What Will My Child Eat?

By William J. Mesibov, MD

Aside from serving his own practice, Kidfixers, in Syosset, Dr. Mesibov has served as a teaching attending physician at Long Island Jewish Schneiders' Children’s Hospital for more than two decades, is an attending pediatrician at the North Shore University Hospital in Manhasset, and author of the book, "Where in the World Did You Hear That? A Pediatrician Separates Fact from Fiction." He can be reached at 516-921-2122, willmesi@prodigy.net and www.kidfixer.com.

The first time I encountered a child with a food fetish, I thought his parents were joking. Their son, they explained, a well mannered, handsome twelve year old refused to eat anything but bagels and cream cheese. No meat, no chicken, no fruit, no veggies, no pasta, no rice, no cake, no juice. According to his mom, he had been drinking milk and eating bagels and cream cheese exclusively since he was a toddler. I thought he would “grow out of it.” I was wrong. He persisted following this bizarre diet throughout high school. No amount of coercion or persuasion by parents or doctors could change his eating habits. It wasn’t until he went off to college that he attempted to change. What happened? Away at school, he realized that he was considered “odd” and, finally, at the age of nineteen, asked me to refer him to a psychologist for help. With help, his eating habits eventually normalized. A good outcome at last but, who knows what arterial damage his years of cream cheese brought? Eating properly is more than a social skill, it’s the foundation for a healthy life.

Where in the world did you hear?

Lots of kids are fussy eaters. Don’t worry about their eating habits, they’ll outgrow them. Just make sure they eat something, it doesn’t matter what it is.

Sound Advice:

Bad idea! Pediatricians are challenged on a regular basis by children with compulsive eating habits. The food chosen by the compulsive eater varies from child to child, being as bizarre as Fruit Loops or Captain Crunch to more common items such as macaroni and cheese, peanut butter, frankfurters, chicken nuggets or french fries. And, of course, these kids never eat vegetables and almost never any finned fish. Parents of these food fetish children invariably yield to their children’s demands, thinking it’s only a “phase” and choosing to go along with desires of the child rather than face conflict at meals or refusal to eat entirely. This parental passiveness only reinforces the child’s fixation on his bizarre and unhealthy diet, often leading to a lifetime of unbalanced, unhealthy eating. Not all children will eventually see the light as the “bagel boy” luckily did. I’ve encountered adults who confessed to me that they can’t eat in public because the sight of “normal” food actually makes them ill. What a life!

Lopsided eating isn’t only a social liability, it’s a threat to health. It’s well recognized that a balanced diet consisting of vegetables, fruit, nuts, fish and dairy promotes good health and, according to some studies, a longer life by more than a decade. Diets high in saturated fats promote atherosclerosis and heart disease, even in the arteries of children and teens. Vegetables and fruits are sources of anti-oxidants, substances which protect against heart disease and cellular damage. Children who are allowed to grow older with unhealthy eating habits often continue these horrendous patterns throughout adulthood, suffering from obesity, suboptimal health and, in some, premature death.

So what can parents do? First and foremost, parents must not stand idly by while their child continues to consume unhealthy food. When I was quite small my mother often reminded me that the starving children overseas (in post WWII Europe) would be only too happy to eat anything and that I should be grateful to have wholesome food. I wasn’t grateful but I did respond to her chiding. And as a physician, I have found that children from less advantaged homes tend to reject food less than more privileged children. Why? Fewer choices. One no-nonsense caretaker grandmother was surprised when I asked if her grandchildren were picky. “Picky?” she looked at me as if I was strange, “They eat what I give them.”

Why don’t all children eat what they are given? They’re never hungry. The reason? Snacks. Well-meaning parents are often intimidated by their children’s refusal to eat. These poor parents allow themselves to be bullied and yield to their kids’ desires by giving them unhealthy snacks, high in fats and sugar, throughout the day. Naturally, when lunch or dinner is served, the kids have no appetite, vegetables and healthy proteins are rejected on sight. Faced with this rebellion, mom compounds the nutritional disaster by becoming a short-order cook, removing the offensive healthy meal and replacing it with macaroni and cheese, hot dogs, french fries or chicken nuggets. Afraid her children will starve if they refuse the food on the table, wanting to avoid a mealtime struggle, she unwittingly perpetuates an unhealthy routine.

Children are best served by three healthy meals daily consisting of a blend of protein, carbohydrates and fats. Snacking is unnecessary both from a nutritional and an energy pick-up standpoint. Yet, in our society, snacks have become woven into the daily routine of many families. Therefore, it is important that those snacks are healthy, consisting of fruit or vegetables and never given closer than three hours before the next major meal. Snacks which are high in sugars or fats are appealing to most children but are unhealthy and lessen the desire to eat good food.