Whether or not your child has Gastroesophageal Reflux, picky eating is common in children ages 15 months to 3 years of age. Picky eating is often characterized by only eating a few foods and beverages, skipping whole food groups (such as fruits and vegetables) and having a negative reaction to non preferred foods or new foods. Some toddlers are very opinionated about the color, texture and taste of foods too. Toddlers are bursting with new skills such as talking, walking and climbing so it makes sense that your toddler will quickly discover the power of "no" when you present mashed green veggies and other delectable treats.
In addition to strong food preferences, foods that trigger heartburn or a sour taste in the mouth such as citrus, tomato and spicy foods may be on the "do not eat" list. For a toddler with reflux, picky eating may be caused by food that urps up, past memories of discomfort or negative associations with food. I call a picky eater with reflux a "careful eater" because she has learned through past experience that certain foods cause discomfort so she is very careful about what she puts in her mouth. It can be really hard, if not impossible to differentiate between typical picky eating and avoidance of foods that trigger reflux symptoms.
Toddlers with reflux may have a more intense reaction to foods. I call this "beyond picky". Some picky eaters have such a strong aversion to food that there is poor weight gain, weight loss and nutritional deficiencies. You will need to work closely with your child’s doctor if picky eating progresses to this level. A feeding therapist or feeding specialist can be enormously helpful for really advanced feeding challenges.
If you have a picky eater in your house, you are probably frustrated and annoyed that your toddler does not eat no matter what you try. You should always consult the doctor for advice on healthy eating, weight, height and nutritional needs. Ask your doctor for advice on portion size and milk/formula intake to ensure proper growth. Some toddlers with reflux need special assistance to eat a balanced diet and gain weight.
Tips for helping your "Careful Eater" approach new foods:
· Schedule: It is important to schedule at least one family meal per day. Keep to a schedule of meals and snacks throughout the day.
· Portion Sizes: Keep in mind that her eating habits may be changing. She may have an "eating window" when she eats her best meal of the day. For instance, your toddler may nibble all day and eat a big dinner. It may seem impossible for her to run and play on a nibble of cracker and a sip of milk but somehow that is entirely normal for some toddlers.
· Growing: As she grows taller, the steady weight gain of infancy may slow down and it may seem that she is eating less. This is entirely normal. Ask your doctor to review the growth chart with you to ensure that she is following this pattern.
· Snack Time: Make healthy snack choices a family affair. Everyone will benefit from healthy snacks and healthy eating habits. Remember: You can still hide that chocolate bar in the cabinet for an emergency or when your toddler is in bed. Healthy snacks may include: fruit and dip, dry cereal, crackers with cheese or peanut butter, yogurt, smoothie or a bagel.
· Check your emotions at the kitchen door: Mealtime can be an emotional time for you and your child. You may be worried about nutrition and her limited diet. She might see your worried face and react accordingly. Mealtime should be a pleasurable and relaxed, at least for your one family meal per day.
· Begging, Bribing and Sneaking: If possible, try to resist begging, bribing or sneaking a bite in when she is busy. While these methods may work in the short term, they will surely backfire in the long run as she figures out what you are up to.
· Play Date: Arrange to have a mealtime play date with a "super eater". You know who I am talking about-your niece, neighbor or co worker’s toddler who eats every meal, every food group and then begs for more. Both you and your toddler will stare in amazement as this little eating machine goes to work. Toddlers are inclined to imitate other children so watching another child eat the foods she resists may be beneficial.
· Vitamins and Nutritional Drinks: Talk to the doctor about vitamins and nutritional drinks. It may be necessary to supplement the diet if your toddler is not eating a balanced diet.
It is common to feel stressed about feeding your child with reflux. Most of us struggled to feed our babies and help them grow. Now we have new challenges as our toddlers are still struggling with lingering reflux issues and becoming more opinionated about what they will eat and drink. Just like every other aspect of parenting, you have the opportunity to teach your child new skills. Developing good eating habits is a combination of providing healthy food choices, modeling good eating habits and waiting for her to move on to another challenging developmental issue Believe it or not, most children do move on from picky eating!
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