Q&A: 15 Month Old Refuses Solid Food

CME WebsitesChild Routines, Mealtime

blockquote_bgOur daughter is 15 months old and she does not take table food yet. We offer her and sometimes she would accept a little, but most of the time she would shake her head no and would turn away. We had a pediatric consult yesterday and she is 24 lbs. The doctor said she is above average for weight, and she does take the stage 3 foods very well, but I’m just concerned if she’s getting delayed with her eating skills. What can we do to improve her on that?

In consulting physician’s weight charts, a child of 15-17 months typically does weigh between 23-24 lbs, so it is good your daughter is a healthy weight for her age and it sounds like her doctor is pleased with her weight. I am also glad to hear that your daughter is not having trouble accepting Stage 3 foods, because we often hear of children having difficulty with Stage 3’s (gagging due to the texture/consistency) and many times recommend that parents go directly from Stage 2’s to mashed, soft or chopped tables foods. When your daughter shakes her head no, or pushes food away or throws it, don’t take it personally and try not to react in any way, but praise her for any attempts she makes at touching new foods, playing with new foods or putting new foods to her lips or into her mouth (even if she spits it back out).

It can take a child as many as 17 presentations (over several meals or days) for them to try a new food. So if she shakes her head no or pushes it away at one meal, don’t be afraid to make repeated attempts with the same food at another meal or on another day. Make sure to chop all foods into very small bite sizes and try not to overwhelm her by putting too much on her plate or tray. Encourage use of a spoon or poking foods with a fork, but at this age finger feeding is still fine. I’m not sure what types of foods you have tried but here are some ideas for healthy meals for a young toddler:

  • Breakfast- Cheerios dry or with milk, waffles, eggs, yogurt, fruit
  • Lunch & Dinners- green beans, lentils, chickpeas, carrots, artichokes, spinach, sweet potatoes, butternut squash, yellow squash, potatoes, broccoli, rice, tofu, chicken, fish, turkey burgers, veggie burgers
  • Snacks- yogurt, cheese, bananas, strawberries (make sure child has no allergies), blueberries (high in antioxidants), oranges

Use foods from the family meal that you chop very small. It’s best to begin with foods that are easy to chew, such as chopped pasta, cooked vegetables, cooked potatoes (without the skin), or canned or very ripe fruits. Let her watch you remove her food from serving dishes so she sees it is the same as what the rest of the family is eating. This usually makes these new foods particularly interesting to experiment with and eventually eat. As she becomes comfortable with finely chopped foods, gradually increase the size of her foods to bite-sized pieces.

If you are feeding your daughter place food (scrambled eggs and small graham cracker pieces are good) between her gums or molars on one side of her mouth. This will encourage her to move her tongue to get the food.

Offer toasted bread strips, strips of soft cheese, and other appropriate finger foods. It is safest to hold on to one end of the food as she chews so she doesn’t get too much at once. But this will encourage her to bite and chew. She needs to learn to lateralize her tongue (move it from side to side) and develop a rotary chew.

You can also place small items of food like an apple slice into a mesh food bag (sold at places like Toys R Us), it’s a little bag with a handle on the end intended to help kids learn to bite and chew, but prevent choking since the food is inside the mesh bag and can only be tasted and not swallowed.

Learning to eat foods and progress through textures is more than developing chewing and swallowing skills, although these skills are necessary to successfully eat regular table foods. Remember learning to eat table foods is messy too, but while exploring food, children learn about the feel, smell, and temperature of foods.

If you continue to have concerns with your daughter’s progression to table foods, I suggest consulting your local early intervention provider to ask for a feeding evaluation from a trained occupational or speech therapist. I am not sure how close this program is to you, but this group deals specifically with toddlers and introducing foods.