It is important your child eats and drinks regularly throughout the day and the best way of ensuring this happens is to establish regular mealtimes. Not only will this encourage your child to eat in a calm and enjoyable manner but family mealtimes are also a sociable event, where family members meet and talk amicably in a friendly and supportive atmosphere. Many children who come into foster care have never had mealtimes or sat at a dining table and do not know how to use a knife and fork. One of the first things I do when a child arrives is to establish a routine, which includes regular bath and bed times, and meals at set times at which the family eats at the table. A routine where all members of the family know what is expected feels safe, secure and reliable to a child, and so too with mealtimes.
The importance of mealtimes
* The child’s food and fluid intake can be easily monitored by the parent to ensure the child is eating a healthy diet, which is sufficient for their needs but not excessive. It will be obvious what the child has eaten from what remains on the plate.
* Family meals at the table encourage family members to bond with each other and enjoy each other’s company.
* Children can learn table manners and how to use cutlery, usually by imitating their parents. Table manners and knowing how to use cutlery are very important in adult life.
* Children can sit upright at a table (rather than slouching on a sofa), which encourages good digestion.
So these are the main reasons why children should eat family meals at the table, but what exactly is a good mealtime and how do we achieve it?
Establishing good mealtimes
* Aim to have at least one family meal together every day that includes all family members. For practical reasons this is often the evening meal.
* Establish good hygiene, with the children washing their hands before the meal and changing out of any very dirty clothes, for example if they have just come in from the garden caked in mud.
* Create good practice by calling the family for dinner a couple of minutes before the food is ready, so that they arrive at the table just before you serve the meal.
* As far as is practical, include children in the preparation of the meal, laying the table and clearing away afterwards. Children love to help and even young children can be taught to lay a place at a table.
* Switch off the television during mealtimes so that the focus is on the meal, the people and eating, not on the television screen. Likewise, books, magazines and hand-held game consoles should be left away from the table.
* Provide nutritious food that is simple, varied and appealing to children. While an adult might relish Stilton and broccoli soup, followed by glazed duck breast with port and caramelised orange sauce, most children will not.
* Serve the same food to all family members unless your child has special dietary needs. I deal with food fussiness on the next page.
* Keep the talk at the table light and positive, so that all family members have a chance to share their news as well as eating. The meal table is not a place for siblings to continue a disagreement or for parents to criticise or discipline their children.
* As far as possible have meals at the same time each day. This will ensure children (and adults) eat and drink regularly, which is essential to maintain energy levels and concentration.
* Start young. As soon as your children can comfortably sit upright – between four and six months – bring them to the table in a high chair. If good eating habits are established early, your children will continue to have them throughout their lives.
Food fussiness and refusal to eat
Nothing is guaranteed to wind up a parent and worry them more than a child picking at their food or refusing to eat. As parents we nurture and love our children and take pride in seeing them grow and thrive. Food is essential to sustain life and therefore an intrinsic part of that nurturing and love, so that if a child rejects the food we have lovingly prepared then it is easy to feel they are rejecting us. Children soon realise how much it means to us as parents to see our child eat healthily – look how much trouble we go to buying and preparing food – so accepting or rejecting food can be used by a child as a way of controlling a parent. I say more on that below.
The majority of children I’ve fostered have come to me with some form of ‘eating disorder’: refusing to eat, eating the smallest of amounts, eating only sweet foods, or gorging or bingeing until they are physically sick. However, all the children, without exception, significantly improved or recovered completely, and were eating healthily by the time they left me. My adopted daughter, Lucy, overcame anorexia within a year of coming to me. Based on training, research and twenty-five years of fostering experience, here are my guidelines for achieving healthy eating.
Expect your child to eat As you should expect good behaviour from your child, so you should expect your child to eat – at the table and the same food as other family members. Be confident in your expectation and don’t falter. Your child will soon realise that eating as everyone else in the family is doing is the norm and your expectations will be complied with.
Make healthy eating the norm You and the other members of your family need to make sure healthy eating at mealtimes is the norm by setting a good example. You can’t expect your child to eat heartily, healthily and happily if you are sitting there picking at your food, claiming you are on a diet or not eating at all.
Start early Establish good eating practices for your child as soon as you can, ideally when he or she can sit upright and join the family at the table. If good eating practices are established early in childhood, a child is far less likely to develop eating difficulties later. If your child is already a problem eater, start the new routine (see here) as soon as possible and be firm with your expectations.
Encourage children to feed themselves Give your child responsibility for feeding themselves as soon as they are able. Children can start eating finger foods from six months, and they can also be encouraged to hold the spoon, bottle or feeder cup while you feed them. Feeding him- or herself is one of the many self-care skills a child needs to be taught early. It gives the child confidence and autonomy, and a child is far less likely to reject food if they are feeding themselves rather than having food pushed into their mouth.
Check nothing is worrying your child If your child suddenly starts to refuse food, make sure there is nothing worrying them. Worries can take away a child’s appetite just as they can an adult’s. Don’t ask the child at the table if they are worried about anything, but wait until later when there are just the two of you and you have time. You may need to coax the worry out of your child, so be relaxed, gentle, and take your time. If there is something worrying your child, reassure them and deal with the problem.
Give children equal amounts of attention Make sure your child is receiving their fair share of attention – both at the meal table and generally. If your child is feeling left out or undervalued for any reason, refusing food can be a good way of getting attention, just as naughty behaviour can. Food and emotion are linked, and extreme eating disorders such as anorexia or bulimia have emotional/psychological roots, which is why in such cases the whole family goes into therapy and not just the sufferer.
Serve suitable-sized portions Make sure you are not giving your child too much food. Children’s stomachs are a lot smaller than adults’, so they feel full sooner. If you give your child more food then they can eat they will of course leave some. A general guideline is that a child’s stomach is the size of their fist, as is an adult’s. Give your child a suitable-sized portion; they can always have seconds if they are still hungry.
Keep meals simple Keep food simple, especially with young children. If a child has too many different foods on their plate (or too much), they may take the easiest solution and eat nothing.
Limit snacking While a little snack mid-morning or mid-afternoon will sustain a child’s energy levels between meals, too many, too large or very sweet snacks will dramatically reduce a child’s appetite at the meal table.
Never use food for punishment Never use the withholding of food as a means of punishment: You’ll go to your room without any tea. Apart from food deprivation being unacceptable, you will also be storing up trouble for later by bringing food into the emotional arena, so the next time your child is angry with you they will refuse to eat. And try not to bribe children with sweet things, tempting though it can be at times: ‘When you’ve done your reading/homework/piano practice you can have a chocolate barr.’ Use something unconnected with food as a reward – for example, extra television time, or another fifteen minutes’ playing outside before bedtime. Linking food and behaviour will cause problems.
Be firm Lots of books talk about presenting food and then taking it away if the child doesn’t eat. I doubt many parents could do this. I don’t adhere to this philosophy. In my experience a parent (or carer) often has to be firm with a child if they are completely refusing to eat or not eating enough for their needs. If necessary, allow your child extra time to eat. Chat lightly and allow other siblings to leave the table if they have long ago finished while you remain or busy yourself nearby. You don’t want your child to feel isolated by being left alone at the table, but neither should they force siblings to sit at the table. Don’t point out the child’s slow eating, although you can say lightly: ‘Come on, finish your meal and then you can play’ (or whatever they are planning to do after the meal). If necessary, tell them they have to eat so much before they can leave the table. The longer a child is allowed to indulge in poor eating, the bigger the problem will be to solve, so be firm.
Accept genuine dislikes Obviously don’t force your child to eat a food he or she genuinely doesn’t like. All children have food preferences and a few dislikes are acceptable, but refusing to eat all nutritious food is not.
Don’t allow food to be a means of control Food refusal, as already mentioned, can be a way of controlling or blackmailing a parent. Don’t pander to a child’s fussy ways and don’t be tempted to give them something different if they have eaten little or nothing. You will find that a child who is using food as a way to control and manipulate you will like something one day and reject it another. If you give the child something different (at the meal table or later) it will prove to the child that he or she has status above the rest of the family and is in control.
Use common sense Don’t worry if your child doesn’t want to eat one day or eats very little. A child’s body usually regulates its food intake and that can vary from day to day. If a child is physically active one day they will need more than if they have been travelling in a car or sitting on a sofa. Or possibly they may be sickening for something: sometimes a child suddenly refusing to eat is the first indication they are not well. If your child refuses food, don’t react; just assume it will pass and the child will be eating normally in the morning and in most cases that is what will happen. If not, assess the situation, include the child in mealtimes and follow the above guidelines.