Help! My child won't eat! How to deal with a reluctant eater.

All Children go through phases of eating more and eating less. This is completely normal. I think of them as being like the hungry caterpillar when they eat and eat and fatten up. Then they go through a growth phase and might not eat as much but they grow taller and leaner. People generally eat according to need but it can be very worrying for a parent if a child has a very poor appetite. There are lots of things that you can do to alleviate your fears and encourage the return of a healthy appetite.

The first thing to do is Assess the problem and rule out any really serious issues.

1. Are they loosing weight? If a child is actually loosing weight over a period of a few weeks it is vitally important that you get the medical services involved. Even if your child is overweight and weigh-loss is desirable it is important to monitor their health during that process. It is especially important to check there is no underlying illness causing them to lose weight. A simple urine sample will check for kidney function, muscle wasting, diabetes and some infections. If you have reason to believe your child's weight has dropped (as opposed just not increased) you should discuss it with your health visitor if they are under 5 or your Doctor. They may monitor your child's weight to reassure you or refer you to a dietician, paediatrician or other specialist. If your child's weight is stable or increasing there are lots of ways you can help get them back to normal eating.

2. Do they eat snacks? Would they refuse sweets? Okay so they have started to turn their nose up at broccoli but can they still munch through their favourite dinner? If your child is eating what they want to rather than what you want them to at least they still have an appetite. It's your job to ensure that what they are eating is healthy. Snacks loaded with sugar and salt are not very healthy and you will have to address the problem but at least they are eating. read on down for suggestions on how to improve their diet.

3. How are they emotionally? Are they upset about something? Are they getting lots of unusual attention because of their behaviour? Give them lots of love and spend time with them doing something non-food related that they enjoy. Give them lots of opportunities to tell you if there is something worrying them, it's okay to ask directly if they are upset about anything but remember that children are unlikely to know why they aren't eating. A better way might be to chat with them about school, their friends and their lives in general. Pay attention to their answers and show you care by remembering what they tell you. Keep your tone friendly to reassure them. Make sure that you don't make a fuss about them not eating. Try to back off without letting them run rings around you. Don't let their negative behaviour (not eating) trigger rewards (being allowed to have chocolate cake for dinner).

The next step is to list what they do eat. Are they refusing family meals because they fill up on something else? Will they eat raw vegetables but not cooked ones or vice versa? Do they like to see what is in their food or could you sneak puréed veg into the sauce? Do they like spicy or plain food? Are they a pudding person or do they get in a fruit frenzy? Will they eat character yoghurts but not the ordinary ones?

Tidy up your family eating habits.Eating meals all together at the table is a great way to spend a bit of time together.

• Get the timing right! You know they are more likely to eat if they are hungry so watch their snacking pattern to work out when that is. Are you eating too late and palming the kids off with snacks? Bring dinner forward to a time when they are hungry. Alternatively if everyone is snacking after dinner maybe you are serving it too early. Try making it 1 hour later and banning snacks for that hour. Better still take them out for a walk in that hour instead of battling over food they aren't ready for. You'd be amazed how much a bit of fresh air improved the appetite.

• What example do you set? Are you up and down like a yo-yo or do you eat your meal standing up at the stove? Any new way of doing things is much more likely to be a success if the adults join in too.

• Get rid of the distractions. Turn off the TV, Turn off the radio. Ban books, games and toys from the table and separate squabbling siblings. Civilised conversation might be conducive but only so long as the spoon keeps moving.
• Make rules that help and make them achievable. Don't give up and don't give in!
• Put out smaller plates and don't pile food on. As a guide your stomach is about the size of your clenched fist. If they only have a few spoonfuls on their plate at a time they won't be 'over-faced' and put off.
• If they eat a little of everything they can have a little more of everything. The Pink Floyd rule is a good one (no pudding if you dinnie eat your meat which means if you don't eat your main meal). if you are really concerned you could allow a piece of fruit.
• Make snacks work with you not against you. Stop buying biscuits, crisps, cakes or fizzy juice. Try listing healthy snacks your child will eat and sticking to just them for a week. Suggestions include cheese, carrot or cucumber sticks, friut (think beyond just apples and bananas- Melon slices, pineapple, mixed berries and coconut are all good ideas) rice-cakes, oatcakes, nuts, trail mixes, dried fruit including apricots, mango and cherries, yogarts and ice-lollies made from fruit juice or milkshakes. When you re-introduce biscuits cake and crisps try to reduce the quantities and choose healthier options such as fig rolls and fruit cakes.

• Finally make it fun! Here are my top ideas for making food fun!

1. Children are much more willing to try new things if they had a hand in making them. Choose a food they already like and make a big deal of letting them make it themselves. Salad is a no-cook dish that they can help make.
2. Make-Your-Own pizzas or Make-Your-Own baked potatoes both work well. Offer a choice of familiar toppings and provide a few unusual ones too. Baked beans are just as good on Pizza! You can all vote on your favourites and try to think up new toppings to try next time.
3. Have a theme night. For Chinese New Year we had Make-Your-Own Chinese fried rice with different veg and spice mixes to choose from. We each picked what we wanted and put it in an individual bowl with cold boiled rice. I then fried it up with soy sauce and put it back in the bowl hot. Everyone loved it! Look out for special occasions to celebrate.
4. Play a game. For really young children the rainbow food game is a good way to increase the variety of foods they will eat. The aim is to eat as many different colours as possible. There are no winners or losers in this game and don't play it with skittles! Put out a mixture of salad veg and start by telling them the colours of the rainbow and then tell them you are trying to build a rainbow in your tummy. Call out gleefully "I've got a red!" as you scoff a cherry tomato and they will soon be happily scoffing away beside you!
5. Make them feel they have the power for a change! Let older children cook once or twice a week. They can cook whatever they like as long as it's a balanced meal. The more you try to control what they do the harder they will dig their heels in so try to let go of the reins. Buy them a cook-book or say "Fine! if you don't like my cooking you do it!" and let them get on with it. You might end up eating fish fingers and salad tortilla wraps for dinner occasionally but it'll be fun and they will start to appreciate haw hard you work to prepare meals.
6. Try having a 5 a day chart. It's recommended to eat 5 portions of fruit and veg a day and while children need smaller portions they still need just as much variety. You might have fun doing this as a family and you might be surprised by the results. It doesn't have to be difficult though- 3 dried apricots and a glass of fruit juice is a quick way to bag your first 2!
7. Ring the changes. Ask friends what they cook for dinner and try their favourite dish on your family. You could try a new recipe from hub-pages there are plenty of good ones.
8. Have friends over and make a big deal of choosing the menu. Your child may enjoy decorating and setting the table and making place names.
9. Make a picture. Lots of kids cookery programs make faces with food and they can't all be wrong. Bake your own scones and cut them in different shapes with cookie cutters. Cut star shapes to make eggy bread or bake Nigella's cheesy feet. Make a party hedgehog out of half an orange spiked with cocktail sticks and add cheese cubes, cherry tomatoes, mini saussages, pineapple chunks to the spikes. Make birds nests out of spagetti or apple boats. You can even buy plates with faces on for you to add the food to!
10. Advertise! The media knows that something can be made more appealing if it has an interesting or fun name- Hidden treasure, Bear food, witches fingers and dragon tongues are some of the foods my children have enjoyed. Use your imagination. Broccoli trees are fine but I bet you can think up more

Keep a diary as you try to make these changes and reward yourself for all your hard work. It's okay to have an easy day sometimes. If your child only eats sausages and you work really hard at increasing their range you can both celebrate by having sausages for tea at the end of the week. It's really hard to change behaviours and you are already doing so well by trying! Keep trying and one day you will realise it's not a problem any more....Something else is!