Fussy eating

Fussy or picky eating is very common in toddlers and children, it often starts around the time that they move around independently and can peak at about 2 year’s old. If you don’t have a fussy eater you are very lucky as neophobia (the fear of new things) is a phase most children go through. It is thought that it is an evolutionary trait which prevents young children eating poisonous berries and that sort of thing off the ground. My 4 year old is going through an extended fussy stage so I can empathise on this subject, it’s very frustrating!

frustrated-mom-cartoon

Now, fussy, picky or faddy eating is on a sliding scale which goes all the way to oral hypersensitivity and extreme food refusal. Oral hypersensitivity is more like a phobia to food and children will often hate things in their mouths or getting messy at all. They may also have very rigid behaviours such as only eating crunchy things, food of a certain colour, or food that has to be the same brand. If your child is displaying any of these signs, please speak to your GP or Paediatrician, they may need to be referred to a specialist feeding clinic. If you are not sure, I would be happy to have a chat to establish if specialised help is needed. If you believe your child is losing weight, has symptoms of extreme fatigue or gastrointestinal problems including constipation please contact your GP or Dietitian.

What I am talking about here is behavioural picky eating, so for example my child is very picky with lots of food and would only eat sausage and chips if he were to choose but will eat other things when encouraged and he loves olives. Clearly he is not orally hypersensitive and most importantly he is lively, healthy and is growing appropriately.

So, how do we tackle fussy eating? Well, there are whole books on the subject so I’m not going to go into too much detail, but here are a few pointers.

The Golden Rules of tackling fussy eating:

  1. RELAX! I know you don’t believe me, but if you’re stressed the whole situation will be stressful for everyone concerned. It may mean that children are not looking forward to mealtimes due to the atmosphere and you have a problem before they’ve even sat down.
  2. Have 3 regular meal times sat at the table. You may have to have a star chart to even get this far! It is ideal for the whole family to sit down together but if you can’t, at least sit down next to your child while they are eating.
  3. You dictate what is on the menu. Don’t ask them what they want as they will then refuse anything you suggest. If you have nailed number 2 then you present them with food as they sit down.
  4. Offer food that is acceptable to them along with a challenging food. It depends how fussy your child is, a lot will be ok with the challenging food being on their plate, some will not. You may have to put what the rest of the family are having on a small plate next to them. If they show ANY interest in the challenging food, heap praise on them. Even if they just smell or poke it.
  5. When your child refuses to eat something, DON’T react. Children love attention and unfortunately that can include negative attention. Just ignore any unwanted behaviour or shrug it off.
  6. Praise any wanted behaviour. This can include sitting at the table, smelling food, touching food, talking about food and of course eating food. Star charts or getting stickers for eating well can be good motivators too.
  7. Get children involved. With everything food related, shopping, planning, cooking, even growing food. The more you demystify food the better. And it’s a great sense of achievement for children to eat something they have made.
  8. DON’T make deals! Never say, if you eat this you can have your pudding. All they have heard is pudding and it’s game over!
  9. ALWAYS offer pudding. I know it’s counter-intuitive but it doesn’t need to be chocolate fudge cake. A yoghurt and a piece of fruit would be fine. have the second course just means they have more opportunity for extra nutrients.
  10. DON’T disguise or hide food. They are not daft, it might work in tomato sauce a few times but as soon as they figure it out they’re not even going to eat the original food that they did like.
  11. Remember that their portions should be quite small. If they say they are full after a few mouthfuls then they might be. The Infant and toddler forum have an excellent fact sheet which shows what portion sizes should look like, click here.
  12. Give them a supplement containing vitamin D. New guidance has come out which recommends that everyone in the British population should be taking a vitamin D supplement, children need 10mcg or 400IU per day. And if you think their diet is particularly narrow give them a multivitamin suitable for their age.

And remember, this will not solve itself overnight. It is a long slow process. A child has to try something 15 times for them to get used to it. I know it’s difficult but do try to not worry. If your child is lively, growing well, opening their bowels and passing urine regularly they are probably doing ok!

The Infant and Toddler Forum  and www.gosh.nhs.uk from Great Ormond Street Hospital have good factsheets on fussy or picky eating. If you need general advice on healthy eating for children, this fact sheet from the BDA is useful.

If you are still worried and need to speak to somebody urgently, you can contact me and I can help or advise who is best to speak to.

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