Until recently, mealtime had become a battle of wills in our household.  My headstrong two and a half year old son, Brody, preferred to smash, throw, or finger-paint with his food as opposed to eating it.  Presentation was definitely not the issue, as I always prepared his food in perfectly appealing, bite-sized shapes. If he did not want what I offered, I tried something different.  I’d even attempted bribery, with treats or fun activities, if he would just eat his food!  In my desperation I had resorted to following him around while he played and shoving spoonfuls of yogurt or applesauce into his mouth.  Nothing else was working. Eager for some suggestions, I asked our pediatrician, Dr. Robert W. Mills of Pediatricare Associates, for his advice, and picked up a copy of My Child Won’t Eat, by Carlos Gonzales. I came away with some incredibly liberating information.

Stop the Pressure to Eat

“Stop tugging your end of the rope,” Dr. Mills recommended. Explaining it as an issue of control which would only worsen the more I pushed, he advised me to let go.  He suggested I leave a plate of healthy food in a place where my son could eat it when he wanted to, and warned against putting any pressure on the act of eating itself.  “Kids are not going to starve themselves unless there is a neurological issue,” Dr. Mills assured me. 

Gonzalez agrees. In My Child Won’t Eat, he stresses, “It is appetite that regulates the intake of food, and at least in children, it does so in a way that adequately meets their needs.”  Gonzales also cautions against using such methods as distractions  (spoons as airplanes), television, begging, promises (you can have ice cream if you eat your peas), threats, supplications, and comparisons (don’t you want to be big and strong like daddy?).   I was guilty of a few of these methods, none of which was the least bit effective.

Expecting My Child Won’t Eat to supply me with an arsenal of tips to coax my son into cleaning his plate, I came away with a completely different, vitally important message: toddlers have only one relationship with food; as nourishment.  They only eat because they have to, unlike adults who eat for enjoyment, or as a way to release stress, etc.   “Do not force your child to eat.  Never make him eat in any way, under any circumstance, for any reason…  The majority of children who refuse to eat do it simply because they do not need more food.”  Let your child take the lead.

Make food available, not mandatory

Now at mealtimes, I conjure Dr. Mills’ advice to me, “It’s not your job; it’s his job.” It is a parent’s job to make healthy foods available.  How much a child eats, when he eats (if he eats) is his responsibility.  Dr. Mills assured me Brody will eat when he is hungry, even if that isn’t at a frequency to which I am accustomed (or comfortable with). It is completely normal for a toddler to go a day or more without eating.  In a pinch, he told me to give Brody a Flintstones vitamin with Iron.   

Oftentimes, my son eats very little.  Other times, he eats everything he is offered. Most importantly, I try not to forget Dr. Mills’ advice to “Let it go.”  Brody’s got this.

Tips for dealing with picky eaters

• Offer nutrient-dense foods such as peanut butter, avocado, and yogurt.
•  Remember toddler-sized portions are only ¼ of an adult-sized portion.  
• Keep servings small and wait until your child asks for more.
• Offer a variety of healthy foods at times you know your toddler is hungry.
• Make a finger food tray of healthy foods in an easily accessible place and keep it readily available for grazing.
• Aim for a balanced week’s intake of food rather than a balanced day. 
• Always offer one thing your toddler likes at every meal.
• Let them choose when you can, for instance: apples or grapes?
• Let your toddler help you make their food; they will be more likely to eat it!
• Try to remember this is just a normal stage of development and expect inconsistency- what was gobbled up one day may be untouched the next.

Emetophobia is an intense, irrational fear of vomiting, including a fear of seeing vomit or watching the action of vomiting.  Undoubtedly, no one enjoys throwing up or seeing another person in the process, but for some, including me; it can be absolutely petrifying and almost debilitating.

Buggin out 

The first time I saw someone vomit, I was at the boardwalk on the New Jersey shore and a teenage boy got off a ride and threw up a few feet from me.  My mother inadvertently led me in that direction, literally inches from it, and I was so shaken by it that though I was only 3 years old, I can recall it vividly.  It was terrifying.

Throughout life, I’ve worried about being in the vicinity of a person who throws up.  I’ve gotten slightly better at dealing with my fear of vomit over the years, although I will still do absolutely anything and everything to prevent myself from vomiting (I can count on one hand the number of times I actually have thrown up).  I was never the friend who would hold your hair back for you during the act, and I don’t check on my husband when he’s in the midst of a battle with food poisoning. 

Generational change

When I had my son, I immediately felt an immense sense of selflessness.  I would do anything in the world for him and loved him more than life.  Still, I worried over how I would deal with this fear of mine.  I got through the baby vomit stage just fine, but when he started on solids I started to obsessively worry about him getting the stomach flu.  How would I handle it?

The stomach flu is not actually the flu, but rather one of many viruses (such as norovirus and rotavirus) that attack the gastrointestinal tract, causing nausea, vomiting, and diarrhea.  According to the Center for Disease Control, it is spread by eating contaminated food, touching contaminated surfaces, or having direct contact with an infected person.  Daycare centers, schools, and cruise trips are common outbreak settings (you will certainly never catch me on a cruise).

The impossibility of avoiding vomit

One winter morning when my son was about 18 months old, we walked into the Andersons market to do some shopping.  Without warning, it happened.  He threw up as we were entering the store.  I was startled, but incredibly, I did not feel rattled or anxious.  There was no time for that.  He, on the other hand, was crying, extremely frightened.  My only instinct was to comfort and reassure him.  I was amazed at the ease with which I handled this.

I added another notch to my belt last summer during a family trip to New Hampshire.  We flew the first leg of the journey and drove the remaining 200 miles.  The narrow, winding, mountainous roads were making me queasy; I was begging my husband for the umpteenth time to slow down when a distressed cry of “Mommy!” came from the backseat.  I turned around just as my son got sick all over himself.  Once again, I was able to put my own discomfort aside to focus on my son.  Even better, this time my husband was there to help clean him up and change his clothes while I did the consoling. 

So far this winter we have been lucky, but exposure is inevitable.  The preoccupation I have endured for so much of my life is slowly letting up.  I do stash towels under his crib for easy access and keep a barf-cleaning kit in my car (which I made certain had a leather interior because it’s easier to clean).  We always wash our hands the minute we get home from any outing, and I am a bit obsessive with hand sanitizer usage when on the go.  Unfortunately for me, vomit is something you really cannot prepare for with a toddler.   I take a bit of comfort in the knowledge that I’ve handled it twice now, and am confident I will do so again throughout my son’s childhood.

Some tips:

1. Keep a carpet cleaner’s number handy
2. Draw a smiley face on the bottom of a bowl and tell them to aim for it
3. If they don’t make it to the bathroom, tell them to stay in one spot (it’s easier to clean)
4. Have your pediatrician call in some Zofran
5. Offer ice chips instead of fluid until they are well- tolerated
6. Lots of cuddles and extra love are in order