If you’re the parent of a picky eater with type 1 diabetes, you’re not only worried about whether your child is getting proper nutrition, you also have worries about what to do if you’ve given insulin for a certain amount of food and your child refuses to eat it. Or what to do if your child is sneaking food you haven’t dosed for… But Jaclyn Gee, a certified child life specialist at the Naomi Berrie Diabetes Center at Columbia University Medical Center in New York City, explains that much of the best advice for parents of picky eaters is actually universal. Here are her top five tips.

  1. Teach Them Well.
    Give your child information about why good nutrition and eating a variety of foods are important. Even young children can understand that “insulin will help turn their food into energy, and we have to make sure that we match the insulin and the food just right. Not too much and not too little.” Patiently explaining this until your child ‘gets’ it will help her know why it’s best to try to finish her food at meals and why she cannot sneak food at other times. If you do catch her sneaking food, check her blood sugar, and lovingly remind her why this behavior can be dangerous. These situations can be anxiety-provoking, but it’s important to stay calm and convey the necessary information. If you get emotional, your message will be less effective.
  2. Don’t Send the Wrong Message.
    Some children figure out that if they don’t finish their meal, they’ll be given a treat, like a cookie or ice cream, to make up for the amount of insulin their parents dosed. There might be occasions when you give your child sugary food in an emergency to bring up their blood sugar quickly; however, if you make a regular practice of it, you’ll be teaching him that failing to eat nutritious food at a meal will get them the sugary snacks they may prefer. If you’ve given insulin for a particular meal, sit with him until he finishes the food you’ve offered. If you use the popular “no-thank-you bite” strategy, offer more of the part of the meal your child liked (rather than a separate treat) to make up the difference.
  3. Don’t Worry That They’ll Starve.
    There was a time when everyone ate one meal. There was one family dinner rather than the more common short-order kitchens of today, where a different dish is made for each member of the home. Often parents report their children will only eat pizza, or macaroni and cheese, or chicken nuggets. The question is, who makes those foods for them? The answer is often well-meaning parents who are afraid their little ones will otherwise starve. Of course, this leads children to draw the (accurate) conclusion that all they have to do to get the food they want is to refuse the food Mom and Dad made. The thing is, says Gee, “Children won’t let themselves starve.” In fact, it’s okay to let a child miss a meal. If she’s truly hungry, she’ll eat the food you provide. If you’ve already given the insulin for the meal and she absolutely refuses to eat it, offer an alternative that you pick and be clear that multiple-choice meals will not be happening every day.
  4. Try, Try Again.
    It takes a long time to learn how to eat good, healthy food. Don’t give up on your child. Keep giving him or her opportunities to try things. Sometimes it takes many attempts before kids realize they like something. One great way to get a child to try new things is to plan menus together. The more children participate in the meal planning and preparation, the more likely they are to try the foods they make and enjoy them. It’s okay to include some of their favorite foods on the menu if they’re in balance with other healthy, new foods that they’re willing to give a try. For example, try a “pizza night” with lots of veggie toppings.
  5. Let Food Be Food.
    Food can already be an emotional focal point for children with type 1 diabetes, accompanied by complicated feelings. That’s why it’s important to help your child let food simply be food. What this means is not using food as either a reward or a punishment. The less you do this, the more you allow food to be what it is — a source of nourishment and enjoyment.

As you try some of these new practices, your child might rebel or resist. Give clear and consistent messages about how mealtime in your home works, and soon enough they should involve less stress and more time for connection, conversation, and fun.

Disclaimer: The experiences and suggestions recounted in these articles are not intended as medical advice, and they are not necessarily the “typical” experiences of families with a child who has type 1 diabetes. These situations are unique to the families depicted. Families should check with their healthcare professionals regarding the treatment of type 1 diabetes and the frequency of blood glucose monitoring.

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