People in the Know: Refusing Meals

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Q: My newly diagnosed 8-year-old refused to eat breakfast today, because he said he didn’t want a shot. How can we make taking insulin less of an ordeal -- and help him understand the importance of meals?

A: By age 8, most kids know that getting themselves dressed, eating breakfast, and brushing their teeth are three non-negotiable routines. For children diagnosed with diabetes, there is one more item to add to this list: taking insulin.

If you haven’t already, start by explaining to your son -- in a calm, neutral tone -- that taking insulin and eating a nourishing breakfast will help him do the things he wants to during the day, like play at recess with his friends, do well on tests and projects, and, in general, help him to feel good and full of energy. It’s also important for your son to know that skipping his insulin may result in everything from frequent urination to vomiting -- and who wants to deal with that?

At the same time, this doesn’t mean dismissing your son’s frustrations. One of the key goals of diabetes management is to make sure care tasks are as emotionally and physically painless as possible. It could be that your son is feeling bad about having diabetes, and complaining about his shots is his way to vent. On the other hand, it might be a good time to check in with your diabetes educator to get some feedback on your injection techniques (or discuss the alternative of an insulin pump).

It may also be that your son is sending you a very strong signal that he needs to feel more in control of his life, beginning with his mornings. A colleague once put it this way: “It’s very important to give the diabetes back to the child.” Here are some ways to make this happen:

Brainstorm Breakfast Put your son in charge of the breakfast menu by having him come up with a list of foods he would like to eat; the two of you can then work together on counting the carbs and creating balance. If he thinks a bowl of cereal every day is a good idea, suggest tossing in a serving of sliced almonds or adding a side of scrambled eggs to his meal as a way to add fats and protein and a little variety.     

Get Organized The faster the morning routine of checking blood sugars and dosing insulin can go, the less time there is for frustration to build. Before going to bed at night, gather all the morning diabetes supplies in one place and do some basic breakfast prep by getting out the dishes and moving breakfast ingredients to the front of the fridge. Your son can help with these tasks -- another way to hand over control.

Co-parent Cohesively: If you and your partner share breakfast duties on different days, make sure you are both following the same routines for blood sugar checks and meals. If one parent promises fast food drive-thru for breakfast as long as the child gives in and takes his insulin, it’s no wonder the other parent meets resistance when dishing out oatmeal. Helping a child find a consistent routine requires all caregivers to be on the same page.    

Distract Him To take his mind off injections, encourage your son to snuggle with the family pet or talk to his sibling or his other parent while you’re going about the task.

Offer Small Rewards If your son shows improved willingness to do his morning routines, doling out small rewards in the form of stickers or little toy cars can reinforce how much his cooperation is valued. Even saying how proud you are that he is such a trooper for getting over his frustration can go a long way with an 8-year-old.

Finally, have you checked into how other parents handle meals with their kids? Online or local support groups are great resources for ideas and strategies. With any luck, soon you’ll have some tips of your own to share.   

--Susan Weiner, R.D., C.D.E., is a registered dietitian, certified diabetes educator, author and speaker who maintains a private practice in New York.

 

How Other Parents Deal

“I have become a big fan of slow-cooker oatmeal in my house. When I put it on before I go to sleep, everyone wakes to the most delicious smell of cinnamon and baked apples or whatever I’ve added to it. No one can resist, not even my cranky 12-year-old son who, on most days, would rather sleep until right before the bus rounds the corner on our street.”  

-- Samantha, Albany, N.Y., mom of 12-year-old Matthew

 

Disclaimer: The information in these articles is not intended as medical advice. Families should check with their healthcare professionals regarding individual care.

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