Facilitating (Not Forcing) Your Child’s Eating (Extreme Picky Eating Edition)

“I’m not forcing, I’m just aggressively facilitating…” I was watching a show on Netflix* when I caught this line, “I’m not forcing, I’m just aggressively facilitating.” My ears perked at the words facilitation and force, and of course made me think of children with extreme picky eating, of feeding, and the “aggressive facilitation” that can sometimes happen, even in feeding therapies. There is much research that suggests that when children are pressured or coerced to eat, overall intake, and intake of fruits and veggies decreases.  Here are a few examples… “…approximately half of all mothers and a greater proportion of fathers… ignore the child’s hunger signals and may use force, punishment, or inappropriate rewards to coerce the child to eat. These practices initially appear effective, but become counterproductive, resulting in poor adjustment of energy intake, consumption of fewer fruits and vegetables, and a greater risk of under- or overweight.” (Kerzner 2015) “…stringent parental controls can… limit children’s acceptance of a variety of foods and disrupt children’s regulation of energy intake by altering children’s responsiveness to internal cues of hunger and satiety.” (Brown & Ogden, 2004) Pressure to eat likely disrupts child’s ability to respond to internal cues of hunger and satiety (Carper et al., 2000) Pressure to eat … “exacerbate feeding problems and make mealtimes more negative for both parent and child.” (Harris 1992; Skuse 1993) Pressuring strategies could be implicated in the development and persistence of these problems (Farrow & Blissett, 2008) Pressure to eat predicted food avoidance behaviors: slow eating, emotional undereating, satiety responsiveness (Powell 2011) Parent prompts assoc w/ food avoidant behaviors, correcting for child emotionality and maternal...

He’ll Grow Out of It? Disappointing Guideline from Picky Eating Study

An observational study titled, “Trajectories of Picky Eating during Childhood: A General Population Study.” (International Journal of Eating Disorders) had some interesting findings following over 4000* Dutch children through age six. Unfortunately, the guideline offered in the conclusion will do little to help clinicians help children with picky eating. First, what the study showed: At 18 months about 26% of children were reported as “picky” At age three, about 27% By age six the number declined to 13% 46% were described as picky at some point in childhood The following factors were associated with “persistent” picky eating (beyond age six): male gender low birth weight non-Western maternal ethnicity low parental income shorter duration of exclusive breast feeding and early intro to solids This study confirms findings from other studies that typical picky eating is often a phase. It did not delve into the experience of the persistent picky eater or severity.  And the problematic conclusion and discussion: “Commonly, health professionals tend to regard picky eating as a transient phase of the development of the preschool child. However, many parents of picky eaters seek medical help for their children’s pickiness, and express frustration with physicians for dismissing their concerns. We argue that indeed picky eating between the ages of 0 and 4 years may in general be considered as part of normal development. As a guideline, health care professionals could focus on a duration >3 years of picky eating, non-Dutch (non-Western) descent and low family income to monitor for risk at becoming a persistent picky eater.” This makes those of us supporting parents of children with extreme picky eating slap...

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