We received several questions related to food issues. Dr. Cline answers them in this article about how parents can best help their children develop healthy attitudes around food and avoid potentially life-threatening ones.  

When Food Fights Can Be a Matter of Life and Death
By Foster W. Cline, M.D. 

It is important for all children to learn to make good choices around healthy eating.  However, for children with certain medical conditions, making healthy food choices can become a life and death issue.  When issues are life and death matters, anxiety always rears its ugly head. Anxious parents and anxious children understandably may handle life and death decisions, issues and communication poorly.

All small children, in toddlerhood and soon thereafter, go through a period in which they are picky eaters.  When handled correctly, this is generally a passing stage of life.  However, when it is handled poorly, picky eating may become a life stance.  We have all known adults who have not out-grown their picky eating habits and tend to drive others crazy at the table.  So let's get at the essentials of ensuring that picky eating is a stage of childhood and not a life stance.*

1)   No matter how the food problem is handled, Love and Logic principles emphasize that when parents show frustration it always makes the situation worse.  The phrase “Anger and frustration fuel misbehavior” has become a useful mantra in many Love and Logic homes to help parents maintain self-control during frustrating parenting situations. Love and Logic teaches parents to replace their anger and frustration with empathy and consequences. This essential information is covered on pages 22-31 and 81-84 in the book Parenting Children with Health Issues.

2)   Next, parents need to ask themselves whether a particular food fight is really worth the battle.  Usually it is not.  In all my years of practice, I have never seen a young child die of malnutrition when food is available.  Even anorexia does not start until age 9 or 10.  When the body really needs particular vitamins, minerals and foods, there is generally a craving.  Sailors racked with scurvy crave citrus fruit and pregnant women crave iron rich foods.  Studies have shown that most children, if given the freedom of choice, generally make healthy choices.  When eating certain foods are essential to a child’s good health (as in cystic fibrosis), the following methods are usually effective:

a.   Rewarding the correct choices is always more effective than consequencing or punishing poor choices.  Thus, the parent who says, "I can hardly wait for you to try my cake after you have finished your peas," is more effective than the parent who says, "If you don't eat your peas, there will be no dessert." And remember, the best reward you can give your children is your encouragement (for them!) rather than praise when they make a wise choice.  "Wow, I bet you are proud of yourself for eating all those peas," rather than, "Mommy is so proud of you for eating all those peas." The important differences between praise and encouragement are covered on pages 88-93.

b.   Follow Mary Poppins’ advice and add a bit of sweet to whatever may be distasteful.  “A little bit of sugar makes the medicine go down.”

c.   Set the model by having fun around good eating habits.  A father might say to his wife, "Susie, knock me on my noggin.  See how hard my head is?  Give me some more milk.  I've got to have more milk!” (And everyone around the table laughs.)

d.   Use choices to share the control and avoid power struggles over food. “Would you like carrots or broccoli?” “Would you prefer chocolate or white milk?” Read about the correct use of choices on pages 55-56.

3)   Finally, make sure that almost all the food available is healthy.  Some parents beg for trouble by giving out too much candy and sweets in the first place!   

* Please be sure to check first with your doctor about possible medically-based reasons for a child's refusal to eat. Acid reflux and other conditions can cause children to stop eating.

Posted 4/21/07