In our culture, like so many others, food and feeding is equated with love and nurturing. The feeding process, when done in a mutually respecting manner, is one of the quickest ways of building and maintaining a positive, trusting relationship. But so often what starts out as a symbol of love and nurturing, ends up for many parents as a power struggle at the dinner table.
One such scenario may be fueled by concerns that a child is not eating enough. The parent is concerned that the child is undernourished and on the verge of starvation. Here begins the all too common mealtime activity between parents and child of gentle coaxing, begging, pleading, and outright bribery. It is not uncommon for the frustrated parent to resort to an unsuccessful attempt at “making their child eat”. These scenes will often finally culminate in a test of wills, and what might appear to be a standoff at the OK Corral.
Under these circumstances, one of two things may happen. Either the child unwillingly accepts the food...or flatly refuses it. The parent involved may feel frustrated or inadequate. She or he may feel like a total failure at the seemingly simple task of feeding their child. Even more devastating is the feeling of personal rejection, especially if the child accepts the same food from someone else.
Children do not like to see the person who guides and loves them frustrated or despairing of them. The child also does not enjoy having to go to bed scared or defiant as a way of showing that their caregiver is not listening to their needs.
The above scenario is an example of a feeding relationship gone wrong. Generally speaking, a feeding relationship is created when a caregiver prepares and offers food to a child. The child responds to the offer by accepting or rejecting the offer. The nature of the relationship is further re-enforced when the caregiver in turn responds to the child in a more or less supportive manner.... which then leads to a counter move by the child.....and so on. Over time, the predominant feelings, whether positive or negative, that result from these feeding interactions will determine whether this is a positive, respectful and supportive feeding relationship, or one more likely to result in a negative relationship with food for the child, and potentially also a negative relationship between the caregiver and the child.
Common feeding/ eating problems
There is convincing evidence to suggest that 25-30% of children are affected by feeding /eating problems, which in turn often impacts on both physical and emotional growth and development. Common problems include poor food acceptance at all ages, undereating or overeating compared to actual physiological or emotional need, vomiting or gagging at the sight of certain foods, failure to progress appropriately to solids and table foods (in the absence of a medical explanation), excessive finickiness, and what can be
characterized as unacceptable behaviors by the child at mealtimes.
These can be frustrating issues for parents to deal with. Part of the frustration comes from not knowing if or when it is appropriate to intervene in the situation, or to “let it run its course”. After all, what toddler do you know who is not a picky eater at some stage? Who ever said teenagers are supposed to love vegetables? The dislike of broccoli is genetic, isn’t it?
In order to encourage physical growth and healthy psycho-social development, it is important to be able to distinguish between normal versus problematic feeding and eating behaviors. The other frustrating aspect of opening Pandora’s box and asking whether or not there is a problem, is, if it is determined that there is a problem, then what do you do
about it? (We are ever mindful of the fact that forced feeding is unethical and illegal in Canada. But so too is letting a child starve). No wonder parents caught in these feeding dilemmas feel like they are in a Catch-22 situation.
Here then are my top five most often overlooked fundamentals about children’s eating and feeding children. These are taken from my experience working as an outpatient dietitian in the eating disorders clinic and the out-patient pediatric department of a large urban hospital, as well as in my private practice. In addition to overlooking these fundamentals, parents frequently experience some level of difficulty in honoring the principle known as the Division of Responsibility in Feeding. Ellen Satter, the foremost
clinician and author in the area of feeding children, developed the Division of Responsibility in Feeding over 30 years ago. The principle holds that parents (caregivers) are responsible for selecting, preparing and offering food to their children. They are also responsible for determining mealtime structure such as times and place where the meals and snacks will be eaten. The child’s responsibility is to choose to eat from the selection offered, or to choose not to eat. When the Division of Responsibility is blurred, a mealtime struggle often results.