ADHD Weekly, February 16, 2023

Getting children to eat their vegetables can be a struggle for any parent. You may struggle even more if your child is diagnosed with ADHD and prescribed medication that causes them to lose their appetite. If your child skips lunch at school or refuses to eat their dinner, saying they’re not hungry, it may be due to a common side effect of stimulant medication used to treat ADHD. If their plate is still full at the end of mealtime, there are things you can do to make sure that they eat healthy when they do have an appetite.

When a child first starts on stimulant medication, it is common for them to be less hungry early on. After continued use, side effects like loss of appetite may go away altogether, says L. Eugene Arnold, MD, MEd. He is professor emeritus at The Ohio State University and CHADD’s resident expert. Dr. Arnold reassures parents that there are ways to work around a child’s loss of appetite without making mealtime a struggle. You can provide your child with healthy foods during times when they are hungry, perhaps at breakfast just before they take their medication or in the evening for a late snack, he says.

Some children who take a short-acting medication may not be hungry until after that dose has worn off around midafternoon. Those who take an extended-release medication may not have an appetite for a good part of the day. Plan healthy meals and snacks for when their appetite returns, in either later afternoon or evening. Keep in mind times during the day your child is the most hungry.

“Sometimes you just can’t stick to regular mealtimes,” says the parent of a child with ADHD who shared her experiences on a popular social media site. What worked for her child, she says, was offering him smaller meals throughout the day. She cautions other parents not to make a fuss or get stressed out if their child refuses food at certain times.

“Like the doctor told me,” she says “don’t stress over it. Let him eat when he is hungry.”

This may mean offering your child nutritious and tasty foods when they are more likely to have an appetite, even if the mealtimes seem unusual. Sometimes a smoothie or shake with protein, vitamins, and minerals instead of an early meal can give them the nutrition they need throughout the day. Talk with your children’s prescribers and ask about fortified drinks if you are concerned.

Breakfast: The most important meal of the day

Mornings can be chaotic, especially for parents of children with ADHD. It may be tempting to overlook a good breakfast in the bustle to get the family up and out the door in the morning. For children who take stimulant medication, however, breakfast can be the most important part of their day. Dr. Arnold says that breakfast is a great time for children to consume healthy food before their medication kicks in. He often suggests that parents offer a protein-rich, low-sugar breakfast before giving a child their medication for the day.

Not only is breakfast a good time for children to consume important nutrients, but a good breakfast may also improve ADHD symptoms, at least for the early part of the day.

“Children who eat a substantial breakfast spend more time on task later in the morning than those who eat minimal or no breakfast,” says Marianne Glanzman, MD. “The inclusion of protein with carbohydrate is best for sustained cognitive performance over several hours.”

Dr. Glanzman is a developmental pediatrician who specializes in the treatment of children with ADHD at the Children’s Hospital of Philadelphia. Starting your child’s day off with a good breakfast, she says, helps to improve their attention during the school day.

Easy snacking

While you may be tempted to let your child eat whatever they want when they are hungry just to get calories in, experts say it’s better to have a plan to encourage good eating habits. Some parents posting on a popular social media site said they gave their children ice cream or candy bars before bedtime just to get their child to eat something. Nutritionist Laura Stevens, MS, recommends parents resist the temptation and instead have tasty and convenient whole foods on hand for when hunger returns. She has researched the role of nutrition and food sensitivities in children with ADHD and is an author of several books on the topic.

“Make sure in your anxiety to make him eat more that you don’t just use junk foods because he’ll eat those,” she says. “You want to make those snacks nutritious foods.”

One tip she shares with parents is to put a plate of cut vegetables out on the table while you are preparing dinner. Hungry children can easily grab the healthy snack as they cruise through the kitchen or dining room. Dr. Arnold points out that if your child doesn’t eat their dinner, just cover their plate and bring it out later in the evening when they are hungry. That way they will have a nutritious meal ready to eat even if they end up eating it right before bedtime, he says.

Both experts remind parents to be flexible in their approach to get their children to eat healthy and to work with the times when their children are most hungry. Having a plan can go a long way toward working around reduced appetites due to medication.

Try not to get upset if your child isn’t hungry at dinnertime, they recommend. The struggle over meals can make the situation worse and hurt your relationship with your child.

“The one thing you don’t want to do is turn dinnertime into World War III,” says Ms. Stevens. “You want it to be calm and peaceful.”

More on eating habits and ADHD:

• Nutrition and ADHD
• What Should I Feed My Child with ADHD?
• Five Ways Nutrition Can Impact ADHD Symptoms
• Breakfast Tips for Busy Minds
• Webinar: Nutrition in Support of ADHD Treatment
• Podcast: How to Help Your Child with ADHD Create Healthy Eating Habits

Join the discussion: what tips do you have to help children at well?