Meal times should be enjoyable for baby and parents, but sadly this is not always the case. It can be a frustrating or stressful time for all involved. This article describes reasons for common feeding problems such as food refusal, picky eating, gagging and vomiting at meal times.
Reasons babies refuse solids
1. Illness
A sudden change in appetite is a common sign of illness.
What to do
- See your doctor, if your child develops any unusual symptoms or if she refuses to drink.
- Offer plenty of fluids.
- Offer meals but expect that she may reject them while she's unwell.
2. Drinks Too much milk
The most common reasons for a healthy thriving child to refuse solid foods is because she fills up on milk (breast, formula or other) and is not hungry for other food, or because she prefers to drink milk rather than eat solids. A child only needs a certain amount of calories in her day to provide for her growth and energy needs, if these calories are provided by milk there's little appetite left for solid foods.
What to do
- If necessary reduce the amount of formula your child is offered to the recommended daily intake for her age. (Take a look at our article Estimate how much milk your baby needs for a guide).
- If your breast fed baby is healthy and thriving, reducing the number of breast feeds may encourage a greater appetite for solid foods.
- For children over 9 months or age, offer solids before milk.
3. Juice
Fruit juice is high in energy (calories) and can reduce a child's appetite for solids. Although fruit is important to a balanced diet, it's not necessary for your child to drink fruit juice. In fact, eating fruit is better for your child because it provides additional fiber which is not available in juices.
What to do
- Reduce the amount of juice your child drinks or offer water instead of juice.
- Offer a variety of fruits.
4. High energy foods
Some foods may look small but provide lots of energy (calories). For examples chocolate, sweets, crisps, cookies, even bananas (although nutritious, are high in calories compared to other fruits).
What to do
- Offer your child food based on the knowledge that everything she eats should count towards her daily nutritional requirements.
- Offer treats sparingly and only after nutritious food has been eaten.
- Offer only 1/2 a banana.
5. Snacking at the wrong times
If your child is snacking (or drinking milk or juice) shortly before a meal, this may affect her appetite and she may not eat as well when a meal is offered.
What to do
- Offer small nutritious snacks mid way between main meals.
- Discourage her from "grazing" throughout the day.
- Avoid offering snacks and drinks (other than water) less than 2 hours before a main meal.
6. Food preferences
Don't expect the first time a food is offered that it will be an instant hit. It can take as many as 8-10 times before a new food is accepted.
What to do
- Don't accept the first rejection as a permanent dislike.
- Don't force her to eat it but continue to offer the rejected food at other times.
7. Too tired to eat
Understandably, there will be times when your child is too tired to eat. (See signs of Over-tiredness). Young children need to eat much earlier than adults.
What to do
- Offer meals and snack at regular times during the day.
- Offer food before your child becomes too tired.
- Offer the evening meal at least 2 hours before her bedtime.
- If she's is too tired to eat in the evenings, offer her main meal at lunch time.
8. Too excited/ distracted to eat
If there are too many distractions, your child may not be interested in eating.
What to do
- Provide some 'wind down' time before meals with quiet play.
- Switch off the television at meal times.
- Encourage your child to sit at the table for meals.
- Eat with your child - make eating an enjoyable social experience.
9. Frustration
As a child starts to assert her independence she will want to explore her food and begin to feed herself. If she's stopped because of the "mess" this can be very frustrating for her. It would be unrealistic to expect your child to learn table manners before she has learned to feed herself. Some mess is unavoidable while a child is learning.
A child can also feel overwhelmed by the size of the meal or from being offered too many choices.
What to do
- As soon as your child is old enough to hold a spoon, provide her with her own spoon at meal times. Occasionally (not constantly) assist her by guiding her hand. If necessary continue to offer her food from an additional spoon.
- Allow her to feed herself with her hands if she wants to. (Put newspaper under her high chair to collect anything that falls).
- If your child doesn't want your help with feeding then allow her to eat independently. Provide foods that she can pick up with her fingers.
- Keep meal sizes realistic. Remember a meal size for a toddler is about ? to 1/3 the size of an adult's.
10. Teething
A child can lose her appetite due to teething discomfort. This will generally only last a couple of days.
What to do
- Offer regular meals and snacks but accept her rejection of them.
- Offer soft foods at these times.
- Offer plenty of fluids.
11. Development
Babies under the age of 4 months are not developmentally ready to eat solid foods. Babies are born with an extrusion reflex (sometimes referred to as a tongue-thrust reflex) which helps them to feed from the breast or bottle. For most children this reflex disappears by around the age of 3 - 4 months, but for some it can take longer.
While this reflex is still present, semi solid food tend to be pushed out of the mouth. This is not a sign of rejection of the food but an indication that a child is not ready for solids. Children will have difficulty coordinating the necessary tongue movements to get the food to the back of the throat to be swallowed, until this reflex has disappeared. (See our article on Starting Solids for more information.)
What to do
If your baby's extrusion reflex is still present, wait another 2 weeks and try again.
12. Feeding aversion
Babies and young children can develop an aversion to feeding if they feel pressured to eat. Pressure make the feeding experience either unpleasant or stressful. When repeated baby no longer wants to eat.
What to do
- Remove all pressure.
- See Feeding Aversion article.
Reasons your baby is a finicky or picky eater
1. Food preferences
Even from a very young age children learn what they like and what they don't. If given the choice they will eat foods they prefer (usually something sweet). However, children don't know what's good for them and have no idea about a balanced nutritious diet. It's possible to give too much of one food, even when it is nutritious. A variety of nutritious food provides for a more balanced diet.
What to do
- Because babies and toddlers eat so little, make sure everything your child is offered is nutritious.
- Try to maintain a balance to your child's diet by limiting excesses of one particular food.
- Offer treats sparingly.
2. Food allergies or intolerances
It's possible for a child to develop an aversion to a food if she's allergic to. However, she's unlikely to develop an aversion unless she has experienced unpleasant reactions from eating the food in the past. If a child has a food allergy, she will generally display symptoms such as diarrhea, rashes, asthma or hay fever like symptoms soon after the offending food is eaten.
What to do
- Only introduce one new food at a time, so you will be able to identify exactly which food she reacts to.
- When a new food is introduced allow a period of 3 days before introducing another new food (some symptoms may not develop for days).
3. Too many choices
Children can often feel overwhelmed by too many food choices.
What to do
- Avoid making meal times a buffet where your child is presented with numerous options.
- Allow her to decide between 2 nutritious alternatives (an occasional treat is fine but after nutritious foods). If she doesn't decide, then decide for her.
4. Behavioral
Put yourself into your child's shoes. How much attention would you be getting when it comes to food?
Do you provide a 'floor show' as you try to coax her to eat or do you follow her around, frequently offering her food or placing food in her mouth? Do you offer her rewards if she eats? Unfortunately, with the very best intentions parents can unknowingly reinforce a behavioral eating problem in their child.
What to do
- If your child doesn't want to eat, don't pressure her.
- Wait until the next meal or snack to offer food again.
- Don't offer rewards for eating.
REMEMBER a healthy child will not starve, so long as food is offered on a regular basis. Initially, she may refuse to eat food presented to her, either because she's not hungry or because she's waiting to see if her "favourites" arrive.
Why babies gag
Healthy thriving children gag (and occasionally vomit) on food while they're learning to eat. This is normal! Gagging is a reflex that babies are born with to prevent from choking as they learn to chew and cope with lumpy foods.
When introducing lumpier textured food your baby may spit it out or gag. This does not mean she's not ready, it simply means she needs more practice. It's important to keep offering lumpy textured foods. Gagging is more frightening to you than it is for your baby.
What to do
- Try not to react too much (your baby can become frightened by your reaction.)
- Wait until your baby has recovered and try again.
- Always supervise your child while she's eating.
Why babies vomit while eating
Where a child is healthy and thriving, vomiting or spitting up during eating is rarely due to a physical problem.
1. Developmental
Occasionally, gagging will result in vomiting. This is all part of the learning experience.
2. Behavioral
When a parent worries about what a child eats, it's not uncommon to start pressuring the child to eat. Sometimes meals times can continue over an hour or more with the child being coaxed, bribed, or even threatened to eat. When a child is pressured to eat she may vomit, because she's had enough. After a while she can learn to vomit deliberately when parents fail to take notice of other cues that she's had enough.
3. Food allergy or intolerance
Vomiting can be a sign of a food allergy or intolerance. However, if she is sensitive enough to vomit up because of food allergy or intolerance she will normally have other symptoms as well, which can involve rashes, asthma or hay fever like symptoms and diarrhea.
4. Physical problem/Illness
See your doctor if your child is ill, not drinking or not gaining enough weight.
Written by Rowena Bennett.