Supporting a Positive Feeding Relationship with Positive Mealtime Interactions

There are a number of ways to support children at mealtime:

  • acknowledge and follow the child’s hunger and satiation cues; ideally, internal cues of hunger drive a child to eat, not external motivators
  • in supporting oral sensorimotor development, provide feedback on the child’s efforts and successes; acknowledgement of a child’s attempts includes verbal praise and non-verbal praise, e.g. a hug, that matches their self-regulation needs
  • playing with the food is reinforcing in and of itself; a positive interaction at any level should be recognized as success
  • use of rewards should be used in the short term with the intention of elimination
  • force feeding or wiping food from a child’s face during meals can be a sensory trigger leading to negative association with mealtimes and the parent or caregiver

Support the Parent and Child’s Role

It is the parent’s responsibility to choose what, when and where to eat and the child’s responsibility to decide whether to eat or not, and how much they will eat (Satter, 2007). Throughout the process, parents should be encouraged to:

  • learn to trust the child’s appetite and help them to understand their body signs for whether they are full or hungry
  • let the child have a sense of control by offering them child-appropriate choices, e.g. selecting where they sit, which plate they use or how the food is presented – on a plate or in a serving bowl
  • provide foods that are in keeping with the child’s sensory preferences and oral sensorimotor function and capabilities, expand foods by changing one dimension of the food while retaining the others, e.g. colour, shape

A single or combination of any of these factors influences the caregiver-child relationship (Goday, et al., 2019).

Refer to:
Nutrition Guideline: Health Feeding Relationship
Ellyn Satter's Division of Responsibility in Feeding

In addition, encourage the parent to not punish the child during mealtime (Cathey & Gaylord, 2004). Reinforce that toddlers will be messy. Allow for mess and exploratory play, especially for those children who are hypersensitive with food, taste, touch and texture.

Establish Expectations and Model Desired Behaviours

Support the family in choosing acceptable family rules that provide structure, allow exploration, are attainable and tailor strategies to the child’s current abilities and preferences.

Suggest:

  • they reduce focus on undesired mealtime behaviours; respond to these behaviours in a calm and neutral manner and state expectations, e.g. “Food stays on the table”; ignore undesired behaviours if safe to do so
  • during family meals, parents and/or siblings should sit where the child can see them so that they can be a model for appropriate mealtime and food interactions