“He won’t eat”

I regularly encounter children whose caregivers report that they “won’t eat” and I don’t mean while feeling ill.  The parents think the problem is chronic.  When I look at the child I know that this statement is not accurate because the child does not look under nourished.  In fact, some of these children are fat.  How can that be?  

1)  The child is expected to eat much more food than their body actually needs.  A toddler is not supposed to eat half as much as an adult.  One tablespoon for year of age up to a max of a half cup is a good rule of thumb for portion sizes for children.  That means a 2 year old might only eat half of a chicken tenderloin, 2 tablespoons of mashed potatoes and 2 tablespoons of veggies at a large meal.  The MyPyramid.gov website has a calculator for daily food portions for preschoolers.  (Use this one for ages 6 and up. )

2) The child drinks hundreds of calories of juice, milk or worse each day.  They fill up on what they drink and are not hungry.  Anyone who drinks 5 glasses of apple juice has consumed at least 500 calories.  Milk has at least a few more calories.  If you eliminate the juice, soda, etc and limit milk to 2 cups, the child’s appetite will increase and they will eat more.  Be ready for some tantrums though.  It is often easier to completely eliminate juice, KoolAide or soda than to moderate portions.  Then you can simply say “It is all gone.”  Some children go on strike and refuse to drink if their favorite beverage is not available.  Don’t worry.  Thirst is a powerful force.  Everyone will eventually drink water if they are thirsty enough.

3) The child and parent argue over eating and the child views eating as a struggle for power.  Even 9 month olds can get in this battle for control.  The solution is easier said than done.  Stop showing an interest in what and how much your child eats.  When there is no grappling for control, the child will eat if they are hungry.  Depending on age, this process can take days to weeks.

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