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Emma Haycraft shares evidence-based ideas for helping children to eat healthily

We all want children to eat a healthy, balanced diet, and caregivers have a really important role in feeding children in their care, yet children often have other ideas!

Most children go through a phase of fussy eating1 and this behaviour is totally normal. How this fussiness is managed can affect whether children outgrow it, or if it will continue as they get older, and this is why caregivers are vital for helping children to develop healthy eating habits.

There are some common feeding pitfalls that caregivers may encounter, including: children refusing to eat foods; children having preferences for unhealthy foods; caregivers pressuring children to eat more than they want to; caregivers restricting children’s access to certain foods; and caregivers using food as a reward for good behaviour. 

Food refusal 

Being faced with a child who refuses to eat fruit or vegetables, but who will happily eat cake, chips and other “junk” foods, can be worrying for those who are taking care of them. Caregivers may feel a need to force the child to eat food, believing that this is in the child’s best interests. But compelling a child to eat a food, or to eat more than they wish, can have unintended consequences.

Research has shown that foods people are pressured or forced to eat become less desirable2, which means children are even less likely to want to eat their cabbage or pasta bake if they feel pressurised. 

Evidence also shows us that if a child is repeatedly pressured to eat more than they want to at mealtimes it can “teach” them to ignore their internal signals about fullness and hunger which, in the long-term, will contribute to children putting on weight and potentially becoming overweight or obese3.

If a child is refusing to eat foods, there are certain practical steps I recommend, including: 

Examine the evidence 
Think about how long it is since the child last had a snack or filling drink such as milk. Might they be too tired to sit at the table and eat well? Are they feeling unwell? If they are poorly, they may not want to eat.

Check portion sizes – the rule of palm 
As a guide, a single portion is roughly what would fit in the palm of the child’s hand. Meals should include a palm of the main attraction and two to three palms of the accompanying foods. Providing too much food could be why children refuse to eat it.

Don’t use food as a reward

It can be tempting, and often very effective, to use food as a reward for good behaviour, either at the table (“Eat all of your cauliflower and then you can have a yoghurt”) or elsewhere (“We have to go home now. If you come without crying, we can get an ice lolly on the way”). However, using food in these ways can have a negative effect on children’s developing preferences and future eating behaviour4-6.  

Research shows that using food as a reward or a bribe is associated with a number of less desirable outcomes. These include: children’s liking for the non-reward food (cauliflower) decreasing (“cauliflower must be bad if I’m being bribed to eat it!”); increased liking for the reward food (yoghurt or ice lollies); and poor diet, as the foods that are most often used as rewards are often unhealthy, sugary treats and snacks that can contribute to being overweight, obesity, and an unhealthy diet.

Instead, I suggest offering children real, tangible objects or experiences as rewards, rather than food.  A sticker, small toy or trip to the swimming pool can all be very rewarding for the child.  

Ultimately, eating food should be an enjoyable experience.  Food is a fuel, not a tool.

Ten tips for healthy, happy mealtimes

  1. Offering children a variety of different tastes and textures when young will encourage them to enjoy a range of foods as they grow.
  2. Toddlers can struggle to eat large amounts of food at one mealtime. Three small meals and three small snacks spaced equally throughout the day often works best.
  3. Food is a necessity. It should not to be used as a reward or taken away as a punishment.  
  4. Restricting foods can make them unintentionally desirable. 
  5. If you must restrict, it’s better to restrict covertly. It’s harder to refuse a child when the temptation is in front of them.
  6. It can take 15 to 20 exposures before a child accepts a new taste. Introduce foods gradually, over time.
  7. Do not force feed children. The “clean your plate” mantra is a thing of the past and could teach children to ignore the natural signs of feeling full.
  8. Praise children for trying new foods and for exhibiting appropriate behaviour at the table.
  9. Children love to copy. If they see you enjoying your vegetables at the dinner table, they are likely to have a go themselves. 
  10. Try to have at least some meals at the table each week and avoid giving children meals in front of the television as this can distract them from eating.

About the author

Dr Emma Haycraft is a Reader in Psychology at Loughborough University. With Dr Gemma Witcomb and Dr Claire Farrow, Emma has developed the Child Feeding Guide to promote healthy eating habits and behaviours in children.

www.childfeedingguide.co.uk

@EmmaHaycraft

 @ChildFeedingGuide

Footnotes

  1. Carruth, B.R., Ziegler, P.J., Gordon, A. and Barr, S.I. (2004). Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food. Journal of the American Dietetic Association, 104, 57-64.
  2. Galloway, A.T., Fiorito, L.M., Francis, L.A., and Birch, L.L. (2006). “Finish your soup”. Counterproductive effects of pressuring children to eat on intake and affect. Appetite, 46, 318–323.
  3. Carper, J.L., Fisher, J.O., and Birch, L.L. (2000). Young girls’ emerging dietary restraint and disinhibition are related to parental control in child feeding. Appetite, 35(2), 121-129.
  4. Puhl, R.M., Schwartz, M.B. (2003). If you are good you can have a cookie: How memories of childhood food rules link to adult eating behaviors. Eating Behaviours, 4(3), 283-93.
  5. Farrow, C., Haycraft, E. and Blissett, J. (2015).  Teaching our children when to eat: how parental feeding practices inform the development of emotional eating. A longitudinal experimental design. American Journal of Clinical Nutrition, 101(5), 908-913.
  6. Blissett, J., Haycraft, E. and Farrow, C. (2010). Inducing preschool children’s emotional eating: Relations with parental feeding practices. American Journal of Clinical Nutrition, 92, 359-365. doi: 10.3945/ajcn.2010.29375.
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