A main concern of mothers is that their children might not eat enough or do not eat what they should, and often refuse what they cook. Sometimes mothers cook two meals, one for the parents and one for their children. Meals become a continuous struggle where mothers chase their children and might feed them up to an age of 8 years.
Hearing all these stories, it seems to be a very difficult task to feed children and we are often asked for help to solve this problem.
But things are not that straightforward as it seems at first. There are many reasons why children might refuse to eat and often we find several of these reasons simultaneously. That means, before jumping to solutions we must analyze what really happens. Only then we are able to improve the health of a child and the functioning of a family.
Why don’t children eat enough or refuse food?
1. The child might not be hungry
a. Parents might have excessive expectations of what a child should eat
Parents have certain ideas of what children should eat and how their children should look like. These little round babies with a lot of fat on their cheeks, the belly and the thighs give them the impression of health. But nothing can be further from the truth. Overweight is not an expression of health. As half of the children in Greece are overweight or obese, parents get a wrong impression when they look at other children. The sad reality is that many children are just overfed. They are literally fed up with food. Therefore, they eat only what really attracts them and what is easy to consume.
b. Children are snacking too often
In former times, food was provided at certain hours and to certain occasions. But nowadays food is everywhere. Children eat all the time. When mealtime comes, they are just not hungry. They react lukewarm to whatever they are offered, not eating with interest or appetite. This does not establish a good relation to food.
c. Parents never wait until the child gets hungry.
Many mothers fear that a child might not eat enough and consequently feed them continuously whenever an occasion occurs. Mothers are happy if the child ingests the quantity of food they imagined as appropriate for a day. Moreover, there is a tendency to spare the child of the unease of hunger. But it is very good for children to be hungry. Hunger reduces the resistance to insulin which plays an important role in the development of obesity. Hunger increases the joy of eating. Hunger strengthens willpower, motivation and endurance. Hunger provides a driving force to eat more healthy food. Without this feeling of hunger, the relation to food is fundamentally spoiled. Children become unable to distinguish between hunger, sadness or boredom. This inability to feel hungry is a first step into chronic diseases. Working with obese, the discovery of hunger is an important sign and major step towards health.
Conclusion: In Greece there is a major problem in dealing with food, especially in children. It is no surprise that Greece is one of the leading countries of childhood obesity in the world. The dysfunctional relation often starts with the first days of life, or, at least during the first months. When parents become aware that there is a problem, often at an age of 6-8, already deep-rooted behaviours exist that are not easily changed. It is rarely about a child not eating enough.
2. The child might not feel well
There are many other reasons why children have no real appetite. Children suffer from a latent unease. They just do not feel well and express this in different ways. Not eating is just one.
a. Many drugs create a feeling of unease or lack of appetite.
Children consume a lot of drugs from the very first days of life. Too many things are pharmaceutically treated when a cautious natural treatment would do the same. Drugs seem to solve problems more quickly, but they leave their imprint on the vitality of the child. Nearly all drugs may affect appetite and wellbeing. Iron is a substance well-known for disturbing the function of the intestines. Many parents are surprised that all asthma sprays might create nausea, dizziness and influence the appetite of a child. The same do the nasal decongestants and they should not be used up to the age of six or even twelve according to different official guidelines.
b. A spoiled gut flora changes appetite, energy and behaviour.
When the gut flora is disturbed, children often suffer from this kind of unease that is characterized by a lack of appetite. The composition of the flora highly depends on the kind of food children eat. If children consume too many sweets, they breed in their intestines certain bacteria that release hormones which induce a craving for sweets. That means that the craving for sweets it is often not only an inadequate behaviour of the child. It is a real addiction induced by internal hormones. Accordingly, many life-style factors change the composition of the gut flora strongly influencing the behavior of a child. Even depression is attributed to a spoiled gut flora.
The flora might be deranged by many drugs. Especially antibiotics have a long-lasting impact on the gut flora. But also, the antacid drugs given for the regurgitation of the baby might fundamentally change the gut flora. That is, the disturbance of the gut flora might have its cause many months before the development of the lack of appetite.
Conclusion: Improving the gut intestine should be a major concern in feeding and is more important than body weight.
c. Children might have too little exercise and too much screen time.
Screen time impedes well-being and changes appetite. With a lack of motion children get not as hungry as they used to have in former times with more somatic challenges. Moreover, with more screen time kids snack more often. At times, parents use the screen to feed children, even reinforcing this connection screen and food.
Conclusion: Restricting screen time is an effective method to create a healthier relation to food.
d. The child does not like the smell and taste of the food
Children who are brought up with a lot of processed food have an underdeveloped taste. Even the receptors on the tongue are under-developed. When children express their dislike for a food with a loud Ugh, they really feel that way. The destruction of the natural taste starts early in life with all the sweetened milks, teas, drinks and creams that are often enriched with artificial vanilla. This is how children become very early imprinted to industrially processed food. They never learn to taste real food and therefore reject it. Whereas babies easily try out many things, children between 4-8 are often extremely conservative, refusing everything new. This is called neophobia. At times already toddlers eat only noodles or cooked potatoes spitting out everything else. But these are phases and should not disturb parents. It just needs a bit of fantasy. The solution of junk food (“at least the child eats baked rolls”) should be avoided.
Conclusion: The education of taste is an important part in the upbringing of a child. It takes time and often patience. Especially when the taste receptors on the tongue are not developed one must be a bit creative. The receptors develop after a few months and children start to taste more naturally.
e. In refusing food children might express autonomy
Children, in growing up, develop an ever-greater autonomy. They go their own way. An important opportunity to demonstrate their autonomy is by refusing food. This is a natural process and can be handled with compassion and a smile.
The more anxious mothers are about the quantity of food, the greater the power of a child by refusing food and the greater the struggle on both sides. At times eating becomes a kind of war zone. Mothers design new tricks to overpower the resistance of the child and the child tries to make the life of the mother ever harder. Asking the therapist for support, parents just want another weapon to crush the autonomy of the child.
Conclusion: A struggle of power might be a main reason for refusing food. Handling this attempt for autonomy inappropriately spoils the family relation and lies the seeds for nutritional problems later.
f. Children might have their own problems
Not wanting to eat might be the expression of inner tension. Already starting with the kindergarten children might express their problems in refusing food. Especially when the behavior of the child changes abruptly it is important to search for events in the wider environment that might burden or even harm the child.
g. Children might refuse food due to a family legacy
It is a common pattern that men like to eat meat every day. By refusing a healthy diet, children support their father and follow their prototype. Respectively eating mothers’ diet, they support the mother and her legacy. Eating certain foods and refusing others becomes an expression of inner-family struggles that has nothing to do with food or taste. Quite often also the grandparents are involved in these inner familiar contest and dispute. Yet, family struggles are normal. They just should not be acted out in the field of eating.
h. Advertisements, peers and the confession to food
All food advertisements agree in one point: Food is lifestyle and a confession. Certain foods and drinks are fashionable. The advertisement pretends that consuming these products one will feel joy, life, freedom or whatever. Social groups follow such messages and define themselves by a certain way of consumption. A child trying to belong to such a group will also adopt this eating and drinking style.
Parents who try to provide their children a healthy food and who do not want to leave their children to the market, have to take this into account. Trying to convince their children to eat a certain food because it is healthy will be a failure. “This is good for you” is not thrilling and has no sex-appeal. It has no chance to compete with joy or freedom. Healthy food has a different kind of advertisement. Healthy food is an expression of cleverness (in contrast to the stupidity of following stupid ads). It is tasty, although it needs a bit of effort to discover it. It is fun and creative. It is an expression of the will to live a good life. It is energetic, much more than energy drinks.
Healthy food provides a different approach to life, an exciting one. It provides quality and satisfaction. It is much more than just getting stuffed and making it through the day.
 Modified after Fishel AK (2015): Home for dinner, New York, p 25