Creating Positive Mealtimes & Coping with Specific Challenges
Mealtimes can be a battleground for many families. Is my child eating enough? Are they getting enough of the “right” foods? Why do they refuse to eat so much of what I prepare?! Should I allow dessert when they’ve hardly eaten dinner? Do other parents go through this struggle every night? What if they’re developing a life-long, terrible relationship with food? Help!
Does this sound familiar? If so, you’re not alone. As a clinician specializing in eating behaviors, I’ve worked with numerous families navigating all types of mealtime dilemmas, ranging from fussy eating to tableside meltdowns. For those caregivers that have children with anxiety, eating disorders, ADHD, autism spectrum disorder, or extremely picky eating, additional challenges can present themselves as well. The good news is that we have ways to effectively approach meals with less stress and more ease for a variety of different needs and circumstances. There IS hope. Mealtimes can become a time of connection and bonding for your family! We just need to unlearn a lot of what we’ve been previously taught, get creative and flexible, and practice a ton of compassion for ourselves and our kids.
Strategies for Mealtime Success
Here are some strategies to help instill a positive relationship with food for your child, and to create more peaceful mealtimes. Think of these as foundational, guiding concepts; the specific application of these concepts, however, may vary depending on your child’s circumstances and unique needs.
1. Create a Consistent but Flexible Feeding Routine: A regular routine and a structured approach to feeding is crucial for young kids. Here’s why: we want our kids to be able to attend to their bodily cues regularly, and when the body isn’t fed consistently, certain cues are shut down (the full spectrum of hunger) while others are ramped up (urges to binge).
What this looks like in practice:
- Feeding younger children every 2-3 hours, feeding school-aged children every 2-4 hours; serving breakfast soon after waking
- Serving meals that are based on family preferences, lifestyle, and culture
- Providing a variety of nourishing and delicious foods (grains, protein, fats, fruits/vegetables, sweets/desserts)
- Disengaging from a “diet mentality” that posits certain foods are good and certain foods are bad, as well as the mentality that certain bodies are good and certain bodies are bad (this takes a lot of unlearning for most!)
- Including at least one of your child’s preferred foods at every meal (something the child likes and will eat, e.g., yogurt, bread, pasta, applesauce, etc.)
- Allowing your child to help in meal preparation (if developmentally appropriate)
- Providing choice when appropriate (e.g., “I’m serving a salad or green beans to go along with the meal, which would you prefer?”)
- Promoting flexibility, as opposed to rigidity (e.g., allowing for “non-planned” food items, eating in the car if that’s what it takes to get your child fed before an activity, providing a pre-dinner snack if a meal is running late, etc.)
2. Take the Pressure Off: When mealtimes are fraught with power struggles- and this typically occurs when we put pressure on our child to eat in a certain way, it can be a recipe for disaster. Try to approach mealtimes without verbal or nonverbal pressure.
What this looks like in practice:
- Allowing children to self-serve or serving your child without saying things like “Ok, let’s be sure to try that broccoli tonight!”, or “Finish your salmon and rice and then you’ll get ice cream!” (Family-style meals, where each member serves themselves from larger dishes placed on the table, can be an incredible way to naturally reduce food-pressure and to increase a sense of agency and control for your child.)
- Avoiding conversations centered around food choices/consumption
- No bribing, punishing, entering into negotiations regarding food, etc.; allowing your child to choose what and how much they eat
- Introducing new foods slowly and without pressure; pairing a new food with something they already like and serving it in smaller portions to start (And remember- it can take up to 20 or more times of exposure, without expectation, for your child to actually begin liking a new food)
3. Adopt a Strengths-Based Approach: Focus on the positive aspects of your child’s current relationship with food, or at least on their intrinsic positive qualities in general. For example, if a child is attempting to try a new food, celebrate their willingness to try new things rather than focusing on the quantity eaten.
What this looks like in practice:
- Praising your child for efforts made and a willing, open approach
- Trusting in children’s natural ability to feed themselves, and to honor their bodies’ hunger/fullness cues (this can be difficult when we’ve grown up immersed in a diet culture that taught us not to trust our bodies)
- Believing that you and your child can find tools to help emotionally regulate and navigate mealtimes
Specific Challenges
Children have many unique presenting issues and challenges that can further complicate mealtimes, certainly more than could be adequately covered in a single blog post. However, here are a few common struggles, how they manifest at mealtimes, as well as interventions and considerations.
1. Anxiety
How it can “show up” at mealtimes:
- Children with anxiety may experience physical symptoms like stomach aches or nausea, which can reduce their appetite
- Kids may also be in a chronic “fight, flight, or freeze” response, in which access to hunger/fullness cues is impaired
- Your child may fear trying new foods or worry about food textures and smells, due to how this may impact their stomach
- As a result, many anxious children engage in picky eating or avoidance of meals altogether
Specific considerations and interventions to try:
- Create a calm environment; ensure mealtimes are relaxed as possible
- Engage in mindfulness practices; help your child utilize simple breathing exercises or imagery before meals to reduce anxiety
- Be mindful of how much you associate food with physical symptoms that could be better attributed to anxiety/stress (e.g., instead of “Oh, that pasta is hurting your stomach, sweetie?”, try looking at the bigger picture of what could be going on with your child… sometimes we quickly associate food with negative physical symptoms, which can create anxiety/avoidance around the food…then, the next time we eat that food we may very well have a reaction to it- because our body is not accustomed to it, and it reinforces the whole cycle...)
- The aforementioned, foundational concepts of a consistent, flexible feeding routine and a strengths-based approach to food are also key
2. Eating Disorders:
How it can “show up” at mealtimes:
- Children may fear eating certain foods, avoid eating all together or severely restrict/limit food intake, or engage in binge eating or purging behaviors after meals
- They may become preoccupied with calories and food content,
- They may become highly emotionally dysregulated at mealtimes (yelling, sulking, refusing to eat) or “zone out” completely
Specific considerations and interventions to try:
- Avoid food talk; focus on positive or neutral topics for dinnertime discussions (not anything connected with body image, food, or highly distressing topics)
- Use distress tolerance skills at the table (e.g., distraction by playing a word game at the dinner table or listening to music; self-soothing with a stress ball or sensory tool at the table or a heating pad after the meal; deep breathing; or affirmations that encourage positivity and empowerment)
- Model healthy behaviors; demonstrate a balanced, intuitive approach to eating
- Inoculate your home against diet culture; don’t use dichotomous terms when referring to foods (e.g., healthy vs. unhealthy, good vs. bad), and don’t equate size/appearance with someone’s worth
- Encourage embodiment; promote activities or practices in your home that serve to connect the mind/body (yoga, slow walks, meditation, etc.)
- Seek professional support; work with a therapist, dietitian and medical doctor specializing in eating disorders
- For some eating disorders, a high level of structure (and much less flexibility) is required for healing; think of this as the “training wheels” or scaffolding necessary to get a child back on track… the goal is always to help the child reconnect with their own inner compass/intuitive eater when it comes to food, whatever that looks like for them
3. Sensory Issues:
How it can “show up” at mealtimes:
- Children may be hypersensitive to textures, smells, or tastes, making certain foods unappealing or intolerable
- They may gag or refuse to eat foods with specific textures
Specific considerations and interventions to try:
- Gradual exposure; introduce new textures slowly and in a non-threatening way.
- Sensory play; allow non-food sensory play to increase comfort with different textures
- Safe foods; always have a few preferred foods available to ensure they have something to eat.
- Separate foods; avoid mixing foods- serve them separately to prevent overwhelming sensory experiences
4. Autism Spectrum Disorder (ASD) (see also the work of Naureen Hunani)
How it can “show up” at mealtimes:
- Children with ASD may have strong food preferences or aversions, and/or rigid routines around eating
- Sensory sensitivities can further complicate their willingness to try new foods
Specific considerations and interventions to try:
- Visual schedules; use visual aids to outline meal times and what to expect
- Utilize alarms/reminders for mealtimes when necessary (e.g., you can set a timer on your child’s phone or device to remind them a mealtime is approaching…kids with ASD might not be able to connect with hunger/fullness cues very well, and that’s ok)
- Sensory tools to enable emotional regulation and soothing at the dinner table
- Food chaining; gradually introduce new foods that are similar to preferred foods
- Incorporate interests; use their interests to make meals more engaging and less stressful
- Patience and flexibility; be patient and flexible with their eating habits and preferences… choose to see their struggles with certain foods from a compassion lens…this is a wiring issue, not a choice
- Normalize your child’s experience and trust that they (and you) can cope effectively with meals when adequately supported; know that it just might look different than others kids’ eating behaviors, and that’s perfectly ok
- Be a critical consumer of information you “take in” about parenting a child with ASD; the information and advice you are given could be steeped in diet culture or other ineffective/harmful messaging
5. ADHD:
How it can “show up” at mealtimes:
- Children with ADHD may be easily distracted, making it difficult to sit through meals
- They might have impulsive eating habits, leading to overeating or missing meals
Specific considerations and interventions to try:
- Minimize distractions/limit sensory overload; create a quiet, distraction-free eating environment with cues of safety
- Smaller, frequent meals; offer smaller, more frequent meals to accommodate shorter attention spans
- Clear, succinct instructions; provide clear and simple instructions during meal times
- Physical activity; allow for physical activity before meals to help them settle their nervous system
6. General Picky Eating:
How it can “show up” at mealtimes:
- Children may refuse to eat certain foods or a limited variety of foods, impacting their nutritional intake
- Picky eating can lead to mealtime battles and stress for both the child and the parent
Specific considerations and interventions to try:
- Family meals; eat together as a family, as much as possible, to normalize and model positive eating behaviors
- Food pairing; pair new foods with favorite foods in order to make them less intimidating
- Make it fun; use creative presentation or involve the child in meal prep to make trying new foods more enjoyable (e.g., make food art- arrange fruits and vegetables to make faces, animals, or other designs to make eating more fun)
- Incorporate storytelling; tell stories about the foods they are eating, such as where they come from or how they grow
- Food play; allow children to play with their food outside of mealtime- sensory play with different textures and colors can reduce aversions and make them more comfortable
- Gardening; start a small garden or even a few potted plants (growing their own vegetables or herbs can spark curiosity and willingness to try what they’ve grown)
- Food exploration days; dedicate specific days for exploring new foods- make it an exciting event where the child can choose new foods to try from the grocery store
- The aforementioned, foundational concept of taking the pressure off is also also key! (expose your kids to new foods repeatedly, but without pressure- as hard as that can be at times!)
Navigating challenging mealtimes requires patience, compassion, creativity, and a willingness to adapt. By understanding the unique needs of each child and implementing supportive strategies, parents can develop a positive and nurturing mealtime environment. Progress may be slow, but be sure to celebrate the small victories along the way… and know that you are fully capable of instilling a positive relationship with food for your child.
I’d love to hear from you! What obstacles are getting in the way of a positive mealtime environment in your home? What strategies are you finding the most effective in dealing with these challenges?