In our free Facebook group, Parenting Picky Eaters, we have some very frequently asked questions. One of the most frequent questions relates to drinking water. It is undeniable that fluid intake is essential. yes, ESSENTIAL.

AND parents, especially when their children are ill, can often feel immense pressure to make sure their children are drinking enough water. Children may refuse water due to a huge range of reasons. Unsurprisingly, this is just like how food refusal stems from a plethora of reasons too.

Reasons why children may refuse water

Some of the reasons why children refuse water can include (not an exhaustive list);

  • Taste/smell variations
  • Temperature variations
  • Environmental variations (which is a a HUGE category covering things from a distracting environment through to seating that doesn’t support their posture.)
  • Presentation variation (different cup etc)
  • Constipation & pain (hence, resulting in quite a viscous cycle)
  • Sore mouths (eg. mouth ulcers, dental pain)
  • Medical and physical barriers (incl. swallowing concerns)
  • Past associations with pain and/or parental stress and pressure
  • Avoiding going to the toilet

As you read through the above list, you may think of “solutions”. Yet, sometimes it is our solution oriented agenda that can make it even harder to see water go past the lips of our children. And for many of our children we could have multiple reasons simultaneously at play.

What is interoception?

Before we get into “solution mode” it is important for me to go back and address the elephant in the room – interoception. This is probably a new word for many of us. I know I certainly wasn’t learning about my interoceptive sensory system along with sight, hearing, touch, smell and taste at school! Yet, our interoceptive sensory system plays a MASSIVE role in our everyday activities. Interoception is our body’s internal sensory system. It is the system that delivers messages about how our body is feeling to our brain so that we can tune in, work out what that signal means and do something about it. We interpret so many of these signals on a daily basis – many of us probably don’t have to consciously think about them to any extent.

Let’s look at some examples …

I tune in and feel sweat on my brow and heat in my armpits. I work out that as feeling as “hot”. So, I act by fanning myself.

My muscles in my arms feel heavy and my eyelids are getting harder to keep opened. I work out this means that I am tired. So, I may start stretching out my muscles to get some blood flowing this brings about an automatic response of a yawn that will help me distribute more oxygen around my body.

A growling belly and fidgety fingers? This is my sure-fire-way to tell me I am hungry! This gets me thinking about when my next meal time is and how I will need to act. What does your body do to signal to you that you are hungry? It is probably not the same as me!

As much as these worked examples may seem “easy” to correlate my body’s signals to the feelings and then to my action, for some of us that process is far from easy. Everybody is DIFFERENT when it comes to sensing what is going on within our own body. Our interoception sensory differences are individual (in fact all of our sensory differences are individual). And, importantly, our sensory differences warrant respect from others too.

How does interoception relate to drinking water?

Thirst is a “feeling” that we need to interpret from our interoceptive sensory signals. For some people this signal could start off as a dry throat, dry mouth or taking some extra swallows. For others, it may only be when they are panting or have the beginnings of a dull headache that the signal is cutting through. Hence, we can see that a barrier for our own interpretation of the signals is sensing the signals themselves.

It is no wonder that common areas of parenting struggles are based on helping children with daily activities that are so extensively connected to THEIR interoceptive system. Namely, THEIR sleeping, THEIR toileting and THEIR feeding.

Simone Emery, Occupational Therapist – Your Feeding Team

How can we help our child tune in, work out and act on thirst?

When we add in the layer of trying to help our child figure out “thirst” for themselves – we are starting to see just how complicated it could get. Remember: it takes practice for children to interpret their body signals. Even with practice, our bodies can get good at shutting out the messages. Or our brains can misunderstand the signal. Or we never really receive the signals to our brains in the first place. So, the first place to start is help your child tune in to what their body signals are for thirst and this will be different for every single family.

Some examples to help kids tune in are as follows:

  • Have a fun clap-back or sing-song phrase to draw your child’s attention away from their play so that you can check in with them on their body cues.
  • When checking on body cues, ask specific questions like: “I noticed you were licking your lips. I sometimes do that when I am thirsty. do you think you might be thirsty?” or “I just noticed my mouth is feeling a bit more dry than usual which tells me I feel thirsty. It made me wonder if your mouth also feels dry?”
  • Intentionally practice tuning-in with a body scan meditation (Your Feeding Team members have access to Simone’s body scan here with a unique focus on bladder awareness.)

Some ways to help children work-out their sensory signals*

  • Engage them in some age-appropriate “trials” – run on the spot for 1 min, take a walk around the block on a summer day or swallow 4 times in a row as fast as you can – When you do these together try tuning in again to the body and see what everyone in the family is feeling. THERE ARE NO WRONG ANSWERS.

*depends on your child’s age and your OT may be able to provide you with more strategies that suit your family’s situation – these are just 3 example trials.

Some ways to help children have positive experiences when drinking water

Children will also need positive experiences of drinking water. This will lead to a positive expectation that drinking it is going to meet their bodily need of quenching thirst.

Drink water together regularly.

Try drinking water from different vessels to see how successful they are – consider things like a) the gradient (steepness) of the walls of a cup, b) the material it is made from, c) how heavy it is for your child to hold, d) the temperature of the water, e) freshness of the water, f) how easy it is to suck through the straw/hole (if you are using a modified cup – especially “leakproof” vessels that are notoriously hard to drink from) – pro tip: try drinking out of it yourself!, g) taste / smell

What if your child already has negative associations with drinking water?

Unfortunately for some children, drinking water has not been positive in the past OR they are concerned about what happens when they do drink too much water ie, more frequent need to urinate (pee).

The first thing to do in this instance is to consider why water is to “blame”. What is the actual negative experience? Remember, your child’s feelings about water are valid. Examples of where drinking/water can be seen as the “baddie” because the child hates toing to the toilet:

  • History of constipation / pain / UTI’s
  • Gravitational insecurity / balance issues that makes some toilets very hard to sit upon
  • Avoids other sensory properties of toilets – hand dryers, flushing noise, sound of wee/poo hitting bowl water, smells, feel of toilet paper,
  • Anxiety (in a manner of forms from FOMO to asking a partner to leave class with them or interrupting the teacher)
  • Routine changes / new environments
  • Feeling of embarrassment/guilt in the past of wetting bed overnight when they could not wake in time.

To reestablish/establish positive associations with drinking water, you may need to work back through the tune-in, work out and act cycle with an approach that is curious and less solution oriented. If you need additional support around this, consider joining Your Feeding Team.

As a parent or caregiver wanting learn further about Interoception you can get more information here on Kelly Mahler’s website. Kelly is a fountain of knowledge on interoception.

As with all general advice on the internet, you do need to come to this information with curiosity and look at it through the lens of a wider experience. Internet articles are not a substitute for more tailored information from your health professional team. Yet, if you do find this helpful – please share this article with your community and consider joining us at Your Feeding Team to dive in deeper.

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