Q&A: Toddler Drinking Excessive Fluids But Won’t Eat

CME WebsitesChild Routines, Mealtime

blockquote_bgI will ask at my child’s next doctor’s appointment but why do you list the following as developmental delays? What kind of delays/issues could this be a sign of? Excessive fluid intake and minimal food. Pushing away food. My child is 22 months. He would definitely prefer to drink milk and juice for his meal. He does eat throughout the day but not a lot. We try not to give him too much milk and we still, usually, dilute juice with water.

We as therapists are used to hearing parents describe their toddlers as “picky eaters”, but it is our job to determine if the child is just going through a typical toddler stage or if there is something more contributing to the child’s pickiness or food refusal. We treat many children who were described as just “picky” but were later found through an evaluation by an occupational therapist to have an underlying sensory or oral motor issue that was impacting the child’s ability to maintain a healthy diet.

According to the American Academy of Pediatrics guidelines, only low-fat milk should be served to children older than age two and children ages 1 to 3 years old should just be drinking about 2 cups of milk each day, so no more than 16 ounces. Too much milk, especially whole milk, is not a good thing. Keep in mind that many toddler “sipper” cups today are in large 7-12 oz sizes. The American Academy of Pediatrics also recommends that children ages 1 to 6 drink only 4 to 6 ounces of juice each day, so far less than a cup. A healthier alternative to fruit juices is fresh fruit which contains more fiber and nutrients.

Children will learn to drink water if it’s the beverage of choice that is offered at meals. If you always serve milk or juice at meals, young children will always associate mealtimes with those beverages. If water is the only choice offered, children will eventually drink it. Children who fill up on liquids, are just that-full, so why would they want to eat when they are not hungry? The best way to help toddlers establish healthy mealtime habits is to have a set mealtime schedule and offer a few healthy snacks throughout the day. It may help to keep a list of the different foods your child likes and that will give you a better idea for how to prepare a balanced diet for them. Breakfast, lunch and dinner should take place at fairly consistent times and be a pleasant, distraction free time (no toys or watching tv). As long as your child is gaining weight and healthy, they are probably getting enough to eat. As toddlers they may eat less at one meal, but make up for it at another meal by eating more.

They also may go through phases of preferring only certain foods and resisting trying new foods. Keep in mind it typically takes a child 17 tastes or tries before they may begin to eat a new food, so don’t stop offering new food choices if they are initially pushed away. For toddlers, do not offer a snack if a main meal will be served within the hour since you want the child to come to the table hungry. Set a good example by having others at the table eat a variety of foods. Avoid bribing your child to eat or scolding them for not eating, try to keep mealtimes pleasant. If your child is healthy and growing properly and your pediatrician is pleased at your visit you should have nothing to worry about, just try to build in some of the above tips for reducing fluids and increasing healthy fruit and nutritional food alternatives. Lastly, there is a condition called “polydipsia” which literally means excessive fluid intake, that combined with other factors such as excessive urination, dry mouth & tiredness can be signs of diabetes. If you feel your child’s limited diet is affecting his nutrition and/or weight gain, or if you feel your child has difficulty with chewing or swallowing foods or you see an aversion to certain textures of food you may want to seek an early intervention evaluation by contacting your local provider. This link is a provider in your area.