead to diarrhea, and fill kids up so they won't eat as much as they need to. Kids who drink too much can seem finicky because they don't have much room in their stomach for food.
• Try to feed your child only when he or she is sitting down at the table or highchair. Stand-up eaters can become all day snackers who are picky at mealtime because they are not hungry. Don't permit continuous nibbling.

Mealtime Choking Hazards

According to the Centers for Disease Control (CDC), the most common cause of non-fatal choking incidents is food. Certain foods are hard for children to chew without a full set of teeth and before mature chewing patterns are established. The following foods could cause a child to choke:

• Hot dogs or sausage
• Hard candies, including jelly beans
• Grapes, cherry tomatoes, olives, or other small round foods
• Nuts
• Popcorn
• Raw carrots, celery, beans, or any hard vegetable
• Apple chunks and slices
• Seeds such as pumpkin or sunflower
• Large chunks of any food such as meat or potatoes
• Large lumps of peanut butter (it is better to spread it thinly onto a cracker) or caramel

When your child is ready to try some of these foods it is important to watch closely when he or she is eating them. Remember, any object that is 1 inch in diameter can plug your child's throat and objects smaller than that can be inhaled.