Q. My toddler is a bottomless pit one day and then will hardly eat anything for dinner the next day. I am concerned that he may starve or stop eating. What should I do?
A. It is quite common for toddlers to eat irregularly and have sporadic eating patterns. As long as your toddler is growing well and you have no concerns about food variety and nutrition, you need not worry. If you are concerned about weight, growth or your child’s nutrition, you should access help as soon as possible. Children with poor eating skills or patterns do not simply “outgrow” these issues and often need assistance in working through feeding problems so that they do not become complicated medical or behavioral problems.
First of all, remember that healthy toddlers (without a feeding disorder) will consume enough food to meet their nutritional needs, even on a picky eating day. Their growth has slowed down from when they were infants, so missing a meal once in a while should not impact their growth. If you are unsure about your child’s weight and growth, talk with your pediatrician.
Toddlerhood is the best time to establish healthy eating patterns. If you eat healthy, your child will eat healthy. Do not ever give in and provide your child favored junk foods thinking “at least he is eating something.” This is very poor judgment and will definitely set you up for mealtime battles and set your child up for a lifetime of poor and unhealthy eating habits.
When your child decides that he doesn’t want to eat, do not be tempted to force your child to eat. Placing pressure on your child to eat will only backfire. The more pressure you place on your child, the more likely he will resist and less likely he will be to eat. Children who are forced to eat consume less than children who are not forced.
When parents are stressed about their child’s eating habits, they may resort to bribing and tricking. Resist the temptation to bribe your child to eat his green beans with candy or dessert. Bribing and tricking tactics are successful only in the short term and most often result in long-term problems. Your child may be willing to eat to get dessert one time. The problem is he will comply only if he really wants the “reward.” If he doesn’t really want the “reward,” he will refuse or hold out for a “better” reward.
Ok, so what should you do?
First of all stay calm. If he misses a meal (assuming that he is healthy without a feeding disorder), he will not starve.
Offer good nutritious foods for every mealtime or snack time. It is your child’s responsibility to eat. Your responsibility is to provide the food. If he doesn’t eat, he will not starve. He will most likely “make up for it” during the next meal, the next snack or the next day.
Make sure that you eat with your child and make sure that you eat the foods that you would like your child to eat.
Continue to offer the food at another meal. Do not write off a food because it is refused. It can take up to 20 unstressed offerings for a child without feeding difficulties to accept a food.
If you are still worried and you don’t feel that these tips will help, the best thing to do is to discuss your concerns with your pediatrician and ask for a referral for a feeding evaluation. Hopefully, the evaluation will bring you peace of mind and help you not worry. And if there are problems that need to be addressed, the sooner you get help, the better.
If you have a question about your child's health or happiness, ask Joan or any of our experts by sending email to firstname.lastname@example.org.
Joan Dietrich Comrie of Carolina Pediatric Dysphagia has dedicated her entire career to studying, teaching and practicing in the area of dysphagia, specifically pediatric dysphagia. She received her bachelor of science degree and then her master of science degree in the area of speech pathology at the University of Wisconsin-Madison in 1986. Before starting Carolina Pediatric Dysphagia in 1996, she worked at several hospitals (Cardinal Hill Rehabilitation Hospital, Lexington, Ky., Vanderbilt Medical Center, Nashville, Tenn., and WakeMed, Raleigh) where she developed or reorganized the hospital's pediatric dysphagia program.
Joan has spoken on the topic of pediatric dysphagia nationally and internationally. She has published in a professional journal. She co-taught the first dysphagia course offered at UNC and continues to guest lecture to several university graduate level speech pathology programs and to the UNC Medical Students who complete their rotation at WakeMed. She has served as chairman and member of a subcommittee of the Special Interest Division #13 of the American Speech Language Hearing Association (ASHA). She has received her certificate of clinical competence (CCC) through ASHA and is licensed in the state of North Carolina.