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How can I get my granddaughter to eat properly?

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Two years is the typical age when children assert their independence. This means your granddaughter will be showing positive developments such as toilet training, good communication by speech and body language and the ability to feed herself.

She will also help to dress herself (maybe choosing her own clothes) and play well both on her own and increasingly with other children. In addition, she will be starting to realise that she has choice and free will. She will probably be saying 'no' at times, refuse to do what you want her to and may have temper tantrums at times.

Another way of asserting herself is by not eating what you give her. The fact that she appears to be in good health shows she is getting enough food to grow well.

Keep in mind several reassuring thoughts:
• healthy children eat when they are hungry and not before
• a child who refuses to eat is not hungry and doesn't need food
• no healthy child has ever starved to death from stubbornly refusing food

Most toddlers have times when their diets become very limited. They will only eat food prepared in a certain way and may develop strong likes and dislikes. Days of only eating bananas and bread may be followed by a hatred of everything except fish fingers and chips.

These food fads are very common and are usually used to show their ability to choose. Food fads are rarely a danger to health. Usually they change so frequently that the diet eventually becomes quite varied.

What sometimes happens is that a particular like or dislike becomes reinforced by your own habits. If you know that your granddaughter never eats cheese you may never offer it to her. After a year or two all your family and friends know that 'she doesn't eat cheese' and so on with other food items. It may then surprise you to find that she'll eat some items at school or a friend's house but not at home.

Remember no single food is essential to a child's diet. You can easily find a healthy substitute to the food she will not eat. Vegetables contain valuable vitamins and fibre but if she refuses them remember that so do fruit and fruit juices and breakfast cereals.

Meat contains iron but so do green vegetables and dried fruits especially apricots. Cheese contains calcium and vitamin D but so do yogurts, fromage frais and milk.

Don't bully or bribe her to eat a particular food. Just offer her an alternative fruit, breakfast cereal or salad vegetables of one kind or another. You can disguise grated carrots in Bolognese or tomato sauce for pasta and liquidise vegetables in home made soup.

Milk will fill her up and suppress her appetite. Try to avoid giving her more than a pint a day. Even other drinks will fill her up and stop her wanting to eat. Save her milk or other drinks until after she has eaten.

The important thing is to keep offering her a choice of foods from week to week and make sure that she sees you eating a variety of foods. We all lead such hectic lives that there aren't always the opportunities to sit and eat with our children but try to do so several times a week.

Children are great copiers and will often want the foods they see you eating. If your granddaughter sees you eating healthily there's more of a chance that she'll eventually start following your habits.

Avoid making meal times an issue. The more attention you pay to your granddaughter's food refusal the more she may pursue it.

If she leaves the food on her plate do not get angry or threaten her; in particular do not bribe her, for example with sweets, if she eats it as this will reinforce her food refusal next time in the hope of more rewards. Simply calmly remove her plate.

However, avoid giving her snacks between meals even if she says she is hungry as these will stop her eating at the next meal.

Make food attractive and fun by displaying it in imaginative ways on her plate, for example by making it into a face, train or house.

All these tricks are more effective than putting a plate of her least favourite food in front of her and trying to make her eat it.

We recommend readers seek personal medical attention in appropriate circumstances