Challenges with Eating

What do you do if your child has trouble with food or meals? Many children with disabilities or special health care needs have challenges with eating, food or weight. You might be trying to figure out how to help your child eat more, eat less or get food into their body if they can’t eat on their own.

As a parent, you’re already doing many things to help your child. So, when they have a hard time eating, it can be stressful and scary. Also, food can be such an emotional issue. You might be worried that other people are judging you.

It can also wear you out. You don’t want every meal to be a fight. Your relationship with your child is more important than if they eat the same thing for a week straight or skip meals. But you don’t want to watch your child get sick, run out of energy or stop growing.

You are not alone. This page has tips and stories from parents dealing with eating challenges. We hope that it gives ideas and support for today, tomorrow and beyond. As one parent said, “You feel like a failure, but it’s not your fault. Don’t blame yourself! Don’t take it personally!”

Different Kinds of Eating Challenges

Eating challenges look different in each family. Some children flat out refuse to eat or have anxiety. And others only want to eat certain kinds of food. Some children lose weight or stop growing. And others might gain weight easily. Some children need the help of a feeding tube (also called a g-tube), a doctor, a therapist or medication to eat. Medications might also get in the way of eating or hunger. So can sensory or other physical conditions like reflux, low muscle tone and other oral motor issues. Mental health and body image or weight worries can play a role too.

Sometimes, you don’t know exactly why your child has an eating challenge, but you and their doctor are worried. Below are some of the main eating challenges we have heard about from parents.

Failure to Thrive

Children who don’t eat enough or can’t keep on weight might be diagnosed with failure to thrive. This means that a doctor sees that your child is not growing or not growing fast enough. They are shorter and smaller than most other children of the same age. They might have delays reaching their developmental milestones (something a typically developing child should do around a certain age).

These are scary things to hear as a parent. You wonder, will my child be OK? Did I do something wrong? What happens next?

First, know that many children have had this condition: 5 to 10% of all children in the United States get this diagnosis. And there are many different causes for failure to thrive.

Here are a few quotes from parents who dealt with this diagnosis:

“I went home from the doctor and tried the hardest I could for a year – different foods, textures and recipes. I let my aunt, mother-in-law and mom cook for him. The speech therapist came with her blender, straws and cookware. It was enough to make my child sweat every time he saw us holding a spoon!”

“Take the time you need to collect yourself after hearing about failure to thrive. Collect information and research it. Go with your gut. Is this doctor helpful or not?”

“My son is not motivated by food and is underweight. It may be due to his disability and medicines. Our doctor tells us to feed my son fattening things. Like Oreos or pancakes or mashed potatoes.”

“My 3-year-old was 19 pounds when he got his first g-tube. Things got worse before getting better, but they did get better. He started gaining weight and his immune skills got stronger. He could work harder in therapy and improve his motor skills. But something in the back of my head kept telling me I was failing as a mom. Now, when I look back, I know that I did everything I could and nothing else worked. This was the best decision for my son.”

“When my daughter was a newborn, she didn’t have enough strength to suckle. As a new parent, I didn’t know it was a problem. We tried breastfeeding and different nipples on bottles. She was labeled as failure to thrive, which was scary. And then, she had coordination problems with swallowing. Sometimes she couldn’t breathe, so she would panic and not want to try to eat. Now, as a teenager, she eats too much, sometimes until she throws up. We’re working on showing her smaller portions. Just keep trying and don’t blame yourself!”

After a Failure to Thrive Diagnosis

A failure to thrive diagnosis might be the first step to another diagnosis for your child. If you’re just starting your journey as a parent of a child with a disability or special health care needs, see our Diagnosis and Health Care section.

After your child gets a failure to thrive diagnosis, you and your child’s doctor usually make a plan. The doctor might want to talk to you about your child’s eating. They might do some tests to see how your child’s body manages food. The doctor might recommend adding formula if you’re breastfeeding. Or they may recommend adding in high-calorie food or supplements if your child is eating solids. After trying other things, the doctor might suggest that your child get food through a g-tube.

Because there are so many different reasons for failure to thrive, every family’s plan is different. Usually, it’s a process of trying different things and staying in touch with your child’s doctor. You might need to see different doctors or specialists too. See more about solutions for eating challenges later on this page.

Sensory Issues With Food

Some children only like certain types of food. Some have a hard time trying new foods or textures. We heard about children who only wanted mashed potatoes, applesauce, waffles or milk. Many eating challenges are connected to sensory processing issues. This means that a child feels something like a traffic jam in their senses. Too much is happening at once and it’s hard for the child to deal with it. This may include the texture or taste of foods. Even if your child doesn’t have a sensory processing disorder diagnosis, sensory issues might still be the reason for their eating challenges.

Here are some quotes from parents of children with sensory conditions:

“My son has sensory processing disorder. Eating has been a challenge since he was very small. He is at a healthy weight now, mostly because we sometimes get him fast food. He also drinks milk now. And we can hide a lot of good food on a homemade pizza. Or in a smoothie.”

“She refuses to eat unless it’s a food she knows. But we no longer force her to eat. She knows she might have to wait a few hours to eat again if she doesn’t. We made that clear.”

“I just keep trying new things with my son. And I let him enjoy safe foods. Every so often, he’ll try something new that he really likes!”

More than one parent told us they didn’t want food to become a big issue. So, they had to learn to let go sometimes and let their children eat what they liked best for that day. They knew they could always try again another day.

Medications and Eating

All medications have side effects. They can help or heal one issue and create another problem or side effect at the same time. Some medications make some people feel sick to their stomachs, not hungry or extra hungry. Some medications change the way a person’s body deals with food. They can gain or lose weight faster than they would without the medicine.

If your child takes medication or prescription drugs, or is going to start, it’s important to know about the side effects. That way, you, your child and their doctor can decide if the medication is worth it. Does it help more than it hurts?

Also, is your child taking more than one medication? Or a new medication or dose? The way different medications work together might cause eating or weight challenges. Every child’s body responds to medicines in its own way. If you want to know more about a medication, talk to your child’s doctor or pharmacist. It’s a good idea to ask many questions so you know what might happen.

As one parent said, “With doctors, make your voice heard. In our case, we had to try different specialists. Ask about the side effects of medicines. My son can’t tell us about those – losing appetite and nausea. Stay on top of it with your child, but don’t force them. And if they’re not eating, hydration and drinking are still key.”

You know your child best and how they’re doing. After they start a new medication, you can watch for changes in their eating or weight. Don’t be afraid to go back to the doctor or pharmacist and ask more questions. You can always ask if there’s a different medication your child can try.

Solutions for Eating Challenges

There is no one way to solve eating challenges. Just like children grow and change over time, so might their eating. The parents we talked to had all been frustrated and scared at some point. They also shared many things they learned along the way that helped or gave them hope.

When solving eating challenges, working with a doctor is usually an important part of the journey. A nutritionist can be important too. They can look at your child’s food, blood work, medicines and more to see where there might be a problem. You might also work with other health specialists or therapists. Speech therapists can evaluate people with eating challenges and help them find solutions. An occupational therapist might also be part of the treatment.

Find a doctor and other professionals you trust. You want them to be partners with your family. To help keep track of everything, see if your child’s doctor will be their medical home. A care notebook is helpful too. You can keep notes and facts about your child’s eating and weight to share with doctors and others helping you.

Below are some solutions to eating challenges that worked for other parents. There are many ideas out there that you might want to try. This list is just a start:

• Find out what food your child likes. Bring it along when you leave home.
• Try different textures and temperatures for food. Maybe try different brands.
• See where you might “hide” food in other food. Like veggies under cheese on a pizza or in a smoothie.
• Drinks like milk and smoothies can be a meal too.
• Try supplements, like PediaSure or protein powder, and a good daily vitamin to fill in the holes in your child’s diet.
• Talk to your child about different foods and what they do – foods that help with weight gain or weight loss. A nutritionist can talk with you and your child about this too.
• Show your child what a food portion should look like using a measuring cup.
• Try using fun or interesting names for food. For example, one family knew their daughter liked pizza. They found ways to put different kinds of foods into “pizza sandwiches.”
• Don’t worry too much about sticking to regular mealtimes. Your child might need to eat when their body clock is ready. Try to be flexible.
• Give your child some control and don’t force it. As much as you can, be patient.

And to save money when dealing with eating challenges:

• Buy the foods your child likes in bulk! Look for coupons.
• Sign up for WIC if you can for help getting special formula, PediaSure, etc.
• If your child has a g-tube, you don’t have to buy special food. You can get everything you need at a regular grocery store without spending a lot.

This Friendship Circle article also has some solutions to eating challenges for children with disabilities or special health care needs.

If your child has an eating disorder that is a mental health condition, talk to and work with a professional for ideas and solutions. Also, see our Eating Disorders page to learn more.

And here are some quotes from parents with ideas and words of support:

“Keep a sense of humor and compassion for your child! Would you eat a plate of worms if someone offered it to you? Of course not! That's how our kids see these foods we think are great.”

“If you find a food your child will eat, buy a lot of it!”

“There’s a lot of stigma around g-tubes. People try to blame parents or say they’re lazy or giving up. Don’t listen to other people who don’t know what you’re going through. It was right for us. You gotta do what you gotta do!”

“When my daughter was little, maybe 4 years old, we put a microwave at her level. She could reach a box of instant mashed potatoes or frozen meatballs. She could make herself a little bowl and warm it up. She got to take control.”

“Your relationship with your child is more important than food. Yes, of course, I want my child to eat well. And, of course, I'll keep offering. But at the end of the day, I don’t want our connection to each other to get lost in the challenge.”

“Our whole family eats on tiny plates for breakfast and small plates at dinner. It helps my daughter know how much is enough food. And we talk about it.”

“Keep your relationship with your child more important than the food they are consuming!”

You can read more about one parent’s story in our eating challenges article.

When you’re dealing with eating challenges, there will probably be many moments where you need to stop and take a deep breath to think about your next step. Every parent we talked to said they had to get creative and just keep trying. Your child’s eating challenges are not your fault. And there are things you can do to help them.