Imagine you’re at the dinner table with your family, a wonderful spread of food ready to eat, and your child is sitting there refusing to touch a single bite. He or she might be trying to leave the table, head turned with arms folded, or screaming at every moment you attempt to convince him/her to just “take one bite”. If that scenario sounds familiar, you’re not alone.
Working on feeding skills with children is often difficult for both parents and children. Even more so if you include sensory issues, autism characteristics, and age-appropriate meltdowns. The harder it is for kids to eat healthy and with age- appropriate volume, the more anxious parents and children can get, making meal times feel like a battlefield. The whole situation becomes a power struggle and it’s exhausting for the whole family during each mealtime.
When we are stressed or anxious our bodies produce more hormones (cortisol) that actually stops you from feeling hungry, despite having an empty stomach. While adults say that stress can make them overeat, children tend to respond by eating less or not at all. This means anxiety during mealtime puts the child in a fight or flight response.
Signs of a child possibly having anxiety (and/or sensory issues) during mealtime includes:
- Whining or crying
- Refusing to come to the table
- Gagging at the sight/smell of food
- Avoidant body positions (leaning back, turning away from the food, pursing lips tighter together at the sight of food, kicking feet around, trying to get up the moment the sit and food is presented).
- Dissociating from the situation by zoning out or looking “glazed over”
- Shaking, tapping, rocking
- Talking too much (ie: anxious talking) or not at all (ie: shut down)
- Consistent poor behavior at the tables (ex: seeking negative attention)
Why Is This Happening?
There is a variety of reasons as to why feeding issues occur. The following areas are most common: sensory processing issues such as sensitivity to flavors, textures, temperatures or delays in oral motor skill development such as tongue movements, rotary chewing, suck and swallow skills. Children with sensory processing difficulties may have sensory food aversions, if a child is sensitive to oral input. Anxiety includes worry and fear, and you can imagine if a child is avoiding oral input, the worry and/or fear of foods with certain textures, strong flavors, or strong smells can trigger the fight or flight response.
In a recent study in the journal of Pediatrics, it was found that all selective eaters most likely show signs of depression or anxiety. Children with severe selective eating disorders more likely get diagnosed with depression or social anxiety, but also have oral motor problems. There is also a risk with growth issues, food aversions, and heightened sensitivity to food texture, sight, and smell.
Sensory food aversion is described as follows: (1) child refuses to eat specific foods with specific tastes, textures, smells, or appearances; (2) the onset occurs during the introduction of a different type of food; (3) child eats better and more when offered preferred foods; and (4) child has specific nutritional deficiencies or oral motor delay10,11). Children with this type of feeding disorder have a tendency of picky eating. For example, they may eat crunchy foods, but refuse liquid food; they may eat carrots, but refuse spinach.
How to Help
In order to address these anxious feelings and improve the mealtime experience, here are some ideas on how to decrease that anxiety level and make eating and feeding more fun.
- Keep as much of a calm environment as possible, including yourself. Some kids can pick up on your own anxiety and feed off your emotions.
- Help your child stay calm by playing calming music during the meal, such as classical or other instrumental music.
- Set up the meal time environment to promote a positive experience: a fun, personal placemat, a silly straw to drink with, colorful dinnerware.
Addressing parent anxieties is a good precursor to addressing meal times, as kids can be influenced by how their parents feel. Three ways to avoid spreading anxious feelings are: self-care, calm talking or tone, and using calm down strategies together (parent and child). With self-care, it’s important for parents to take their own time to relax and unwind, which can even be done prior to meal times. Calm talk or tone can include keeping voice tone on a relaxed, low level during meal time or during food exploration activities. It can also include the use of minimal verbal prompting and stating positive responses to a child’s progress with exploring/trying foods, such as “you’re eating more of ___, that’s more than last time”, or “you gave ___ a thumbs up today instead of a thumbs down”. By pointing out the progress without needing to use over exaggerated praise, anxieties can also decrease during the meal.
The more we can keep the meal time experience calm and fun, the less anxiety is involved in the process. Meal times are typically a social and enjoyable time. Feeding issues can be challenging, but with the right tools and practice we can make the experience fun and wonderful.
References and Resources:
- How to Approach Feeding Difficulties in Young Children https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5752637/
- Has Anxiety Killed Your Appetite?
https://www.healthline.com/health/mental-health/anxiety-lose-appetite#3 - Is Your Anxiety Rubbing off on Your Kid? 3 Ways to Avoid It https://yourkidstable.com/preventing-kids-from-picking-up-adult-anxiety/?inf_contact_key=72f8eb81592245cbc0c83af95e45478b680f8914173f9191b1c0223e68310bb1
