Picky Eaters

Slide 1: 

-Dr.C.S.N.Vittal Picky Eaters

Healthy Eaters: 

No h/o Food Intolerance Normal Weight and Height No parental concern about child’s eating No psychological and behavioural factors Healthy Eaters

Causes of Infant Mortality: 

Malnutrition 55% Causes of Infant Mortality SILENT KILLER

Correct Norms for Infant and Young Child Feeding: 

Correct Norms for Infant and Young Child Feeding • Initiation of breastfeeding immediately after birth, preferably within one hour. • Exclusive breastfeeding for the first six months i.e., the infants receives only breast milk and nothing else, no other milk. Food, drink or water. • Appropriate and adequate complementary feeding from six months of age while continuing breastfeeding. • Continued breastfeeding upto the age of two years or beyond. NATIONAL GUIDELINES ON INFANT AND YOUNG CHILD FEEDING MINISTRY OF WOMEN AND CHILD DEVELOPMENT (FOOD AND NUTRITION BOARD) GOVERNMENT OF INDIA 2006

Mother’s Milk: 

Mother’s Milk

Malnutrition Trap: 

Malnutrition Trap Liquid Diet Breast Feeding Solid Diet Family Pot Feeding

3 Plank Protein Bridge: 

3 Plank Protein Bridge Available Animal Protein Prolonged Breast Feeding Vegetable Protein Mixture Safety Net

Safety Net: 

Safety Net Supplementary Feeding Group eating Akshayapatra

Slide 9: 

For any child, it is important to get some food from each of the food pyramid groups every day. That's because, for the most part, nutrients aren't shared between them.

Eating Problems: 

Eating Problems Food refusal Poor appetite Inappropriate food for age Extreme or very limited food choices Poor table behaviour

Picky Eaters: 

Picky Eaters Some have past h/o. organic difficulties Have psychological based feeding problem Failure to Thrive

Picky Eaters: 

Picky Eaters You know! My son hardly takes four gulps at lunch. Oh! My son Eats only two gulps.

Eating Problems: 

Eating Problems Failure to thrive Developmentally delayed Infantile anorexia Picky eaters

Picky Eating: 

Picky Eating Food refusal of the child for at least one month that may involve all or certain types of foods. Definition:

Doctor’s Role: 

Doctor’s Role Solve our problem, Pl.

Picky Eaters: 

Picky Eaters What was wrong? Why were these kids such picky eaters?

Doctor’s Goals : 

Doctor’s Goals Identification and management of eating problems in childhood. Appropriate management strategy. Provide opportunities for early detection. For suggestions about prevention and treatment of eating problems.

Slide 18: 

….if someone yells “no” daily at your dinner table, you’re not alone. NO NO NO NO NO

Why toddlers are picky: 

Why toddlers are picky (Between 1 and 3yrs). After a year of rapid growth, toddlers gain weight more slowly. So,they need less food. The fact that these little ones are always on the go also affects their eating patterns. They don't sit still for anything, even food. Snacking their way through the day is more compatible with these busy explorers' lifestyle than sitting down to a full-fledged feast. Being a picky eater is part of what it means to be a toddler.

Battle for Control: 

Children fight with parents for control during mealtime Conflict can develop around: What the child will eat How much they will eat Where they will eat it. Parenting styles may interfere with self-regulation of children’s feeding behaviour. Battle for Control

If you don’t eat …..: 

If you don’t eat ….. .. I won’t talk to you ! .. I give you good beating! .. I take you to Doctor and get you an Injection

Parental Response: 

Parental Response Child’s Response Highly controlling Laissez faire Responsible

Treatment Options: 

Treatment Options Behavioural interventions Mealtime suggestions Oral supplements

Mealtime Suggestions for Parents: 

Mealtime Suggestions for Parents Make meals a pleasant family time Eat as a family at the earliest age possible Serve the nonpreferred or new foods -frequently encourage tasting new foods “Neophobia” – Children are vary of new foods. Familiarity promotes shifts in food preferences

Toddlers from one to three years need between 1,000 and 1,300 calories a day, yet they may not eat this amount every day.: 

Aim for a nutritionally-balanced week, not a balanced day. Expect your child to eat well one day and eat practically nothing the next. Toddlers from one to three years need between 1,000 and 1,300 calories a day, yet they may not eat this amount every day. Toddlers like to binge on one food at a time. They may eat only fruits one day, and vegetables the next.

Tactics for Parents: 

Tactics for Parents To tempt little taste buds & minimize mealtime hassles.

1. Offer a nibble tray: 

1. Offer a nibble tray Toddlers like to graze their way through a variety of foods, so why not offer them a customized smorgasbord? Use an ice-cube tray, a muffin tin, or a compartmentalized dish, and put bite-size portions of colorful and nutritious foods in each section. Call these finger foods playful names that a two-year-old can appreciate

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Young children think that immersing foods in a tasty dip is pure fun (and delightfully messy). 2. Dip it Some possibilities to dip into: Cottage cheese, fruit juice-sweetened preserves, pureed fruits or vegetables, yogurt, plain or sweetened with juice concentrate.

3. Spread it: 

3. Spread it Toddlers like spreading, or more accurately, smearing. Show them how to use a table knife to spread cheese, peanut butter, and fruit concentrate onto crackers, toast, or rice cakes.

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Toddlers are into toppings. 4. Top it Putting nutritious, familiar favorites on top of new and less-desirable foods is a way to broaden the finicky toddler's menu Favorite toppings are yogurt, cream cheese, melted cheese,tomato sauce, applesauce, and peanut butter.

5. Drink it: 

Make a smoothie – together. Milk and fruit – along with supplements such as juice, egg powder, wheat germ, yogurt, honey, and peanut butter – can be the basis of very healthy meals. 5. Drink it If your youngster would rather drink than eat, don't despair So what if they are consumed through a straw? One note of caution: Avoid any drinks with raw eggs or you'll risk salmonella poisoning.

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How much a child will eat often depends on how you cut it. 6. Cut it up Cut sandwiches, pancakes, waffles, and pizza into various shapes using cookie cutters.

7. Package it: 

7. Package it Our kids enjoy the unexpected and fanciful when it comes to serving dishes – anything from plastic measuring cups to ice-cream cones.

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"Doctor, he won't eat his vegetables" 8. Become a veggie vendor So if you aren't the proud parent of a veggie lover, try the following tricks Plant a garden with your child. Slip grated or diced vegetables into favorite foods Use vegetables as finger foods and dip them in a favorite sauce or dip. Concoct creative camouflages. Cut the vegetables into interesting shapes (Make veggie art ).

9. Share it: 

9. Share it If your child is going through a picky-eater stage, invite over a friend who is the same age or slightly older whom you know “likes to eat.” Your child will catch on. Group feeding lets the other kids set the example.

10. Respect tiny tummies: 

10. Respect tiny tummies This less-is-more meal plan is not only more successful with picky eaters, it also has the added benefit of stabilizing blood-sugar levels, which in turn minimizes mood swings. Dole out small portions at first and refill the plate when your child asks for more.

11. Make it accessible: 

11. Make it accessible Reserve a low shelf in the refrigerator for a variety of your toddler's favorite (nutritious) foods and drinks. This tactic also enables children to eat when they are hungry, an important step in acquiring a healthy attitude about food. Give your toddler shelf space.

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12. Use sit-still strategies One reason why toddlers don't like to sit still at the family table is that their feet dangle. Try sitting on a stool while eating. Children are likely to sit and eat longer at a child-size table and chair where their feet touch the ground.

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13. Turn meals upside down. The distinctions between breakfast, lunch, and dinner have little meaning to a child. If your youngster insists on eating pizza in the morning or fruit and cereal in the evening, go with it – better than her not eating at all. This is not to say that you should become a short-order cook, filling lots of special requests, but why not let your toddler set the menu sometimes?

14. Let them cook. : 

14. Let them cook. Let your child help prepare the food. Use cookie cutters to create edible designs out of foods. Give your assistant such jobs as tearing and washing lettuce, scrubbing potatoes, or stirring batter.

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15. Make every calorie count. Offer your child foods that pack lots of nutrition into small doses. Nutrient-dense foods that most children are willing to eat include: Pasta,Brown rice and other grains, Potatoes, Cheese, Poultry, Eggs, Squash, Fish, Sweet potatoes, Kidney beans,Yogurt, etc.

16. Count on inconsistency : 

16. Count on inconsistency What and how much they are willing to eat may vary daily. Don't be surprised if "The only thing consistent about toddler feeding is inconsistency." your child eats a heaping plateful of food one day and practically nothing the next, adores spinach on Tuesday and refuses it on Thursday wants to feed herself at one meal and be totally catered to at another.

17. Relax: 

17. Relax "Try to make mealtime a really relaxed atmosphere talking about the day. Don't bribe and reward your child with things like 'eat your peas and you'll get your desert'. - Breton It's not easy to reason with an opinionated two-year-old. Better to learn to make the sandwich the child's way. Don't interpret this as being stubborn. Toddlers have a mindset about the order of things in their world. Any alternative is unacceptable. This is a passing stage.

Golden Rules: 

Golden Rules No child has ever died of starvation when presented with an array of healthy food choices. Kids often simply don't want to be bothered with having to eat. For them, meal times often represent an unwelcome interruption in their playtime. When children are truly hungry, they will eat.

Slide 45: 

Enforcing meal times /requiring kids to eat a certain amount of food at mealtimes only serves to frustrate both child and adult, and can also lead to the development of life-long eating disorders. Children come to associate food with conflict, and may turn down an offering of their favorite foods just to avoid this situation

Golden Rules: 

Golden Rules DON'T force kids to eat. Instead, offer children the opportunity to sample a variety of healthy food choices at all meal times. Don't expect a complete turn-around over night. Don't expect your kids to like e very new recipe the first time they try it. Don't give up

Slide 47: 

… but one that is worth meeting. Pickiness is a Challenge