As a pediatrician I am embarrassed to admit this, but my 6-year-old son has a terrible diet.
Well, not terribly terrible. He doesn't live on chips and soda. But it's remarkably lacking in the things I always tell my patients to eat, like fruits, vegetables, low-fat dairy and whole grains.
It's not for lack of trying on my part. I serve these foods to him regularly, including in the snack I pack him for school. As I encourage parents in my practice to do, I pack things like grapes and string cheese -- which often come back uneaten. I think it was out of sheer exasperation that he wrote this note to us (in his best kindergarten spelling) that I found in his backpack:
Cheese isn't the only food that gives Liam a "hedache". So do apples, carrots, mandarin oranges, and any green grapes that have even a little bit of brown on them. Yogurt is a problem too, as is salad, spinach, tomatoes, brown rice, and finishing his milk. The genius of his approach cracks me up. He's not saying he doesn't like the foods or understand that they are healthy. He'd be happy to eat them if they didn't give him a headache.
Crackers, pretzels, mashed potatoes, popcorn, pasta, Oreos, Cheezits, French fries, white rice, candy and bagels do not give him a headache. Basically, the diet that suits him best is the White and Sugar diet. Which, interestingly, is the exact same diet that suited his older brother Zack best. (Since my daughters eat pretty well, I can't help wondering if my husband gets the genetic blame.)
I see this all the time in my practice. Well, not the headache part. But when I ask parents if their children are eating fruits and vegetables and other healthy foods, it's really common for me to hear, "He won't eat them." It's really true that once kids are no longer babies, once you are no longer literally spooning the stuff into their mouths, it's hard to get them to eat things they don't want to eat.
I've tried everything I tell parents to do. I started early with healthy foods and have offered them consistently. Our house is stocked with healthy snacks (just ask the older kids, who are always complaining, "there's no sugar in this house!"). We set an example by eating well ourselves -- he's surrounded by examples, including his 11-year-old sister who happily eats the fruit and cheese I pack for her every day. But nothing has worked. As was the case with Zack, he just doesn't like them and will not eat them.
Like I said: embarrassing.
So, having left ideal in the dust, meals are about compromise. Since peas, corn, and the very top of broccoli crowns do not give him headaches, we try to serve them often. We buy fresh grapes every week so as to increase the chances of finding ones that have no brown spots. We have a Three Bite Rule when it comes to foods he doesn't want to eat (mostly this works out okay, although there have been some OK Corral moments over eating three bites of certain vegetables or casseroles that have made me wonder if it's always a good idea). We negotiate over how much milk he needs to drink (we use numbers of gulps or how low he needs to get on the cup). And we give him a multivitamin every day.
Over time, Zack's diet did improve (a lot, actually). He didn't listen to us, but he did listen to coaches and others who told him that a healthy diet would make him a faster swimmer -- and give him a leaner, meaner physique. He discovered that he liked chicken Caesar salads and that carrots weren't evil. It took until late in high school, but that's okay -- I'm all about better late than never when it comes to healthy habits.
So I'm holding out hope that one day cheese won't give Liam a headache. Until then, I'll keep trying and compromising. Which, sometimes, is the best we can do as parents -- or doctors.