Food Issues - The Child Psychology Service

Food Issues

Many children who have started out in homes that were abusive and/or neglectful face significant challenges around food. This can be due to a relatively simple association with a lack of food or it can be more complex and involve an emotional and/or traumatised relationship with food.

Examples of food issues:

Eating too much;
Children who don’t know when they’re hungry or full-up;
Hoarding food;
Stealing food;
Being very fussy about food;
- Not liking food types to touch each other on the plate;
- Eating a limited range of food;
Trouble swallowing/choking on food;
Rigidly controlling food intake;
Finding it difficult to wait for food.

Why do fostered and adopted children have food issues?

The food issues listed above are very common in adopted and fostered children but they vary greatly in their psychological functions, purposes and in their causes.

Many people, often quite rightly, assume that fostered and adopted children who overeat or appear to obsess about food do so because they have been underfed or indeed starved at some point in their past. This explanation makes a lot of sense regarding why children would overeat, hoard and steal food and find it tough to wait when food is being prepared. These anxiety producing situations, when paired with other insensitive or neglectful care prevent the child’s brain from developing their executive functions. These are the skills that would allow your child to learn from your reassurances that they won’t be starved again or your attempts to extend the amount of time they can wait for food using your best reward-punishment thinking.

The experience of scarce access to food is a common one in our children but often the link is not a simple one. Sometimes the same anxious or compulsive behaviours around food can be caused by quite the opposite experience i.e. that food was abundant and perhaps used as an alternative, a surrogate if you like, for intimacy, care, affection and/or attention. It may perhaps have been the only method of connection between a child and their primary carer.

Food and feeding is one of the earliest and most fundamental parts of parenting babies and so any problems with it can become apparent very early in the parent-infant dynamic. For example, it can provide a very early example of intimacy becoming intrusive or serving the needs of the parent rather than the child. This can set up early difficulties in a child’s relationship with food.

A child’s inability to gauge when they are hungry or full-up can be a particular difficulty. This results from early misattuned parenting and parents’ misaligned understanding and sensation of their child’s own inner world. The ability to interpret the meaning of bodily sensations comes from the experience of having an adult interpret the child’s signals and act on the deduced needs e.g. taking a layer of clothes off when the child looks red and sweaty. This develops in a similar way to the ability to understand and regulate emotion.

Difficulty swallowing (and the potential for subsequent food aversion) and limiting the range of foods eaten are indicative of delayed physical development. Evidence is emerging that even primitive brain functions which cause difficulties such as these can be caused by neglect and/or abuse. The tendency to choke on solid food is a perfectly normal reaction in babies who are eating solid food before they are physically ready to do so. Even such fundamental human abilities are now thought be influenced by “good enough” early care. A tendency to stick to a limited range of foods is very typical toddler behaviour. It is an evolutionarily programmed strategy to prevent newly mobile children from eating things which might be poisonous.

Other food-related problems can be indicative of the need for control which blights the relationship experiences of many developmentally traumatised children. This is because they have not had the experience of being able to relax into and trust that their carers will meet their needs and/or treat them fairly without the need for the child to use manipulative strategies.

Understand your own reactions to your child’s food issues. You may have particularly strong ideas about how much food is appropriate or other ways in which people/children should behave around food. You may feel quite frustrated or angry that your reward-punishment strategies are not impacting on your child’s food issues. Try to understand and deal with your feelings about these issues before you try and tackle the issue with your child.

If your child is anxious about food and its availability, perhaps they are stealing or hoarding food. Do not restrict their access to it; this will only increase their anxiety and therefore their need for their compensatory strategy. Reassurance will do not cause harm but is unlikely to prevent the behaviour. Facilitate their access to food and their ability to keep food close, perhaps provide them with a secure tin to keep (relatively healthy) food in hygienically. It can also be useful to put the fun back into your food-based interactions with you child. Try baking together. Prepare for and encourage mess, fun and giggles.

If your child is overeating or unable to sense when they are full then help them to understand their bodily feelings of fullness by using empathic commentary i.e. commentating on what you suspect they are feeling in relation to food e.g. “ooh you must be really hungry because we’re late having our lunch” or “oh gosh I bet your tummy feels quite bloated, we’ve had a very big meal!”. There’s no need to ask questions about this and make sure this is said in a fun, non-judgemental way. Otherwise it is likely that your child’s defences will be activated and they will be unlikely to meaningfully draw a link between what you have said and their bodily sensations.

Contrary to our culturally ingrained reward-punishment thinking, trying to restrict the eating of overeating children or encourage the eating of “fussy” eaters (who react this way as a reaction to their early trauma) are unlikely to be effective. Trying to shape their eating behaviour with punishments (including disapproval or sitting at the table until they have finished what they are given) or rewards (star-charts for trying something new or praise for not requesting extra food) fail to address the emotional/trauma origins of their behaviours and will, in all probability raise their defensiveness. This is because their eating pattern and/or their relationship with food serves an emotional function and is not just the product of bad habit. These emotions are strong and will dominate a child’s behaviour, making them feel that they should not have that emotion will only increase shame. Negative emotions around food are likely to increase the strength of the food issue.

If your child’s food issues are marked by the need to control, impulsivity or by behaviours that are more appropriate to a younger developmental stage, then strategies to facilitate their development via nurturing them in ways that may be typically more appropriate to younger children will help to develop the higher levels of their brain (see Attention-Seeking vs. Attachment-Seeking and Attachment Theory pages).