'Packed lunch', 'pack-up', 'lunch box', 'cold dinner', 'home food' - whatever you call it we are talking about food brought into school for lunch, from home, in a lunch box. This might be a cool bag, a box with their favourite character on, one with compartments, a flask with a delicious smelling meal in.
When I was at school, the packed lunch (as we called it where I am from), was fairly standard. School dinners weren't free so lots of kids and families opted for their trusty packed lunch. These days, with free school meals up to the end of year 2, they are far less popular and in my recent experience (as times have changed) saved for the children who are reluctant eaters. Often, this has been opted for by caregivers who are feeling anxious about their child's eating - if you are yet to start school see my post 'starting school with eating and drinking difficulties'. If your child is already in school and you are feeling concerned and confused about how to move forwards then please do read on.
What is a 'good' packed lunch?
Packed lunch ideally would constitute a balanced meal with foods that should fill your child up with lots of healthy energy for the afternoon of learning, like the ones below. While that would be fantastic if our children would eat that we all know that this might be a stretch for some.
For balance: I'd suggest a sandwich, rice, pasta, wraps, pitta bread as the staple or main part of the meal. Some crackers or baked crisps. Some fruits and vegetables and perhaps a small yoghurt.
Do you really need to send a packed lunch for your child?
There are far fewer children that actually need or benefit from a packed lunch than you might imagine. These children have entrenched and severe sensory eating and drinking difficulties and are at risk of adverse health effects such as low iron or weight loss. For many other children joining in with school meals (while this may seem daunting for you and I totally empathise) is achievable. Here's an example of that:
Clinic anecdotes:
Starting school still only drinking milk: a child I worked with some years ago had started in reception taking all their nutrition and hydration from cows milk throughout the day and night. Mum and school were understandably anxious and worried about how to meet their needs. School reported they would not be able to accommodate bottle drinking unless it was found they had significant needs to continue with milk (such as dysphagia). School also wanted to provide this child with opportunity to make progress and eat and drink age appropriately with peers. Mum wanted this too but she was caught in a vicious cycle - mealtime was very challenging for everyone, so milk was offered to ensure they didn't go hungry then they weren't hungry for food. This child had also got caught up in demanding milk throughout the night making it difficult for the whole family to get any rest.
This child was developing well in all other areas so did not have any additional support provided in school which made this more challenging. School were more than accommodating and found a way to support our therapy.
What did we try?
From day one of therapy (and this was all in their school environment) we decided to make sure they were included in school meals. Up to this point, he had been going home for lunch for their milk. We encouraged and supported Mum to feel comfortable trialing a longer school day so they could stay for lunch.
The child appeared genuinely excited to be lining up with their peers to have lunch. They joined the queue and seemed to have fun picking and choosing what would go on their tray. It was important to advise those familiar with the child to try not to hesitate even though they knew he wouldn't eat the things he had chosen.
They then sat with their friends and whilst he didn't try anything that day this activity demonstrated how motivated he was to be involved. I advised the school to keep at it and over time he started to eat some of the school dinner.
At home, Mum was persevering with offering food in the day time. We offered easy to eat foods such as puree to 'reset' their skills as I like to call it. This also gave them a low pressure and low demand meal that was easier to be successful at and therefore more motivating. In turn, their tummy was filling up and gradually the milk reduced.
Child's food refusal or parental anxiety or both? I worked with a child who started school with a reported severe food refusal. I want to highlight before I go any further that, I empathise whole heartedly with the parental anxiety that comes with a child who is finding eating difficult so this is not in any way a criticism but I feel it is important to demonstrate that sometimes parental anxiety can exacerbate a challenge with food which can then be detrimental to the child.
Anyway, on with the anecdote. This child had started school with a packed lunch and their parents reported they could only eat certain foods and that their weight was a concern. These foods happened to be foods with very low nutritional value or energy. There is no issue with this if a child has severe food refusal and that's all they will eat; some food is ALWAYS better than no food. However, there was no other evidence of severe food refusal - this usually consists of only eating around 10 items of food of a similar texture/flavour/appearance, which was not the case for this child. This child was also not demonstrating any other sensory challenges and had no history of other clinical triggers for food aversion such as vomiting. This child had become aware that they were not doing the same as their friends at lunchtime. Whilst they could sit with their friends initially, they then had move tables because parents had insisted they always eat a certain number of items before they could go and play; this was triggered because they were worried about weight (which once reviewed by a Dietician was within normal range).
What did we try?
This child expressed they wanted to have lunch with their friends and then play outside. Parents felt their child was not going to eat the school dinner so we built a plan to gradually introduce the child to new foods as they were only eating a small range of foods at home and so as to not go too quickly to further worry parents.
We started by going down to the dinner hall before their peers as they had no experience of choosing these foods before. We started with 2 foods the first week, 3 foods the next and so on. At this point they were still eating the items from their packed lunch. However, quite quickly it became apparent that this child was enjoying the new experience and the food. School started sending home information about what they had eaten and liked so that parents could start to do the same at home. It took half a school term to fully achieve school meals with friends with added play time as they had to build confidence and stamina and parents had to build their own confidence that their child was not going to be hungry in the day time.
What did we learn from both scenarios?
This sounds simple but I am not meaning to minimise the anguish and challenge this difficultly presented. It also took a lot of time, perseverance and back steps before considerable progress was made. But, I want to emphasise that progress was made and is possible will seemingly minimal changes to a child's life. Work with school, they want the best for your child. The conclusion - these children appeared to be ones who may need a packed lunch but didn't. Your child could be that child too.
What comes after free school meals and how to manage that.
In year 3, free school meals stop for most children unless they receive pupil premium so caregivers have to decide whether to continue with paid school dinners or to send a packed lunch. It doesn't matter what you decide but I would recommend making the decision with your child. They know themselves best and it's important to give them some autonomy - they are more likely to eat more this way.
If your child chooses packed lunch you can have some boundaried choices. This allows you to provide a well balanced meal without taking autonomy away from your child. You can say we need to choose a food from each group as follows:
Main food
Fruit / veg
Healthy snack
Treat
If those groups are too broad for your child you can offer 2 choices within each group e.g.:
Sandwich or wrap
Apple or pear
Yoghurt or cheese
Crisps or cake
Always provide a bottle of water to help wash it all down and support digestion.
There's a lot of info there. I'd love to hear your thoughts. Are anecdotes helpful or not for you? Have you got specific questions about packed lunch for your child? Leave a comment or get in touch!
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