In this post I will cover:
1. The difference between a fussy eater and a child who has feeding difficulties.
2. What causes children to be fussy eaters, and what causes feeding difficulties in children.
2. Offer advice for how to support children who are picky eaters, and how to support children with feeding difficulties.
What is the difference between a fussy eater and a child with feeding difficulties?
Eat a limited number of foods 20-30.
Avoids some classes of foods (e.g. red meat or green vegetables).
Eats enough to support growth within the age appropriate ranges.
Will try some new foods after repeated exposure.
Can tolerate new foods on their plate some of the time.
Will eat at least one food from most texture groups (e.g. soft, hard, crunchy, chewy).
Usually eats with their family, but may eat different foods to their family members.
Eat less than 20 foods.
Stop eating foods they used to eat.
Refuse to eat certain textures.
May be underweight compared to their peers.
Displays extreme reactions to new food (screaming, crying, lashing out at carers).
Be unwilling to try any new foods, even after repeated exposure.
Regularly eats different foods to family members.
Gag or vomit when eating new foods.
What causes fussy eating?
There is not consensus on what causes fussy eating in children. However, there are a few different theories.
Sensory processing problems. Everyone has their own sensory preferences when it comes to food. However, for some children they may be hypersensitive to certain textures, tastes and smells. This hypersensitivity can cause stress and anxiety when presented with specific foods, and may result in the child refusing to try new foods.
Fussy eating habits modelled by peers or family members. Children learn a great deal through imitation. If they have seen fussy eating behaviours modelled by family members or peers they may also adopt these eating habits.
A part of typical development. Children refusing to eat certain foods may be a part of their development in learning how to assert their independence. Children may be testing the boundaries of what they can and can not control in their environment
What causes feeding problems?
Feeding problems are caused by negative experiences with feeding due to a range of factors including:
1. Medical conditions such as reflux, allergies and dysphagia.
2. Oral motor delays impacting the child’s ability to chew food.
3. Sensory processing problems causing the child to have an extremely limited diet.
Children with one or more of the factors above will have had at least one negative experience with a certain type of food, resulting in the child avoiding this food. For example, a child with oral motor delays may experience feelings of choking on foods with hard or crunchy textures, therefore they will avoid all foods that are hard and crunchy in the future.
How can I help my child who is a fussy eater?
There are many strategies available to support your child with mealtimes. I have posted 5 quick tips below.
1. Provide a regular mealtime routine.
Providing routine times for three main meals and 2-3 snacks per day will support your child to be ready to eat during mealtimes. Providing routine times will also eliminate the opportunity for constant grazing on snacks throughout the day. Learning to eat at routine times is important, as this will support your child with mealtime routines in the future (e.g. Kindergarten and school), it will also support your child to feel hungry at mealtimes, and be more willing to try new foods.
2. Provide repeated exposure to new foods.
Children may need to be exposed to a new food 15-20 times before they are willing to try the food. Offering the new food on their plate without the pressure of eating the food will support your child to gradually become more comfortable with this new food.
I like to be a food scientist with the children I work with, we will put on our science googles and lab coats and fill out our lab sheets with information about the colour, texture, taste, sound and smell of the new food.
3. Allow your child to participate in meal preparation.
Support your child to be involved in buying the ingredients at the supermarket, and to help with preparing the food. Involvement in this process will enhance your child’s ownership over the meal and may encourage them to be more willing to try the new food.
4. Provide your child with controlled choice within mealtimes.
Offering controlled choice means you provide a choice between 2 foods your child could try. For example, you could offer your child broccoli or carrots as the vegetable with their meal. Alternatively, you could offer 2 choices between the complete meal (e.g. you can have stir-fry or fried rice for dinner). Providing controlled choice allows your child to have some control and choice within the mealtime, but prevents you from making a whole seperate meal for your child.
5. Avoid force-feeding your child.
Force-feeding is likely to result in stress and anxiety around mealtimes for your child. Force-feeding may also impact your child’s trust around trying new foods, and may result in your child reducing the amount of foods they are willing to try.
How can I help my child who has feeding difficulties?
The first step is to speak with your Doctor to identify or rule out any underlying medical conditions that may be impacting your child’s feeding (e.g. reflux or allergies).
The next step may be to gain a feeding assessment from a multidisciplinary team to identify why your child is experiencing feeding difficulties. Allied health professionals including Occupational Therapists, Speech and Language Pathologists and Dieticians can all support in identifying the reason why your child is experiencing feeding difficulties. Once the assessment has been completed the multidisciplinary team can form a treatment plan for your child.