Weaning toddlers and school-aged children can be arguably more difficult than weaning infants. Typical eating infants are hard-wired to eat, suck-swallow-breathe, and most of their nutrition comes from drinking. Toddlers and older children, on the other hand, have thoughts and opinions about what they eat. They require a balanced diet of fruits, veggies, meats, carbs, water and milk to maintain adequate nutrition and hydration. Typical toddler eating behaviors are also sporadic. They may eat like a bird for 3-4 days then eat like a grown man the days following. They may refuse a food, meal, or drink they claimed they loved yesterday. These unpredictable, but typical, toddler behaviors around food can be stressful for families weaning their tube-fed children. But rather than pulling your hair out, I want to offer a few suggestions for how to navigate the two most typical (yet frustrating) mealtime behaviors that toddlers exhibit.
Toddlers love to snack. Whether it’s goldfish in the car, candy as a reward for potty training, popcorn with a movie, or enjoying a popsicle on a hot day, toddlers quickly learn that these snacks and special treats are fun and delicious. And, because treats and snacks are typically linked to fun and social engagements around eating, we don’t want to advocate taking them away. But excessive snacking can become a large barrier to weaning toddlers and older children because they quickly learn that snacks, candy, and treats are slightly better tasting than broccoli and chicken. When these thoughts and opinions turn into refusals and food-strikes, it can become an extreme stress for parents weaning their toddlers. It can seem much easier to give in a say “well, at least they ate something,” than to put healthy boundaries around meal times and content. Constant snacking often leads to a cycle of meal refusals, short order cooking, and grazing behavior.
So, setting up consistent meal times is important. This is where you as the parent get to decide when your child eats and what is offered, and the child gets to decide what and how much he eats. Although it is difficult to say “no” when your weaning toddler asks for snacks when it is not a designated eating time, it is important to set boundaries around eating to avoid the cycle of reinforcing snacking behavior. As mentioned in our “Grazing is for Sheep” post, snacking creates signals in the brain where the body neither feels full or hungry. Setting boundaries creates space for these complex little ones to feel hunger, so be confident in saying “no” when your child asks for snacks right before dinner.
Another way to combat this behavior is by eliminating contingencies such as “if you eat your lunch, you can have (insert desired food).” This inherently creates a power struggle between you and your child. What if they refuse to eat any of the food you offer? Do you give in and offer their preferred food just to get them to eat something? This is tempting, especially for parents weaning their children where they feel every calorie counts. The best way to combat this is to take away the contingencies all together. Offer your child her meal, let her choose what and how much she eats (you may even consider including their preferred food with their meal). If you as the parent decide dessert or a treat is happening that day, then offer it with no link or expectation to the meal she just ate.
Ah, the game of cause and effect: the ability for your child to understand that one event brings about another. This is an important development that occurs between 8-12 months old and sets the foundation for complex play, communication skills, and manipulating their environment. You delight over your little one learning that she can activate a light up toy, playing games such as peek-a-boo, and beginning to use early signs/communication. The game of cause and effect is fun, and children learn quickly how to manipulate their environment to create fun. One particular cause and effect behavior at mealtimes that is common for all toddlers (weaning or oral eaters), is throwing. Whether this is food, their plates, into the dog’s mouth, dumping out cups, utensils, what have you – toddlers quickly learn that this behavior is fun and gains them attention. Sometimes this behavior can become more fun than eating! But when you are weaning a toddler, anxiety around mealtimes can increase significantly when you offer her preferred food, and 99% of it ends up being fed to the dog, dumped on her tray, or thrown on the walls. When throwing food and feeding food to the dog becomes a problem, here are some ways to help:
When food is thrown on the floor, casually and non-emotionally pick it up and place it back on the tray with words such as “no throwing” or “we don’t throw food at dinner.” If the child does this again or throws a tantrum, remove him from his chair and try again at the next eating time. This sets up expectations for your child at the table where they learn what is acceptable and what is not.
Try “breaking the chain” of throwing food by changing up mealtime locations. Have a picnic dinner on the floor, lunch around the coffee table, or snack outside. This novel experience typically distracts children from persistently throwing and encourages them to engage in their new surroundings with their meal instead.
Put the dog away from the table before starting the meal. It seems obvious, but it’s amazing how easy this is and how quickly it works! This takes away the fun “effect” piece of this behavior.
Offer food at consistent meal times. If your child is not hungry or she is fully-tube feed, do not expect her to put food in her mouth. Instead, expect her to find another place to put food such as the floor, in the dog’s mouth, or on the wall.
A large part of combating these behaviors is setting expectations for your child at mealtimes and consistently reinforcing those expectations, remembering that these behaviors stem from cause and effect behavior, and if we remove the “fun” part of throwing (e.g. putting the dog away or removal from the table), that behavior is no longer reinforced and will likely decrease. So stay the course! Toddlers may be most predictably unpredictable, in a safe, pressure-free, and respectful environment, they can wean successfully! So don’t give up!
Kathryn Stewart, MS, CCC-SLP, Feeding Specialist