The picky, allergic kid:

A client dialogue:

“Hi there, I’m Noa – Leah?” I greet the expectant brunette, who nods and half-smiles politely.

“Well thanks for being here. You are concerned about your 6-year-old who is a picky eater, right? Can you tell me more about what prompted you to reach out and make the appointment?”

Leah fiddles with her ring and sighs.

“My Aryeh has always been a picky eater – and he has multiple food allergies too – so feeding him has never been easy.”

“Wow”, I nod. “I am an allergy-mom too, so I can relate to that challenge.”

Leah’s face brightens – “Oh, that’s great – I mean, not the allergies - but maybe you can help me better.” She laughs

“I hope so! Tell me more.”

“Well, I mean he’s a great kid – really mature, smart, has friends… but he goes through school barely eating. I mean, he eats a snack bag in the morning, and I don’t even know what they give for snack in the afternoon. Anyway, his doctor was slightly concerned about his growth at his recent well visit – so he recommended we see a pediatric dietitian.”

“Hmm. Ok, thank you for that background. I’d like to hear more specifics. Can you tell me what he eats for breakfast?”

“So thankfully he loves cereal and milk, and he can drink almond milk”

We have lots more to talk about, but the #1 issue that I find with allergic kids is the almond milk, and I tell Leah as much.

“But aren’t almonds healthy?”

“Yes!” I enthuse. “But unfortunately, there are not very many almonds in almond milk. It’s mostly water – and you can serve it instead of water – but it’s a sorely inadequate milk replacement in terms of the protein.“

“Oh, wow. I did not know this. Which milk is better? He’s allergic to soy also..”

“Ripple milk. They even sell it in Gourmet Glatt. Made of pea protein. And it tastes delicious.

“No way!”

No-whey indeed; I chuckle mentally while I print a handy list of other substitutes for common allergens that I recommend. If Aryeh wasn’t allergic to soy I would highly recommend soy milk as well for its excellent nutrition profile. And now that we got this essential issue out of the way, we proceed.

“So, what happens after school? “

“Well, he’s starving when he comes home. He takes whatever snacks he’s in the mood of – pretzels, rice cakes, snack bags. And I don’t have the heart to say no to anything – the poor starving child. If he wants nosh, he has nosh. And then supper is a little while later.”

I nod slowly, listening. “How is supper?”

“It depends on whether he likes it. He either eats it, or he doesn’t. But he’ll randomly turn down food that he usually likes. I know he’s hungry, but he’ll just shut down if the texture is not exactly right and decide he’s not eating it. Honestly, supper is pretty stressful for me because it’s the only real meal that he eats and I want to make sure that he gets enough. I work hard to cook food that is safe for him and it is so frustrating when he won’t even eat it.”

This is a lot of stress on Leah around feeding her allergic, picky son. I can relate to this struggle, and I know so many mothers do as well. I have plenty of ideas that might very well improve the feeding dynamic here; But I like to start with the basics. I find it’s helpful for mothers to learn exactly what is in their control and what is not in their control when it comes to feeding their kids. With Leah’s consent, I begin:

 “The feeding approach that I recommend was created by Ellen Satter and is called the ‘Division of Responsibility’ - DOR for short. And, like it’s name, it delineates between what is the caretaker’s responsibility , and what is the child’s responsibility. It’s pretty simple: Parents are responsible for WHAT is on the menu, WHEN meals and snacks are and WHERE the eating occurs. Then, we must trust the kids to decide HOW MUCH they will actually eat, or IF they will eat a certain food at all.”

Leah squints her eyes in concentration, nodding. “Ok this is interesting – but if it’s my son’s job to decide how much he will eat, or whether he will even eat it at all, then how on earth am I supposed to get him to eat more?”

“Well, first we need to take advantage of what IS in our control. What is in your control?”

“Umm – the menu?”

“Yes! We will need to brainstorm in order to add allergy-friendly items to the menu for Aryeh. And another important part that is in your control is WHEN. The timing of meals and snacks is up to you, and will enable Aryeh to build up an appetite to give him the best chance at succeeding with his food.”

“Let’s meet next week and we can talk more about how to maximize the timing and menu items in order to best support Aryeh.”

I'd love to help support you with your picky and/or allergic or just challenging feeder. Reach out at nourishedwithnoa@gmail.com.

Best,

Noa