The Power of Cues to Eating and Mealtime Routines

First let’s think about another routine, sleeping!

Reading a bedtime story is a common part of bedtime routine, and cue to sleeping.

Think about your bedtime routine. You most likely have a routine you follow that helps set yourself up for a good night’s sleep. This might include things like drinking a cup of tea, taking a shower, brushing your teeth, doing a nighttime skincare routine, reading a book, listening to a podcast, adjusting the temperature, closing the curtains, turning down the lights, and saying goodnight to family members. You likely have a bedtime routine for your children, as well. This may include having a consistent bedtime, taking a bath, putting on pajamas, reading a book together, turning off the lights, singing lullabies, turning on a sound machine, and saying goodnight. Whatever routine you create for yourself and your children helps create cues to sleeping. These routines and environmental modifications, or cues to sleeping, all help tell your body that it’s time to go to sleep.

The Forgotten Mealtime Routine

Serving food family-style, seeing others eat, and the smell of food are all cues to eating.

Now think about your mealtime routine. Do you have one in place? While bedtime routines are commonplace, mealtime routines often fall by the wayside. Mealtimes may be rushed, fit in between activities of a busy day, eaten at different times for everyone in the family, and generally forgotten as something to prioritize. This lack of consistency and routine may be affecting your child’s success at mealtimes and long-term success with healthy eating habits. Just like sleeping, our bodies respond to cues that let us know it’s time to eat. If routines and environmental modifications are not put in place, children might not be provided with the cues needed to set them up for success at meals.

Why are routines important for children?

Routines are important for children, as they provide stability, structure, and a sense of security. Children thrive on predictability and knowing what to expect. Establishing and maintaining routines in various aspects of their lives can have numerous benefits for their development and well-being. Routines create a structured environment that helps children learn to manage their own behavior, emotions, and impulses, which can be hard for children to control during stressful mealtimes. Routines also provide opportunities for quality family time and strengthens family bonds. Shared activities, such as family meals and bedtime routines, create opportunities for meaningful interactions, communication, and connection with your children.

What are Cues to Eating?

As we mentioned above, cues to eating are routines and signals in the environment that tell our body it’s time to eat. Eating is one of the most complex things our body does, as it requires all of the systems of our body to work together. Using predictable routines and environmental modifications help set children up for success for this surprisingly difficult task.

These are common examples of Cues to Eating:

A verbal reminder that it will be time to eat soon.

Research has shown that giving a verbal warning before a transition increases compliance with the change in activity. This helps your little one get emotionally ready for knowing one activity will end, and a mealtime will soon begin. It also starts getting their mind to tune into other cues for mealtime, such as their hunger cues. You can also try using a visual schedule, and/or visual time. For example:

“Dinner is in two minutes”

“A few more minutes to play then it’s time to eat”

Some children also respond well to an auditory and visual timer - “Alexa, set a timer for 2 minutes.”

The sounds and smells of cooking food.

Eating is a full-body sensory experience, including sight, smell, touch, taste, auditory, proprioception, and vestibular systems. Hearing and smelling the food being prepared helps get our sensory system ready to eat. Have you ever not felt too hungry until you smelled food cooking, and all of a sudden you are starving and can’t wait to eat? Those are your cues to eating working!

Seeing and hearing the table being set.

Similar to the cue above, seeing the silverware, cups, and plates being placed on the table is another visual and auditory cue that it’s almost time to eat. These cues result from being routine, as our bodies learn that when we see the table being set, a meal usually follows. Think about walking into a dining room where the table is empty versus set when you arrive at a dinner party. If you see the table is not set, you will likely conclude that dinner will not be served for a little while, whereas if you see the table set, then you likely start thinking about the meal, and your body may start getting ready to eat, such as hunger cues becoming stronger.

Have your children help set the table as part of your mealtime routine, which doubles as a cue to eating.

A consistent feeding schedule to promote hunger cues.

Providing meals on a consistent schedule or intervals can help regulate your child’s hunger cycles. Most children benefit from eating every 2.5-3 hours, which is typically 3 meals and 2 snacks per day. When children graze or snack (this can include all-day access to milk) throughout the day, they are typically eating just enough to take the edge off of their hunger. This means when it’s time for a meal, they may not really feel their hunger, as they have eaten enough to satisfy the initial hunger feeling, though have not actually eaten enough volume or nutrition. This also means they feel hungry more frequently (i.e. always asking for snacks) because they are not eating consistently at meals.

A consistent feeding schedule can help children feel their hunger cues, and help them feel hungry at mealtimes.

Providing children with a consistent feeding schedule/interval routine helps children feel true hunger/full cycles, which will help them tune-in better to their body to create healthy eating habits, as well as be more successful at meals, because they will actually be hungry. By providing food frequently enough, we make sure children are not overly hungry, as this can also cause unsuccessful mealtimes due to strong irritability.

Seeing others eat.

Model eating the foods you want your child to learn to eat.

Seeing other people eat is an important cue to trigger eating. Eating is not just about feeding our body, it is also largely social. When we see others eating and enjoying food, this visual stimulus gets our body ready to eat. Have you ever been minding your own business and then someone next to you starts eating chips? Now you want chips when you weren’t even thinking about chips before. This, again, is a cue to eating at work. This is one reason eating together as a family brings so many benefits, or at the very least, eating at the same time as at least one parent, or even a sibling.

Being in a specific environment.

Different environments can trigger our brain to react in a certain way based on past experiences. If we only ever eat in front of a screen, our brain learns to eat only in front of a screen. If we eat at a table with adults around modeling how to eat, we learn to eat in a social environment, and to eat the foods our family eats. When we go to a restaurant, we know from past experience that we are about to get a meal, and this helps get out body ready to eat. When we go to a movie theater, we may start to crave popcorn because of the smell, as well as past experience of associating the movie theater with popcorn. The idea is to create an environment in your home that helps your child create these same associations, and is one reason why eating at a table, versus in front of the TV, can help your child be more successful in the long run with eating.

Doing physical activity.

I’m sure you’ve heard the saying, “Working up an appetite!” Adults and children alike typically feel hungry after vigorous physical activity because your body just burned up a lot of calories. Playing outside, at the park, or some other physical activity before meals can help regulate your child’s sensory system, as well as help intensify their hunger cues to get their body feel ready to eat. If this is something you do on a regular basis, it will also become part of their routine, which even further solidifies this association.

Cues Not to Eat

Just as there are cues to eating, it is possible to inadvertently create cues not to eat. This can include:

Stressful mealtimes

When children become acutely upset, their appetite decreases, and the rest of the meal is now likely to be a struggle. Becoming stressed during mealtimes can be caused by many triggers, such as a difficult transition to the meal (click here for transition strategies), being pressured to eat (especially non-preferred or novel foods), new smells, inconsistent expectations, children seeking control, etc. By creating a predictable routine, with age-appropriate expectations, and reducing the pressure to eat foods and encouraging children to listen to their own bodies, we can create a more positive experience around mealtimes which can result in better eating.

Specific environments

Just as specific environments can be a cue to eat, some environments can be a cue not to eat. Does your child eat well at daycare but not at home? Or maybe the opposite? Maybe your child eats well at grandma and grandpa’s house, but not at home, or the opposite? Based on routines set in place, the environment (e.g. calm or chaotic, structured or unstructured, supportive seating or unsupportive seating, modeling eating without expectations or pressure to eat), and past experiences of the mealtime in that environment, the environment itself begins to serve as a cue to eat or not eat.

Specific foods

If a child has been pressured to eat non-preferred or new foods in the past, these foods now may become triggers for a meltdown, as well as all new and non-preferred foods. Some children also have difficulty processing the sensory information of new foods and it becomes overwhelming for them, causing them to shut down.

This doesn’t mean we should stop serving new and non-preferred foods. Serving foods your child does not yet eat in very small portions, eating these foods in front of your child, and serving them without the expectation of your child eating them, helps make these foods more familiar and less scary. Allowing your child to play and interact with these foods also makes them more familiar and less scary, can make mealtimes something fun to look forward to, and helps them become familiar with the sensory properties of the food, which can help them get ready to eat it in the future.

It is recommended to serve at least one preferred/safe food along with the new/non-preferred foods.

Top Tips for Incorporating Cues to Eating and a Mealtime Routine

Consider these tips for children that are currently having difficulty with mealtimes, have a limited variety of foods they eat, or to make mealtimes less stressful:

1. Make sure your child has supportive seating, like this chair. You want your child’s stomach to meet the table between their breast bone and belly button, and for their feet to have something firm to rest flat on. This is called a 90-90-90 seating position, as the hips, knees, and ankles should be at 90 degree angles, and allows your child’s energy to go towards eating instead of towards keeping their body supported.

2. Change your child’s seat position at the table to a different spot. Their current spot may be associated with cues not to eat.

3. When possible, have your child close enough by when you are preparing the meal and table so they are able to hear and see the food being cooked and prepared, as well as the table being set. Even better, have your child participate in some way when possible, such as with preparing the food or setting the table (making it age-appropriate). Check out these child-safe step stools, and child-safe cutting utensils.

Use a child-safe step stool so your child can be involved in preparing the food, which can help the food become more familiar, and get your child’s sensory system ready to eat.

4. Incorporate placemats to create a new visual cue to eating when you establish your new mealtime routine. Put the placemats on the table only when it is time to eat.

5. Create a predictable mealtime routine. For example:

1. Give a verbal warning before the meal (option to provide visual and/or auditory timer)

2. Wash hands

3. Give your child a job, for example, putting napkins, forks, or placemats around the table, helping to prepare food, putting rolls in a basket, serving food onto their plate, etc.

4. Sit at the table together, at the same time

5. Serve the same foods to everyone at the table, with single-piece serving sizes for new/non-preferred foods, and at least one safe/preferred food

6. Start off the meal in a positive way, for example, go around the table and say something fun you did today, say a prayer together, or make up your own fun family tradition

6. Eat together as a family, or with at least one adult, as much as possible, in order to model eating the foods you would like your child to learn to eat.

7. Reduce the pressure to eat, and encourage your child to listen to their body’s hunger and full cues.

8. Limit the use of screens during meals to certain occasions, making screens an exception rather than the norm.

9. Serve meals/snacks every 2.5-3 hours, and limit/eliminate snacking and grazing between meals.

10. Limit other distractions during mealtimes, such as pets, loud music, and trying to do other tasks at the same time.

11. Incorporate physical activity, or another regulating task before mealtimes to help regulate your child’s sensory system, to work up an appetite, and to create a routine which helps your child make associations of when it is time to eat.

Remember, change takes time.

All of these strategies take time, effort, and patience. It is not necessarily realistic to start using them all at once. Slowly start incorporating the strategies one by one into your family’s routines. New routines take time to adjust to, so be patient and stick with it, and look for small improvements. While the end goal may be for your child to try and eat new foods, remember that success also looks like: your child sitting at the table for one more minute, your child having a positive meal experience even if they don’t eat a new food, your child tolerating a new food on the table or on their plate, eating at the same time as someone else, eating without a screen, touching or licking a new food, or making it between a planned meal and a planned snack with no grazing. Start implementing these strategies one by one, and you’ll be on your way to more successful mealtimes!

If you are concerned with your child’s feeding and picky eating, speak to your pediatrician and ask for a referral to a feeding therapist (feeding therapists have the title of speech-language pathologist or occupational therapist). Signs your child may benefit from feeding therapy include gagging, vomiting, and/or coughing while eating/drinking, difficulty chewing, rejection of foods, less than 20-30 accepted foods, little to no foods they will eat in certain food groups (e.g. proteins, fruits, vegetables), consistently needing a different meal than the rest of the family, and/or tantrums at the sight or presentation of new or non-preferred foods at the table or on their plate. In some cases, your pediatrician or feeding therapist may also refer you to a gastroenterologist (GI doctor), allergist, otolaryngologist (ENT doctor), or other member of a feeding team.

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