Fussy eating and mealtime challenges
Fussy eating is a relatively common phenomenon in children with studies estimating that between 10-30% of preschool and primary school children are picky with their food (1). It is thought to peak at the age of three (2) and for the vast majority of children it resolves over time. Fussy eaters will typically reject foods leading to a sub-optimal variety of foods in their diet.
Fussy eating is influenced both by your child’s genetic make-up and also by environmental factors (something you can guide and shape). On a positive note in the vast majority of cases there is no significant impact on a child’s growth or nutrition despite them not having a varied diet, however when it comes to mealtimes it can often be extremely stressful for both parents and child. Common mealtime challenges include; food refusal, rejection of previously accepted foods, perception that the child hasn’t eaten enough which in turn can lead to pressure to eat, negotiation, bribery, punishment, distractions at the table and general frustration on both sides.
There are a range of strategies that can be introduced to reduce stress at mealtimes for both parent and child, and to support acceptance of new foods in the longer term.
Manage your expectations; particularly around portion sizes (they’re often smaller than you may think). Also be aware of the impact of snacking/grazing between main meals and consider how best to manage your mealtime/snack schedules.
When introducing new foods, select foods that your family eats regularly as these will already be familiar to your child. You can also choose foods which are similar in size, shape, consistency, texture, colour and/or taste to already accepted foods. This technique is known as food chaining.
Trust your child and let them determine how much they want to eat. “You provide, they decide” is a component of the ‘Division of responsibility’ feeding model by Ellyn Satter (3). Following this approach removes virtually all mealtime battles and moves you away from habits which have crept in which can be unhelpful for long term food acceptance. They include; pressure to eat, use of distractions, bribery or food rewards and offering alternatives. This approach clearly outlines discreet roles for both parents (as the providers) and children (who have the autonomy to choose what and how much of the foods offered that they wish to eat).
Role modelling and eating family meals together, have been shown to have influence over intake of certain foods and also food preferences. Your reluctant child is more likely to eat a food if they see a parent or trusted adult eat it.
Use of language can also have an impact. Opting to use descriptive language rather than emotional language around food is beneficial.
Expose, expose, expose (4)! Parents often stop offering foods after they have been rejected by the child just as few times, however studies tell us that children require multiple repeated positive exposures to food before they may even taste it. Exposure can include looking at pictures of foods, picking out food in the supermarket, prepping and cooking it at home as well as seeing it on the family table or on their plate. For more information about how you can expose to foods whilst also making one meal for the whole family you can download my free fussy eating guide and meal planner.
Avoid pressure and negativity around foods and eating. Pressure can include, coercion “just have bite”, emotional blackmail “if you were a good girl you would eat it because it took me a long time to make it”, direct pressure “you need to eat that those carrots”, bribery “if you eat it you can watch TV” and negative consequences “if you don’t eat it then you won’t have any TV time”.
There are instances when your child may not respond to the strategies outlined as they may have feeding disorder which requires further assessment and more specialist advice and support. If your child has a developmental, sensory or Autistic Spectrum Condition, if their intake is failing to meet their nutritional or growth requirements, if they have a medical condition limiting their diet e.g. coeliac disease or food allergy, chronic illness, or if they have swallowing difficulties then a specialist feeding referral is indicated.
If you are looking for a more comprehensive resource to action the strategies outlined in the blog then take a look at my online fussy eating course.
This blog has been adapted from an excerpt I contributed to the book Still Awake by Lyndsey Hookway.
References
1. Taylor CM, Wernimont SM, Northstone K and Emmett PM (2015). Picky/fussy eating in children: Review of definitions, assessment, prevalence and dietary intakes. Appetite 95, 349-359
2. Taylor CM and Emmett PM (2019). Picky eating in children: causes and consequences. Proc Nutr Soc 78, 161-169
3. https://www.ellynsatterinstitute.org/
4. Spill M, Callahan E, Johns K, et al. Repeated Exposure to Foods and Early Food Acceptance: A Systematic Review [Internet]. Alexandria (VA): USDA Nutrition Evidence Systematic Review; 2019 Apr. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582170/ doi: 10.52570/NESR.PB242018.SR0401
