My 2 year old daughter was diagnosed with Type 1 diabetes last year at the age of 18 months. We pretty much let her eat what she wants and adjust her Humalog accordingly. Lately, she has become very upset when she wants candy or an extra treat and it is not time to eat. I offer her “free food”, but she becomes hysterical if I do not give her what she wants. So, I end up giving in with the attitude she doesn’t understand this yet. I feel totally out of control with her diet. I want to bake cookies with her and let her have special treats, but, even more, I want her to stay healthy. I need some advice on how to feed a 2 year old and what to say to her when she wants something she can’t have.

It is really important to avoid “food wars” with your preschooler. All children need to listen to their own internal sensations of fullness and hunger. So, when you have done your job as a parent by offering healthy, well-balanced meals and snacks, your job is over. It is then your child’s job to eat (or not). Pleading, begging and bargaining over food is never successful.

When it comes to high carbohydrate foods, Humalog can be used to cover what the child eats. This has been a wonderful way of avoiding the concept of forbidden foods. However, no child needs to eat candy or cookies. Moreover, all parents say “no” to their children’s requests about sweets sometimes, and tolerate their child’s temper tantrums after being disappointed. Children must learn that “no” means “no” and that temper tantrums are not strategies that are tolerated.

You may wish to meet with your team dietitian, team social worker, or team psychologist to discuss your child’s food behaviors. Also, you may find the following references worth reading: 1) Disciplining a Child With Diabetes in October, 1999 Diabetes Forecast, and 2) Sweet Kids: How to Balance Diabetes Control & Good Nutrition with Family Peace by Betty Brackenridge & Richard Rubin, published by the American Diabetes Association.

JWB