How to feed fussy eaters

Georgie Stephen Children's Health Leave a Comment

Fussy eating is one of the most common concerns parents have about their children, with more than 50% of mothers reporting that at least one of their children eats ‘poorly’ and recent estimates that around 22% of children under the age of 3 classify as picky eaters. Although the prevalence drops with age, picky eating can persist into older age groups and ongoing food rejection and mealtime battles causes significant stress for both parents and children. Naturally, parents become concerned about their child’s rejection of healthy foods and overall nutritional status and the impact this has on their growth and development, seeking out strategies to address their child’s fussy eating habits.

Fussy or picky eating can present on a spectrum of severity ranging from transient changes in food preferences that are relevant to their developmental stage all the way to highly restrictive food intake that is persistent over time. Understanding where your child falls on this spectrum and the key underlying factors that may be contributing to their fussy eating habits is imperative for going on to choose the right strategies to help them develop their eating skills.

 

Eating is not as easy as you think

Eating is one of the most complex tasks children will ever have to learn. As adults, we often see eating as a simple task – simply pick up food, take a bite, chew, and then swallow. Easy, right? Well for many children, learning to eat is not so straightforward. Eating is in fact a task that requires us to integrate information from eight different senses all at once, including:

  1. Vision
  2. Taste
  3. Smell
  4. Touch
  5. Sound
  6. Proprioception
  7. Vestibular
  8. Interoception

In addition to integrating sensory information, our body must also integrate information from the organ systems and muscle activity to maintain physiological stability and posture, chewing, and sitting. This, in turn, is all influenced by the child’s learning capacity, developmental stage, nutritional status, and environment, including their surroundings and the parent-child relationship.

All in all, it’s a pretty complex task!

 

Causes of fussy eating

Fussy eating can arise for many different reasons. Many people are quick to assume that picky eaters are simply being difficult or defiant when in truth there are often multiple interrelated factors at play, making eating and trying new foods difficult for the child.

These are mostly related to underlying physiological, sensory, and learned behavioural or emotional factors, which may include:

  • Taste sensitivity or kids who are ‘super tasters’
  • Sensory sensitivities to the textures, colours, or smells of foods
  • Food allergies or intolerances
  • Developmental delays
  • Stress and anxiety
  • Developmental shifts from one cognitive stage to the next, which usually happen around 2-3 years of age, 5-7 years of age, and 9-11 years of age
  • Pain and discomfort
  • Tiredness or fatigue
  • Pressure from parents or caregivers
  • Immature oral-motor and/or swallowing skills
  • Sensory processing problems
  • Learning difficulties
  • Food ‘jags’ or the eating of the same foods over and over leading to food burnout
  • Nutritional factors
  • Illness
  • Overconsumption of snack foods
  • Changes in growth and development, for example, slowing of growth (which usually happens around 2-3 years of age) or the reduction of fat tissue (which usually happens around 5-6 years of age)

 

Strategies to help fussy eaters

Ultimately, the goal when working with fussy eaters is to foster their innate curiosity and interest in trying new foods rather than to force or coerce or even trick them to eat certain foods or certain amounts of food.

When it comes to eating, parents should come to the mealtime as if every meal is a class and they are the professors – you are the teacher and will be teaching the skills for eating and the social experience of eating food.

Unfortunately, there is no one size fits all solution to this issue and the most effective strategies for your child will depend largely on their underlying challenges (physiological, sensory, and/or behavioural), as well as their age, and their unique personality and character. This means you may have to experiment with different strategies before you find the right fit for your child and family.

One thing that is absolutely essential for parents when working on any of the strategies discussed below is patience. Fussy eating does not disappear overnight and depending on the severity of your child’s pickiness and the level of skill development that they currently have, addressing concerns can take many months or sometimes over a year for some children. Introduce strategies slowly and be prepared to commit to trying them each for at least a month or more.

In this post, we will discuss some of the first strategies you can consider to help your child move from being a fussy eater to being a more adventurous eater.

 

Repetition

When we look at the research on eating in children, the most important determinant of whether a child will like a food is the extent to which the food is familiar. This is why presenting children with a new food for the first time is often met with resistance and rejection – they are unfamiliar with the foreign food put in front of them and therefore instantly skeptical and unwilling to try it, something often referred to as food neophobia (fear of trying new food).

It can take children, depending on their age and the severity of their eating habits, between 5-12 positive exposures to an unfamiliar food before they will regularly accept the food. Each exposure ideally occurs on separate occasions and separate days. This means that you need to continue to offer new foods, even when faced with repeated rejection. Repeated exposure to food is the key to success in the long term.

Initial offerings of new food are usually met with “yuck”, “gross,” “disgusting,” or “I don’t like that.” We can help kids to express themselves in other ways and reframe their thoughts, such as, “you’re still learning to like zucchini, it might take a few more tastes before you like it,” or, “remember, it takes our brain 10 times to decide if it likes something or not!” You can also prompt them to say, “I’m still learning about that food,” or “I’m not sure about that food yet.”

 

Set regular meal and snack times

Children thrive on routine and when it comes to eating they want to know what to expect and when. Set a regular mealtime schedule, including snack times, and try to stick to this as closely as possible, including on the weekends. Sit down for every meal and snack time and don’t eat on the run or while your kids are focused on other activities. The food should always be the focus – remember, every meal or snack is an opportunity for learning.

Have a set time (e.g. 10am, 12pm) and duration (e.g. 20 minutes for snacks and 30 minutes for meals) in mind and stick to this. Wrap up the meal or snack after the allocated duration. You can choose whatever timing works best for your family, but most young children need to eat every 2-3 hours to maintain energy and nutrient levels. Older school-aged children can go a little longer between eating, for example 3-4 hours, but this will depend on the child, their needs, and their age.

Not only does this approach set up expectations that your child can rely on about when they can expect the next meal, over time it also helps to facilitate greater awareness of their own hunger and satiety signals.

Consider writing the schedule out and placing it on the fridge or family notice board so that it is clear for everyone. For toddlers and younger children, think about including a clock face on the schedule so that you can point out the time relative to the kitchen clock when they ask when snack/meal time will be, which can act as a useful visual prompt while also teaching them about telling the time.

For primary school age children, the scheduling of meals and snacks becomes harder as more of their time is spent away from the home, but continue to stick to your schedule as much as possible in the time that you have control over – before and after school hours and weekends.

 

Consider the division of responsibility for mealtimes

The Division of Responsibility in feeding (DOR) is a fantastic feeding philosophy developed by renowned family and paediatric dietician Ellyn Satter. The basic premise of the approach is that in every feeding interaction (i.e. meals and snacks), both parents and children have their own responsibilities.

Parents decide:

  • What food is provided or served
  • When the meal or snack will happen
  • Where the meal or snack will be eaten

Children decide:

  • Whether they will eat
  • How much of the food provided they will eat

This philosophy aims to repair the feeding relationship parents have with their children – a relationship that is supposed to be one of trust, nourishment, and nurturing. But, so often, for picky eaters and their parents, this relationship is usually one of tension, stress, and anxiety.

DOR helps to restore trust back into the relationship, for both parents and children. Parents learn to trust that their child will eat what their body needs from day to day and children learn to trust that their parents will respect their independence, ability to learn eating skills, and their body’s cues.

This approach can initially raise a lot of anxiety for parents, as they worry that allowing their child to decide whether and how much they will eat will mean that their child will not eat at all or not each enough food, and the consequences this will have on their health. But as long as you are considerate of your child’s food preferences, implementing DOR can lead to great eating success for many families.

You can read more about the DOR and find useful resources here.

Additional strategies

Fussy eating is a big topic and we have lots more tips and strategies up our sleeve to share. The discussion continues in part 2 of this blog, where we will be covering:

  • Why you should introduce a ‘kitchen closed’ rule
  • Why pressure and force doesn’t work for long term change
  • The importance of sharing family meals
  • How to stop short-order cooking for the demands of your fussy eater
  • How getting your kids into the kitchen can help their eating habits
  • And why you should let your kids play with their food

You can read about more of these in part 2 of our fussy eaters blog series here.

Need more help?

The strategies discussed above can be extremely effective at helping most picky eaters to overcome their challenges. However, there are a small proportion of picky eaters whose eating patterns are so restrictive that professional support is needed.

If you have greater concerns about your child’s feeding, you can take the Feeding Matters Infant and Child Feeding Questionnaire online to help you better understand if intervention may be required.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717879/

https://www.ellynsatterinstitute.org/how-to-feed/the-division-of-responsibility-in-feeding/

https://questionnaire.feedingmatters.org/questionnaire

Share On Facebook
Share On Twitter
Share On Linkedin
Share On Pinterest