10 Secrets for getting your Toddler with Type 1 to Eat
Balancing food and insulin are central to diabetes management. When you’re feeding a young child, it can sometimes be tricky to provide a healthy diet while making sure they will eat enough carbohydrates. We often hear parents talk about feeling like they have “given in” to less nutritious carbs when their child refuses a healthier option because insulin was already in their system. This can be especially frustrating for parents who want to expand the variety of foods their children will happily eat.
Eating is a skill that children learn gradually!
It is completely normal for young children to reject foods they have never tried before—and to change their mind about foods they have eaten previously. As young child are learning to eat, all foods are new, even those that are very familiar to you. It generally takes time and repeated exposures to new foods before taste preferences are firmly established. For families with diabetes, this takes place in tandem with establishing diabetes mealtime routines, which can include checking blood glucose, planning for food intake, making insulin dosing decisions and administering insulin. It can be a lot for anyone to manage!
Here are our top 10 tips for managing mealtimes for young children with Type 1 diabetes:
- Set consistent routines for mealtimes incorporating diabetes management tasks, so your child knows what to expect. Have a goal to eat around the same time each day, and your child will start to come to the table hungry and ready to (manage diabetes and) eat!
- Children watch us eat, so be a good role model—try new foods and describe their taste, texture and smell. Children learn about new foods by looking, touching, tasting and spitting out—keep the napkins handy!
- Expect up-and-down eating. Even after your child learns to like a food, they may not want to eat it every time it is on the table. Some families split the insulin dose before and during/after mealtimes—talk to your provider about what they recommend for your child.
- It’s no fun to be a short-order cook. We suggest giving everyone at the table the same food choices options to pick from, selected by you. Don’t limit the menu to foods your child readily accepts, but do have their favorites occasionally.
- When you start to introduce new foods for your child to try, offer new foods first, at the beginning of a meal, when your child is hungry. Pace yourself: offer only one new food at a time, and be sure to serve something that you know your child likes along with the new food.
- Small portions, big benefits. Let your kids try small portions of the new foods that you enjoy. Give them a small taste at first and be patient.
- Some kids may have to be presented with a food 15 or 20 times before they learn to eat it, so be patient and persistent while your child warms up slowly to unfamiliar foods.
- Trying new foods is great, but what if your child is really digging their heels in? Offer milk or another neutral food at the end of the meal to make up for any carbs you gave insulin for but they didn’t end up eating. Make sure the food you offer at the end of the meal is not one of your child’s favorite treat foods, or else it could backfire and end up rewarding their refusals!
- Know your child and pick your battles. Serve food plain if that’s what your child prefers. Explore using plates with sections if your child likes foods to be separate, or some kids prefer new foods mixed in with preferred foods (like peas mixed with mashed potatoes) or with familiar condiments.
- Keep calm and communicate clearly! The way you react to your child during mealtime matters—try to manage any frustration you feel and try to avoid making meals a source of conflict. Step away from the table to regain composure if needed. Responding calmly to your child’s food refusals will help teach them a healthy way to approach food and mealtimes with diabetes. And don’t forget to pile on the praise when they try a new food or cooperate with the diabetes management routine!
These are tips that are generally helpful for parents—we hope you try them out and find the strategies that work best for you. Talk to your diabetes care providers about ways to adjust diabetes management at mealtimes or if you have concerns about your child’s nutritional intake or about meeting expected growth expectations.
This work is funded by the National Institutes of Diabetes and Digestive and Kidney Disease, grants DP3DK103998 and R01DK102561 awarded to Randi Streisand PhD.
Marisa E. Hilliard, PhD, is a pediatric psychologist and behavioral scientist whose work focuses on clinical care and research with young people with type 1 diabetes and their families. Her passion is promoting resilience, and her research focuses on how youth and families overcome the challenges of diabetes to maintain good quality of life, adhere to treatment recommendations and have optimal diabetes control. She is especially interested in transitional times in diabetes management, such as adjusting to life with a new diabetes diagnosis, how family diabetes management shifts across childhood and adolescence and how teenagers prepare to manage their diabetes as young adults. Dr. Hilliard is an assistant professor of pediatrics at Baylor College of Medicine, in the Psychology Section of Texas Children‘s Hospital in Houston, Texas.
Carrie B. Tully, PhD is a pediatric psychologist focusing on research and clinical work with families of children with type 1 diabetes. Her interests focus on the child-parent feeding relationship, physical activity promotion and better understanding methods to support parent adjustment and coping to optimize long-term health in kids with chronic illnesses. Dr. Tully is a postdoctoral fellow at Children’s National Medical Center in the Center for Translational Research on the Behavioral Diabetes Research Team.
“How Children Learn to Like Food” by Ellyn Satter Institute and Choose my Plate (preschoolers).
Rowell, K. & McGloathlin, J. (2015). Helping your child with extreme picky eating: A step-by-step guide for overcoming selective eating, food aversion and feeding disorders. New Harbinger Publications.
Read Kate Felton’s Part Four: All the Things I Thought I Knew.