I started this blog almost two years ago after receiving a series of emails from worried parents and grandparents about difficulties feeding their children. Those emails continue to trickle into my inbox, and I respond with some clinical advice and recommendations. The common theme of these entreaties remains consistent: how can you distinguish between the typical family power struggle and a nascent medical issue.
Even for an experienced clinician, these two things can be very hard to differentiate. Despite the fact that children are born completely dependent, the innate drive to assert independence starts, albeit unconsciously, in infancy. Refusing food may be the most effective way for a child to have an impact on the hovering adults. So the most common fear I hear about from parents is also completely normal childhood behavior.
Some changes in the modern world have exacerbated this dynamic. The family unit has become more and more isolated, and one result is that very few adults ever feed a child. It doesn't take a village to raise a child anymore, just a few tired grown-ups. With fewer adults bearing this load, the intensity of the parent-child bond has escalated accordingly.
The daily feeding ritual is the moment when the child gets an adult's undivided attention. This time consequently becomes a microcosm of the parent-child relationship as a whole, an opportunity for the child to try out a host of feelings and behaviors and see what happens. It's easy to see how this time can quickly escalate into a pitched battle between a recalcitrant child and frustrated adult.
The parent is charged with the responsibility to feed this child. Balancing the confusing and often contradictory information about nutrition and healthfulness with the task of getting food into a child's tummy is no easy feat. What is easily ignored is that the child's individual participation in the food ritual is a form of communication. The parent's inherent fear is unfounded: the child won't starve. Unless there is a clear and very rare medical cause, children are programmed to eat enough to survive. But that doesn't mean the child will eat when the parent wants them to.
Instead, the daily routine offers a child the chance to "talk" to the parent. When the parent really listens, the child's physical and emotional reactions can say much more than the child's ability with words. Even a verbally precocious child won't be able to translate abstract emotions into conversation for many years.
A parent needs to try to listen to what the child is trying to say and respond in kind. That doesn't mean pseudo-psychological babble, but it does mean, for instance, that a tired, cranky child might have trouble sitting through dinner that night and might need a new strategy not to melt down. To the adult, the goal of meal time is to feed the child. To the child, this is time to talk, learn, vent and play.
There is nothing easy about this process, and the rewards happen not over days but over months and years. However, the message sent from not listening to that child is loud and clear: no one is really paying attention.
For a focused, harried parent, the goal of feeding is just to complete the task and perhaps to educate about healthful foods and eating. Whether the obedient child complies or the oppositional one rails against the meals and rules, that child is learning many things through meal time, only one being what foods to eat and what constitutes a meal. The adult reaction to varied behaviors, moods, pickiness and food choices also represents how that child learns to see herself. These experiments aren't just games. They allow a child to figure out who she really is in this world. Parents' actions and reactions end up saying just as much, if not more than, their words.
There are many ways to react to the child who refuses dinner night after night or swallows the meal in three massive gulps or plays with food or turns the meal into a sibling fight. Over time, the family reactions become an expected social paradigm the child knows all too well. Food and meals begin to correlate not only with certain emotions and experiences but also with a reflection of that child's burgeoning identity. From this vantage point, it is artificial to separate food and healthfulness from family dynamics and emotion. The daily ritual of meal time melds quickly with the complicated task of managing the relationship with your child. Remembering this perspective can take away the urgency of of each meal and put the routine of meal time into the context of raising a child.
The fruits of this labor end with really knowing your child. Understanding that feeding a child is a process of communication can be an enormous relief for many parents, but it still begs the following question: how do you still teach your kids about food? We live in a world of complicated food choices, the pressure for thinness and the specter of disordered eating and eating disorders. Any parent would be remiss to ignore these warnings and assume that the norm for a child is an uncomplicated relationship with food. But if the child at meal time isn't really focused on food, when does a parent teach these critical lessons?
I'm going answer these questions by addressing the most common concerns parents express. And I'll take these one at a time over the next several posts: picky eaters, healthy foods, dessert and thin and fat talk.