Overcoming Food Resistance

Yesterday, I wrote about the problem with the Sneaky, Deceptive method of getting your kids to eat nutritious food. Today, I'll look at some ways to get your kids to eat a wide variety of foods.

The first thing is to recognize the difference between dislike and resistance to a new food. We all have foods we dislike. I dislike onions and most fish, while Rudy won't eat beets. We have each tried again and again to enjoy these foods, but cannot seem to overcome our dislike. There's something about the smell, the texture or the taste that just doesn't appeal. Each of us could eat our disliked foods if the alternative was starving, or if we didn't want to offend a host, but we wouldn't enjoy it. I'd have to work hard to choke down a Fish and Pickled Onion Sandwich, even if it was served by the Queen's own hand.

Resistance to a food, however, is when a person refuses to even try the food, especially an unfamiliar food. The first response to seeing, smelling, or hearing about the food is "Yuck!". It can be met by varying degrees of theatrics and hysteria. For example, I made black bean soup for dinner tonight, and I served it with warm tortillas. My 3-year-old, Dylan, usually loves soup, beans, and tortillas. This should have been a simple meal. But Dylan got mad that there was nothing in the tortilla - he wanted a burrito. He kept saying that the soup looked like poo. When I suggested he dip the tortilla in the soup, he began to whine and cry. He repeatedly stated he wouldn't eat it, it was disgusting and he was going to die. All the while, his brother and I sat and happily ate our soup. I'll tell you what happened at the end of the post, but this story is a pretty typical illustration of resistance to a food.

There are a few simple, effective techniques to overcome resistance to a food. But in order for any technique to work, there is one important shift that a parent must make: stop fighting about food. Kids control very little in life, but one thing they can control is what they eat. The usually yucky and occasionally wise Dr. Phil tell parents never to lose a fight with their children. The struggle over food is one the parent can't win. Unless you are prepared to force-feed your child, you cannot control what your child swallows.

My pediatrician told me that parents are responsible for what is served and when it is served, and children are responsible for what and how much they eat. My job is to serve a variety of healthful meals on a regular schedule. It's my kids' job to choose what they're going to eat from what I'm serving, and how much of it they eat. For the most part, I stay out of their choices at the table. This approach gives the kids a sense of control, and it allows me to keep my frustration to a minimum.

There are a few simple rules to making this strategy work:

1. Make sure there is always some non-offensive food the kids can fill up on. Good choice are whole-grain bread, pasta, fruit. It should be healthful enough that if it's the only thing the kid chooses to eat, it's ok.
2. Offer food only at regularly scheduled mealtimes, and have 4-5 meals each day. In our family, the daily meals are breakfast, second breakfast, lunch, nap-snack, and dinner. This enables me to say to a child who refuses to eat, "that's okay, the next meal is nap-snack." Then I stick to it. Because we have 5 meals a day, we all know that it's only going to be a few hours until the next meal. And I can put up with the whining that long.
3. Never become a short-order cook. If you start making special meals for one child because they don't like something, you'll soon be doing it at every meal. If you're making sure that there's bread or fruit on the table, there's no reason to get up and make a special meal. Your child can make do with what's there. My exception to this is breakfast - I'm often a short-order cook at breakfast. Ryan has cereal or a waffle, Dylan has eggs or a waffle, and I have oatmeal. But it only takes 10 minutes to prepare the different meals, so I'm okay with that.
4. Don't take it personally if they refuse to eat something. I spent the better part of Sunday making pizza from scratch. I made my own sauce from tomatoes in our garden, I made crust that rose for hours, I rolled it out so each person could have their own, and I custom-garnished each pizza with toppings chosen by that person. Dylan took one bite of his lovingly crafted pizza and refused to eat any more. He gorged on watermelon. I worked hard on the dinner, and I was disappointed that neither boy ate much (Ryan took 4 bites), but it was not personal. I made a dinner I felt good about, and they chose not to eat it. No problem. (Now, it's a whole different story if my husband refuses to eat something I've worked hard on....)

Given this basic non-confrontational attitude towards meals and foods, how do we then get our kids to eat new and different foods? There are a number of proven techniques.

1. Start young, if possible: kids between 8 and 15 months tend to be less resistant to new foods than pre-schoolers - especially if they've consumed the food in breast milk. They just need to have food presented in manageable pieces. The more food you get your infant to eat, the more acceptable choices you'll have for your toddler and pre-schooler. My pediatrician had me start feeding the babies vegetables. We progressed from rice cereal and oatmeal to squash, carrots, peas, and sweet potatoes. We introduced fruit only later, because kids naturally like sweet foods. So it can be more important to have young toddlers eating tons of veggies, then worry about fruit later.
2. Try, try again: unfamiliar foods are scary to kids starting from about age 2. Studies have shown that it can take 10 or more exposures before a food is familiar enough for neophobic resistance to be removed. Just keep putting the new food out there. Put a little on the plate, ask your child to taste it, but don't coerce the child. Just ask the child to take a taste.
3. Try offering the food when the child is NOT hungry: This is counterintuitive, but studies have shown that hunger and fear can increase food neophobia. People are least resistant to new food when they're at a hunger ebb.
4. Model good eating: kids watch us constantly, and they tend to do what we do rather than what we say. They are not going to eat lots of fruits and veggies if we don't.
5. Leverage your child's role models and heroes: Most kids have someone in their lives they idolize. Having that person present when new foods are introduced, and having that person enthusiastically eat and enjoy the foods, can go a long way to overcoming resistance. This UK study talks about the influence of "The Food Dudes" - superheroes who loves particular veggies - on kids' eating behaviors. My personal experiences: Dylan will eat almost anything his PopPop consumes enthusiastically, especially if he can eat it off PopPop's plate. He'd sit on PopPop's lap and happily consume this watery oatbran concoction that resembled gruel, spinach salad, and steak. He's the same way with his father. Ryan will follow my mother, and to some extent, me.
6. Consider rewarding tasting a food with a non-food reward. This one is a little controversial because the research goes both ways. In the above study, the researchers found that kids who were rewarded with a sticker for trying a new food were willing to try that food again, and again. Follow-ups showed that the kids were happily eating the resisted food months later. The key to this one is that it cannot be a food reward. No "eat your peas and you'll get ice cream". The theory is that a food reward reinforces the idea that a certain food is bad, but a sticker reward doesn't seem to have this association. Other studies have shown that this backfires. But it's worth considering - you know your child best.
7. If all else fails, let it go and try again later: After 10 exposures to a new food, if your child still won't eat it and doesn't like it, move on. There's plenty of good food to try - go for something else. Try the rejected food again in a few months. There are relatively few people who refuse entire classes of food - most people like at least a few vegetables!

We followed these strategies while Dylan was having his meltdown with the black bean soup. I told him kindly that he could eat what he chose, but the next meal was breakfast. I was okay with that because I had tortillas, and I knew he'd eventually eat those. Dylan demanded an alternative meal - watermelon. I said no, we weren't having watermelon tonight. Dylan whined more. Rudy came to the table with his soup and asked for a tortilla. He announced to the room in general that he loved dipping his tortillas in his soup. He offered Dylan part of his tortilla, and said it was really good dipped in soup. Dylan grabbed the tortilla (which he had rejected from me), dipped it in his soup, and ate it. He then announced he loved tortillas in soup, and said it was really good. Ryan started eating spoonfuls of soup, and I asked him if it was good. He said it was great! That's all it took to get Dylan eating spoonfuls of soup. He had a pretty hearty dinner, but it didn't seem that way when we started.

Here are some other resources and other ideas about how to get kids eating:

• PBS Kids Site - creative ideas for making food fun
• New York Times: 6 food mistakes parents make
• Tips from Ellyn Satter: this is oriented to educators, but it has some great ideas
• Ellyn Satter's book "How To Get Your Kid To Eat: But Not Too Much": Outlines the approach my pediatrician taught me, and has a ton of great ideas. The tone of the book is a little pedantic and patronizing, but the techniques work.