Have you ever described your allergic child as a fussy eater? Do you find it challenging to ensure your child eats well? What does it all mean for children with a special need such as food allergies, coeliac disease, diabetes or other health conditions?
On our first visit to the children’s dietitian at our local hospital, I was taken back when the dietitian began to glare at me as I tried to communicate my child’s health issues. “Shh ...Don’t say it!”, she would interject.
We were there for tips and ideas for eating well, as well for weight gain. I kept inadvertently, as if it was some sort of subconscious tick, repeating “…Yes, he’s a “fussy eater”…. right in front of my little man! Despite the dietitians' observation that indeed little ears were listening!
Yikes! I reflected. Yes! I had been blurting out “fussy eater” quite a lot. This really began when I would try to explain to others why my allergic child would refuse food, make faces, or take ages to eat his snack or meal. As if I had to justify the behaviour, as if it was not normal. I felt I needed to communicate to others, to reach out and help them relate by attaching this label.
Even though I knew there was much more to it, I didn’t really think every occasion allowed for a full explanation, a very long story about our history with food, anxieties, ED trips and the like. But the shortcut - affixing a label - was often done and said in front of my little boy. It seemed easier to nod, “Yes, he’s just a picky eater…”. Finally, I could reconsider this, and felt reassured by our lovely dietitian. But I also realised this label might stick if I didn’t make a change!
Allergies, asthma, diabetes, coeliac disease and a myriad or combination of health issues can easily tip your child in to becoming a reluctant eater, or worse lacking nourishment or even underweight. We were there to see our dietitian for multiple reasons, and number one was trying to gain weight, and get back on the graph. As parents know, children in particular need that little bit of extra weight, in case of illness when weight can drop dramatically.
So why is it that kids with food allergies and other health issues can struggle with eating? And how can we help our children eat well and live well? Maybe the first step is awareness and understanding.
Food fears can loom large
Anxiety around food is a normal but significant issue for kids with life threatening food allergies. We can help our children overcome these worries, which can be overbearing. The fact is living with food allergies is a lot of worry for little shoulders.
These food fears and the fussy eating age of 3-5 years (for all children) - neatly or not so neatly - coincided for us. Suddenly, a child that would stuff a whole avocado in his gob, now would push his plate away. We would often sit for over an hour trying to get our child to eat a meal. This is what an anaphylactic reaction can do to a three year old. Favourite foods, or rather the only foods eaten go down to 3 then 2 ! What then?
Perhaps one of the main issues for children at risk of anaphylaxis, is that they don’t understand the why and how of these sudden emergency events like a serious food allergic reaction.
Monkey see monkey do
Parent anxiety and role-modelling is big, as our dietitian helpfully pointed out. But of course as all food allergy parents know, when their children are little in particular, they do need to be vigilant. And here’s the hard part. Holding yourself back when the lady at the shop with such a sweet smile, offers an allergen laden chocolate bar to your child, and you rush over and push it out of the way like some kind of commando in slow mode… “Noooo! “you hear yourself! As you reach out to prevent the event! As if you were trying to stop a truck heading towards your child.
Maybe it’s an overreaction? YES it was… Then the tears come. Wrong again mum! Striking the balance between vigilance and being over the top can easily become blurred, especially in the early days or months of a food allergy diagnosis.
While you do need to be on alert, where you can be more relaxed, take the opportunity. Breathe, and take time to educate yourself, your family and your child.
I think it’s also worth the time to think about spending time on yourself as a parent. For instance, try to come to terms with your own anxieties as a food allergy parent or parent of a child with a health issue. Sorting out rational and irrational fears can really help. Ensure you can have some "me time", talk to friends and loved ones, and do seek professional counselling or advice if you feel the need. I found food allergy counsellor Sloane Millers’, Allergic Girl: Adventures in Living Well with Food Allergies to be a fabulous, intelligent resource and go to on this important topic.
After a reaction food fears can reappear
This is normal and I think anyone, especially children, need time. Time to de-stress, work it out and relax. Recover, talk things through, feel nurtured, feel safe. Play! Back on the trusted, safe and known foods is totally fine in my book and should be encouraged. Take it slow.
This is an issue most allergy parents will be dealing with from day one. Whether it’s preschool, leisure groups or school, there are often food related activities. Often you will need to be your child’s advocate. Unfortunately not every teacher or school will “get it”. Keep in discussion with the school. When food based activities are planned, you need to be informed in advance. If all the kids are participating in a food based activity then so should your child (even if that means a safe alternative). Watching other children eat and have fun, and sitting in the corner being left out is not acceptable. Kids look up to their teachers and when they are excluded by someone who cares and teaches their group, it’s inevitably hurtful and naturally doesn’t help their social emotional relationship with food. Keep the lines of communication open with your child’s teacher and school to ensure your child is safe and included in learning activities.
All in all, as a food allergy parent, I have made countless mistakes, but also we have had some wonderful triumphs along the way to eating well. Here are some of them:
- Spend time reading and checking packet ingredient labels together, even before your child can read. Tell them if it’s safe, it’s great reassurance.
- Touch, feel and be involved with (safe) food. This is something for all kids.
- Go to the market. I am thinking fresh food market here – but any market is great. See if you can encourage your child to pick out a safe food. Of course the safer areas of a market you know would be great. Smell an orange or try a different vegetable. We tried and loved purple carrots!
- Cooking in the kitchen. Get creative. Let you child be in charge when they want to take the lead, great for fostering independence. It can be simple - help butter toast, make a special juice, make pizzas or cupcakes with a friend - whatever you can do that works. Food connection and learning food safety are both great skills for your little person.
- Acknowledge. Adults are also discerning, picky eaters who have foods they love and foods they won’t eat. What are yours? It’s perfectly ok, and great to have favourite foods that you look forward to. Accept that just like adults, there will be many foods your child will not want to eat, so long as there are many that they will eat or at least try.
- Vegetable Gardening. Again, a little can be a lot. Grow a few herbs, carrots or snow peas even in pots, and allow your child to help plant, smell, pick and eat from the herbs or veges you can grow. Encourage positive connections between nature and food, food is natural, eating is natural.·
- Talk about where food is from. According to surveys many children don’t know where many of their foods come from, one survey found one in ten children believed sausage rolls are made by rolling them in flour down hills! Start conversations. Milk is from a cow, and then we make yogurt for instance. How do carrots grow? Where do apples grow? Be open to exposing your child to learning opportunities around safe foods. If your child has an interest in a food, follow their lead and extend the learning experience.
- Try a new food or dish every week. This is how you find the next food you love! Well this might be a little ambitious for some children, but keep the idea flowing that trying new foods is positive, and it’s something that you can keep working on.
- Allergy education at school. See if your school will be involved in a food allergy education program. Donate some inclusive children's allergy books to your child’s school or kindergarten. Educating your child’s peers can really help them to feel safe, supported and included.·
- Keep eating times as relaxed as possible. This is difficult when you have had a busy day, but keep in mind this can make a big difference. Reluctant eaters are often slow eaters who dawdle over their plates. Trying to hurry children to eat can cause them to become stressed, and put them off their food. Be patient, and let kids eat in their own time. Again this is tricky to get the balance right, especially if you’ve ever sat with your child for over an hour at mealtimes.
- Be social! Even for allergic children this is so vital. This is one way in which you can take the emphasis off your child. Children with health issues such as food allergies, diabetes or other conditions often have all the attention on them. Socialise whenever you can even if you are taking your own food, whether it’s a picnic at the park, play-date or dinner with friends, allow your child to learn to eat in a social relaxing atmosphere. This can take time for some children, but persist when you can.
- Talk about food in positive ways. Don’t overdo it of course, but role model about your enthusiasm for food, talk about your favourites. While we try to teach our children the dangers of food, we must also emphasise how food is fun and awesome!
- Make it fun, or change the setting. Be creative! Eat a picnic in the lounge room, eat outside on the grass if it’s sunny, at the park, or with good friends. We have had many picnics inside, with cuddly friends (soft toys) joining in!
- Be aware of stressful situations. We attended a party once and there was an unusual amount of allergens on the party table. We brought our own food, but my son became very stressed that something might happen. We talked it through and sat separately, but it’s good to be aware in these cases, and get through them together. We focused on the fun in this instance rather than the food.
- Imagination and food. Stories and shows that include scenes about food, can provide opportunities to discuss or create appetite in positive ways. If Jake from Adventure Time is enjoying pickles or pie, then maybe you can do the same? Is your child crafting a farm on Minecraft? There are foods in the game they might want to try in real life. Think about advertising, how many times have you seen a commercial that made you think that burger looked great? Or looked at Instagram pictures of food and suddenly felt hungry? Mind and body are connected, this is especially true with food. Opportunities can be anywhere. And imaginative stories can be one avenue for positivity.
- Appetizers. Children are just like adults. Sometimes it can be a case of just getting the eating process started, for instance, pickles, finger food, fruit or a small very light healthy snack before dinner might be what works. Sometimes the more you eat, the more you can eat!
- Food that looks good, tastes good. Sometimes a new plate, or cute side garnish might just help. Again make it fun. No one needs be a chef or artiste, but a little excitement can go a long way. This is especially true when you have a very limited diet due to food allergies.
- Don’t overload the plate and overwhelm. It’s the best thing ever when you hear… “Heh! I ate it all!”, with such glorious satisfaction… or even, yes… asking for seconds! These are great self accomplishments worth celebrating. And it’s part of setting achievable goals too! We all suffer from too much pressure at times, and children are no exception.
- Try to be mindful of other health issues, that might interfere with eating - such as teething, a sore throat, a blocked nose, or an upset tummy. We have had a lot of sore throats that were related to environmental allergies - the sore throats were fairly frequent for some time. So, in this case we would compromise with softer foods, and didn’t force chewy meat, or other foods that were painful at the time.
- Keep offering new foods even if your children rejects them at first. This is really true for younger children in particular but also as children get older their tastes might change. Experts generally think that kids need to see and taste new foods several times before they become 'familiar' and are accepted. Don’t give up too soon!
- Eat out if you can. Find a safe restaurant that your allergic child/ren loves. Allow them the experience to gorge safely and feel normal, and relaxed when eating out. This is really a big one in my book.
- Tackle bullying. Be aware of any bullying in the preschool or school yard. This can adversely affect appetite too, as food allergy teasing/ or bullying can cause a sharp rise in your child’s anxieties and become very stressful all round.
- Talk. Be aware of your child’s anxieties, and keep discussing and educating. They don’t know and fully understand how to stay allergy safe yet. For instance, our child would be scared to ask or even accept a glass of water at a friends’ house. We would let our son know it’s safe, and why, and talk things through.
- Take the emphasis off your child. As above, make it social. Eat as a family. Eat at the same time as your child. Children with health issues like allergies or diabetes feel the pressure on them. Try to divert attention away from them when you can, and let them be.
When we were really struggling with encouraging our child to eat, we discovered
A special soft toy, friend or puppet can, help some children as they do in therapy – express themselves when they are stressed, help open communication and create a voice for an anxious child.
I am sharing my tips as an allergy mum, I am not offering expert or medical advice, but I do highly recommend visiting an experienced children’s dietitian, or specialist qualified counsellor if you feel the need. It can be a tough road to help your child become healthy and confident, but hang in there. If you have any tips, or strategies that have helped encourage your child and you would like to share, please contact us.