MANAGING EVERYDAY MEALTIME PROBLEMS WITH CHILDREN

PLEASE DISCUSS THESE OPTIONS WITH YOUR DIETITIAN BEFORE IMPLEMENTING THEM.

DIFFERENT CENTRES MAY RECOMMEND DIFFERENT PROBLEM SOLVING STRATEGIES.

For over 10 years our support line has taken thousands of calls with many different concerns, these are a selection of the most common mealtime problems.

What happens if my child grabs somebody else’s food and eats some?

  • If spotted in time, carefully remove as much of the extra food as possible.
  • If the food is a high fat/ protein source e.g. some cheese or a sausage, there may be limited effect. If the food is a high carbohydrate source e.g. sweets, bread, biscuits etc, you could try giving a portion of fat soon after, to slow down the absorption and effect of the extra carbohydrate. Fat emulsions such as double cream, Calogen, Carbzero , Liquigen, Betaquik or simple oil or butter are a possibility.
  • You may consider adjusting the foods included in the next meal or snack to compensate?
  • Monitor closely according to your normal protocol (e.g. blood ketones, blood glucose) and have your emergency medications at the ready. It may be that the indiscretion will only have a transitory effect on blood levels and no effect on seizure pattern. Keep a close watch and ensure the diet is very accurate for next few days.

It can be more difficult if you only discover the cheat later in the day and they are not ‘caught in the act’, the advice above may well still help in this circumstance though.

What happens if my child is at school and knocks over half their dinner?

  • We recommend that you ask the school to keep one of your simple replacement meals in the school freezer. This could be an all in one keto muffin or a quiche. As an alternative, the recipe and ingredients for a meal replacement shake can be kept at school for such emergencies.
  • If you live close by, it may be possible to pop down to school with a replacement meal?
  • Talk to the school cook about what food is available that day. It may be that they would be prepared to weigh out meats, vegetables and butter etc to your specified amounts?

What happens if my child gets upset at mealtimes and refuses to eat?

Be completely honest about the situation and firstly ask yourself the following:

a) Are you getting anxious with them about finishing and/or eating all their food?

b) Have they picked up on this? Is it a behavioural problem?

c) Is your child not eating because they see you eating different things to them?

If you have answered ‘Yes’ to any of the above try the following:

  • However much you are anxious – try not to show it. Put the food in front of them and let them get on with it or if you are feeding your child, then try a spoonful – if they refuse take it away and carry on doing what you are doing, leaving a longer gap in between trying or give them something to distract them from the plate of food.  You may have to take the meal away and when your child comes to you hungry then offer the same meal or even a ketoshake alternative.
  • Children are extremely clever if they see their actions getting a reaction from you. Change the pattern and the times if necessary.  Feed them somewhere other than the table, a picnic in the garden (weather permitting) for instance. Use distraction methods – even if it is letting them have their meal in front of the TV.  You may not like the idea but – PICK YOUR BATTLES – this doesn’t need to be one of them.
  • Again, if they see you eating something different this can be the cause of stress for parents and extreme guilt. Some families have got over this by letting their child have their dinner in front of their favourite TV programme.  Child is happy and eating = less family stress.  Also try to eat similar things to your child – everyday family meals can easily be adapted for a keto kiddie – make sure you work this out with your dietitian.

What happens if my child isn’t hungry and won’t finish their meals?

  • Talk to your dietitian about trying to make the meals smaller / check calorie intake.
  • You could go from 3 big meals a day to 4 smaller ones.
  • Snack sizes could be cut down or removed altogether.
  • Check ketone levels. The ketogenic diet works by suppressing appetite so it is normal that a child on the ketogenic diet may not be as enthusiastic about their food as they were before. However, if you notice a recurring trend that your child doesn’t want to eat when their ketones are at a good or high level then it maybe that the level of ketosis needs to be lowered – you need to discuss this with your dietitian.

What happens if my child no longer likes the keto meals they used to like?

  • Don’t use that meal for a while and re-introduce it after a break of a couple of weeks or so.
  • Try to make it look different, try adding a couple of drops of food colouring in some instances!
  • Present the meal in a different way ie. Using Dinner Winner plates that are available from Matthew’s Friends Charity. These can be very useful for the younger children.