PARENTING: Help, my child is a really fussy eater!

15 April 2018

“My 18-month old is a really fussy eater. We’ve tried everything to introduce different foods, but nothing seems to work. What do you advise for helping us get her to eat? And how do we know whether it’s just fussiness or whether there is something else wrong?”

To answer this question, we first need to establish a couple of concepts. As therapists trained in the SOS Feeding Approach, we classify kids with feeding issues into two groups, Picky Eaters and Problem Feeders.

A Problem Feeder typically has a small and constantly reducing group of foods that they will eat. When they stop eating a particular food, they don’t go back to eating it a week or two later. Most times they will refuse to tolerate new, or unliked food on their plates and you’re far more likely to see a meltdown when you introduce a non-preferred food or a new food. A Problem Feeder will also typically refuse entire categories of foods, e.g. all meats, or all crunchy or chewy textures. Some children with these issues will have a medically complex background that has contributed to their avoidance of many foods. Other children with feeding problems may have sensory or oral-motor (muscle tone in and around the mouth) issues that contribute to their extremely limited diets. Extreme restrictive eating can also occur after a traumatic event, such as a choking incident, and have a primarily psychological basis.

If your child is in this situation, the advice is simple, get help as soon as you can, preferably from someone trained and experienced in the SOS Approach, which is clinically effective and designed to be non-stressful to the child.

If your child has only a few of the symptoms described and they:

  • will eat more than 20 different foods
  • will sometimes go back to eating foods they’ve been refusing
  • tolerate new foods on their plate and can touch or taste them
  • don’t avoid whole groups of foods

then your child is more likely to be a Picky Eater, in which case there are some things you can try before you seek help.

Start taking notes about what your child does and doesn’t eat. If you do end up seeking help with your child's eating, this information will be absolute gold to whomever you speak to and will make planning for therapy faster and more effective.

Remember, some degree of pickiness is normal, especially in younger children. Most adults have a few foods that they prefer not to eat, without considering themselves picky!

Routine: If you don’t already have one, think about establishing a mealtime routine. Consider same time, same place, seating etc. You don’t have to do this all the time, but try to focus on doing this for at least two mealtimes a day.

Modelling: Kids learn what they are shown. Repeated exposure to new foods increases the chance that your child will learn to accept the new food. Family meals are important because they let your children see adults do things like chewing and biting, and they get to see you enjoy and prepare food. This plays a huge role in making mealtimes positive.

Managing: Give children food they can access, e.g. a cooked or raw carrot stick they can chew on and easily put in and take out of their mouths on their own, instead of pureed carrot that has to be fed to them on a spoon. 

Learning: Explore food together and give a child an active role in preparing food, like bringing vegetables, peeling them, putting chopped food in a bowl etc. This shows children that food can and does change in texture while remaining the same food. It also allows them to handle and experience food in a context where no one is hanging over them expecting them to eat it.

The importance of positive experiences can’t be overstated. Food is highly reinforcing. Think about the last time you ate out and felt sick; for most people, they will strongly avoid eating at the same place, and often avoid the same type of food or drink, after just one bad experience. If you put yourself in the shoes of a child who struggles to eat, imagine the negative experiences mealtime after mealtime. These experiences can’t be erased but what therapy can do is build enough positive experiences to overwhelm the negative ones. Eventually we build so many positive experiences that your child begins to enjoy and explore food.

Written by

Gam Sefe / Speech Language Pathologist

Gam has 10 years of experience providing speech therapy to kids and adults with and without disabilities. As director of ChatBox Speech Pathology, he manages one of Brisbane’s most dynamic therapy services. www.chatbox.com.au

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