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Children's Health

Stubborn 3 year old

01/23/2009

Question:

I read a response in regards to a three year old picky eater that seems very helpful. The Dr. recommended presenting different foods and requesting the child try a bite, but not requiring them to eat everything on their plate. Our pediatrician has recommended the same thing. My problem is that my 3 year old will not even try one bite. I don`t want to cause the stress at dinner, but I also want my child to obey me. We have tried to offer rewards for trying foods and we`ve tried punishment for not trying foods, but she stands firm. Is there anything else we can do to encourage her to try new foods? She doesn`t even eat the basic foods that most kids eat such as PB & J, Mac & cheese, hot dogs. She only wants restaurant chicken nuggets. I`ve even bought different shaped nuggets. If I actually get a bite of something in her mouth for her to try, she holds it there until it gags her and she throws up. Should I just give up for now and let her live on noodles, rice and fruit (& occasional nugget)? People don`t seem to understand this stubborness. I just don`t want her to be disobedient in other things because she`s disobedient when we ask her to try ONE bite.

Answer:

Feeding your child healthful foods can certainly be a frustrating experience in the toddler and preschooler years. A large part of what makes it challenging stems from their developmental tasks - to become independent of their parents while remaining safe. Toddlers make the wonderful discovery that they are not a part of their powerful parents but are rather, individuals who are separate. This heady discovery leads to lots of testing about the differences between what is the parent and what is the child. Food choices and eating or not provide a repeated daily battleground for testing of what the child wants versus what the parents want.

The other thing that is true is that young children have a built in aversion to new things, which is actually protective, since toddlers and preschoolers are normally driven to explore and try new things. Yet, while the most disgusting flavors and odors do not always deter the driven explorer, explaining why the young child is the one most prone to poisoning, unhappily, it seems that neophobia, or fear of new things, is alive and well in regard to food choice and eating. One way we overcome this distrust of new foods is to continue offering them over and over so that what was once new and unfamiliar becomes familiar and preferred.
It takes a lot of skill not to be sucked onto the battlefield when you know that good nutrition is important. The most important thing you can do at this time is to walk away from engagement in a test of wills around food between your daughter and you. As you have found time after time by now, you cannot make her eat. Force feeding is not an option with a three-year-old. Rewards also don't work very well at this age, again because it puts the parent in the driver's seat because you decide what must be tasted and what the reward is. It is not a matter of obeying and disobeying you. Every child wants and needs the love and approval of their parent. They just have this drive to declare independence and they cannot ignore it nor are they even aware of it.

Another influence on children's preference for bland foods and no variety is the low rate of breastfeeding in the United States. This is supported in research studies. Breast milk varies in taste every time the child nurses if the parent is eating a healthful, varied diet. in contrast, formula fed infants receive a bland product that always tastes the same. It is little wonder that these children are trained to prefer a bland, same taste and texture in their foods as they transition to solids.

So, it is no cowardice or giving in to walk away from the food battleground. It is parental good sense and a smart tactic. There are more important rules for her to obey such as not hurting others or running out in the street where obedience is critical to learning empathy for others and safety. Other comforting and reassuring facts include that all normal, healthy young children, left to their own devices in selecting and eating foods, adjust their daily food intake to exactly match their calorie expenditures in activity. So on really active days, they eat very well and on ill days or tired, low activity days, they eat less. Parents really can trust their children to eat as much as they need on a daily basis. All of this changes at five years of age, when all of us become influenced by how much food is put before us. We eat more when we see more regardless of our hunger or fullness.

Some of the secrets to getting young children to eat a variety of healthful nutrients is to always offer ONLY healthful food choices. Avoid becoming a short order cook as well as giving into demands for unhealthful fat, sugar and salt loaded foods. Walk away from the tantrums. Nothing shuts it down faster than an absent audience. Even yelling at the child is reinforcing of the behavior because the child still gets the positive reward of your attention, albeit, your angry attention. You cannot ever give in to demands for other foods because inconsistent enforcement of rules mightily reinforces undesirable behavior, better even than consistent positive reinforcement.

Your job as a parent is to offer well prepared, healthful foods at regular intervals. Your child's job is to decide whether to eat these foods or not and how much to eat if she eats. The rule is, she eats at the times you decide from among the foods you provide or not, but then she must wait until the next scheduled feeding time if she decides not to eat. She cannot have food until the next snack or meal. This is a huge struggle for many of us as parents. How can we let our child feel hunger and not respond? Because we know that this test of rules will end quickly and our children will eat more healthfully in a short time when we set a limit and stick to it. Hunger is uncomfortable. Children are highly unlikely to inflict this awful feeling on themselves voluntarily over and over again once they know you cannot be moved from your rule. A good appetitive to eat makes food, even our least favorite foods, taste wonderfully. 

Where you can find balance is in offering your child at least one healthful, favored food at each meal or snack and providing while whole grain bread, rolls, or crackers at leach meal or snack as a healthful alternative. Whole grain products offer more nutrients than refined grain products and are more filling with their extra fiber content. This helps ensure that your child can find something to eat at each food offering. Also, don't worry about fruits versus vegetables. They contain the same nutrients and fiber. If your child will not eat vegetables, offer fruit. Fruits of different colors are similar to vegetables of different colors in terms of offering a variety of nutrients.

You will also find yourself faced with fewer food battles if you limit TV viewing, keep your child physically active, and do not offer food whenever she wants. She will burn off calories in play and feel hungry for meals and snacks. She will also see fewer commercials for food products aimed at children, many of them unhealthful. You will receive fewer pleas for these foods. 

Finally, it will not hurt at all to comment calmly but warmly on good feeding and eating behaviors. Over enthusiastic comments can get us as parents in trouble because they are too obviously a ploy to control child behavior. It is more effective to say, "You ate a healthful meal! Good job!" "I think it's great you tried the beans. What did you think?"  

I know that if you follow these suggestions you are likely to encounter some resistance and tantrums. These are never easy to endure. But please hang in there. In one week or less, you will have a more pleasant experience feeding your child, a happier child, and the satisfaction of having provided the good  nutrition that will fuel her growth in mind and body. You are the one who can understand the need for healthful foods. Your child cannot yet make these judgments and choices. As parents we help them learn to make good choices through our leadership and example as parents. I wish you well on this important journey!

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University