My Child Won't Eat

"My child won't eat" is a common complaint but the problem is usually that your child is a picky eater rather than the child won't eat anything at all. Having said that, there are some children, particularly those born prematurely or with health problems, who miss the window when children learn to eat food and feeding in these children can be challenging.

This page covers both picky eaters who are growing and those who are not growing so well or have very limited food they will eat (usually those who have had medical issues as babies) and may even still have a nasogastric tube (this is the child who will not eat and therefore needs to be fed). 

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Should I be concerned if my child won't eat?

In most cases when parents bring their toddler to me because they are worried about them not eating enough, I look at the child and see a well nourished, happy child who is developing normally and whose behaviour is within normal limits for that age. 

However it is still a concern for the parents who come to me that they have a child who only picks at food or never eats the meals put out for her. It's understandable that they say their child won't eat. 

If your child is growing appropriately and is happy and developing normally, don't be concerned. Even though you think your child is not eating, she is getting enough calories to grow and that's what's important. A child won't grow if she doesn't eat anything. So if your child is growing, then she is having calories - this may be by having drinks such as fizzy soft drinks or juice, or having a bite of a biscuit here and a potato crisp there. Nevertheless, your child is having food. To read about how you get your child to have normal family meals, click here.

If your child is not growing appropriately, then you need to see your doctor. If you have a child who had health issues as a baby, your baby may have missed the window of development when eating is learned. This poses specific challenges - read more

To check your child's growth, click here

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How can my child be getting enough calories if she doesn't eat much?

Children who seem not to eat anything are usually grazing. Grazing refers to eating and drinking a little bit at a time throughout the day. I have parents who say, "but she only has half a biscuit" or "she only drinks half her juice" - they are probably right but half a biscuit contains calories and so does juice.

As long as they have access to food, children are very good at getting the energy (calorie) requirements they need. And the fact they are growing appropriately confirms this. Grazing is a common reason a child won't eat meals.

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Why won't my child eat at meal times?

If your child is grazing, then she is getting enough calories and so she won't be hungry at mealtimes (so she won't eat at mealtimes). Children get a lot of their calories from milk, juice and fruit-flavored drinks and so it's important to limit these.

Once a child is over 12 months of age, she should only be having about 2 cups of milk per day - children who have more than 2 cups of cow's milk daily can have low iron stores which in turn reduces the appetite - to view appropriate nutritional requirement for your toddler, click here. If your child is drinking a lot of milk, cut this down to no more than 2 cups per day and consider an iron supplement to see if your child's appetite improves.

Sometimes, a child won't eat at the mealtime because she knows that if she doesn't have the meal, she will be offered something else afterwards. Parents do this because they are worried about a child not eating but, in fact, it only makes the problems worse. Of course, your toddler will hold out for the preferred food if that's what happens every time she refuses dinner.

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Should I force-feed my toddler?

Absolutely not. This will only make any poor eating habits worse. Pay no attention if your child won't eat her meal. Remember you have to ignore behaviors you want to eliminate and praise behavior you want to encourage, so "well done for having that piece of carrot" etc, while not making any fuss that your child hasn't eaten anything. To read more on behavior management, click here

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How can I get my toddler to eat at meal times?

Some children are happy grazing and their parents are happy with them doing that. However, if you want your child to eat at mealtimes, you need to do the following:

  • decide on when you are happy for your child to eat - usually 3 meals and 2 - 3 snacks per day (breakfast, lunch, dinner, mid-morning snack, mid-afternoon snack and perhaps a before-bed snack)
  • do not give your child anything to eat or drink other than water (for thirst) between meals or any water just prior to a meal
  • at mealtime, give your child her meal using appropriate serving sizes (to view information about serving sizes, click here) and don't make a fuss if she doesn't eat anything, but give positive reinforcement when she does eat. After 30 minutes or so, if she is not eating, just remove the meal
  • give lots of positive reinforcement for eating any of the meal - "good job for eating your vegetables"
  • continue with this pattern at each meal / snack timedo not make a fuss or seem concerned if your child won't eat
  • when your child realizes that there is no food at other times, she will eat but it might take a few days. As she will have access to water in between meals and food available regularly at mealtimes, she will be fine

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What if my child doesn't eat for days?

That often happens. If your child is used to being offered an alternative if she doesn't have her meal - which parents feel obliged to do - she will expect an alternative. She has a strong will and will hold out as long as she believes that will work for her (and if you give in, then it will have worked for her). She will be fine not eating for a few days - I tell parents not to be worried even if their child doesn't eat for a week.

If you give in and give food between meals, your child will just learn to be more stubborn at not eating at mealtimes.

If you feel very uncomfortable with your child not eating at meals, rather than give in completely, offer something that you know your child will eat at the next meal / snack time. The message will still be "food only at meal or snack times" but you can relax because you know your child has eaten something. Lots of parents will give their child a before-bed snack such as milk as they know their child will drink this.

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How can I make meals more appealing if my child won't eat?

  • Make sure the portions are not too big - an appropriate serving size for a food is 1 tablespoon per year of age (so a 2 year old only needs 2 tbsp) or alternatively one serving is the size of the palm of your child's hand. A main meal would have one serving of meat/protein, one serving of potatoes/rice and 2 servings of vegetables.
  • Try raw vegetables cut into bite-sized pieces
  • Put a variety of bite-sized finger foods on a small plate for your child to pick at
  • Put the dessert (for example, fruit) on the same plate as the main meal
  • Give more food if your child asks for it
  • Give positive reinforcement for eating and have no drama if she doesn't eat. Don't be too over effusive with the positive reinforcement either - keep things natural
  • Remember a child won't eat food that is unappealing or if it seems too much or too hard to eat. So take the time to make the food look appealing and keep portions small and bite-sized

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How can I introduce new foods?

When a child won't eat a variety of food, it is natural for the parent to become concerned, particularly about whether their child is getting a nutritionally balanced meal.

If you have a child you are still feeding, introduce the new food by giving one spoon or bite of the food at the beginning of the meal - do this daily for a week to 10 days and your baby will probably be happy to continue eating that. You can't give up after one try - you need to try several times.

For older children who are picky, introduce a training plate that goes on the table next to your child's plate. Or you can try the Food Picnic. Remember a child won't eat what is not offered. You may have to offer the food in innovative ways, though.

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How does a training plate work?

A training plate is something you can use to introduce new foods to your toddler while still giving them some control.

The training plate can be a small plate that goes on the table next to your child's meal plate. Put new foods on that plate in bite sized pieces (use different shapes and colors) and encourage your child to put one piece of food from the training plate on his meal plate. Ideally, that piece of food should be eaten but in the first instance, just moving a piece of food from the training plate is enough, even just playing with the food is enough. Give positive reinforcement for any action that is involved with your child "interacting with a new food". You could have a star chart for showing progress with new foods - read more. Keep doing this every day occasionally changing the new foods to be introduced. But don't remove a food from the training plate just because your child didn't like it the first time - every food should be tried at least 10 times. Many times when a parent says their child won't eat a food, I discover they have only tried it a couple of times - that isn't enough.

One important point about the training plate is that the child has some control of what they eat, so they put the food from the training plate onto their plate - you don't suggest or help them do that, just be ready with lots of positive reinforcement when they do. If they choose not to put any food on their plate, don't be concerned or make a fuss about it. In the first instance, your child might just play around with the food on the training plate - that's ok. There are steps between a "child who won't eat a food" and a "child loving a food".

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What is a Food Picnic?

When you have a picky eater and you are trying to introduce new foods, a food picnic is one way that can help. Have a picnic where you put a big sheet on the floor. Have lots of little plates - attractively decorated - with bite-sized food. Have a variety of foods, with different colors, textures and shapes.

Invite other children to the picnic - they can be a similar age or older or younger. Just let them have fun on the floor exploring and eating the food. Don't try and coax your child to try this or that, just let them be. They will learn from the other children eating. It is likely that they will try a new food the first time - even if they don't like it, trying it is an achievement.

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What if my child is not growing well or has a nasogastric tube?

This section is really for the child who won't eat because they had/have health issues (including being born prematurely and/or having nasogastric tubes for feeding) and missed the developmental window when children usually learn to eat.

These infants often still have nasogastric (ng) tubes in place or will not be showing good growth and have limited intake of food, sometimes even an oral aversion (because they associate their mouth with horrible things that have happened to them like ventilation tubes etc). I expect that because of the health issues, your child will be having medical input.

All of the advice above for "My child won't eat" can be used for infants with medical problems, but you may have to do things more slowly and you may need to have a doctor who oversees the process who is relaxed enough to know that your child may initially lose weight as they transition from ng feeds to feeds by mouth or as you introduce new foods. That is ok. We expect there to be some weight loss initially. What we are wanting is a change from a limited oral diet (so a child who won't eat hardly anything) to a diet that contains a variety of foods and a child who is happy to experiment. The change may take time but if you perservere it will happen.

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When Should I Seek Medical Help?

See your doctor if your child has any of the following issues:

  • weight loss
  • gagging or choking on food
  • very limited variety of food (as there may be nutritional deficiencies)
  • refusal to eat complete food groups, e.g. vegetables
  • unusual sensory issues, eg. unusually concerned about texture

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References

  • Fox MK, Reidy K, Novak T, Zeigler P. Sources of energy and nutrients in the diets of infants and toddlers. J Am Diet Assoc. 2006 Jan: 106(1 Suppl 1):S28-42
  • Green C. Toddler Taming. Doubleday. 2001. ISBN: 1 86471 053 5 - this has great information on what to do when a child wont eat

To go to the top of My Child Won't Eat page, click here

To read more about Toddler food, click here

To read about what constitutes a Healthy Toddler Diet, click here

To go to the main Behavior page, click here

To go to the Growth page, click here

To return to the Home page, click here


Last reviewed 29 December 2015

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Dr Maud MD

Dr Maud MD (MBChB, FRACP, FRCPCH), a specialist pediatrician, provides health information and medical advice for parents of babies and toddlers. Read more about Dr Maud.



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