As parents, we see feeding and nurturing our children as basic parenting, so when a child becomes difficult to feed, or fussy about their diet, it often makes parents feel that they are failing in their duty of care and raises concerns about weight loss.
Children become “fussy” about eating for a rich variety of reasons;-
- If food has not been a comfort to them as infants, if it has been associated with pain or discomfort, then they are not particularly keen to eat.
- As they become more mobile, the world is more interesting than the boring idea of stopping an activity to eat.
- Feeling rushed at mealtimes, being constipated, feeling tired or unwell can reduce a child’s appetite.
- Being shouted at discourages eating.
- Being pressured to eat more when they have had enough, or being offered foods continually throughout the day can also reduce interest in food and feeding.
The most common medical reasons for refusing food are Constipation and Anaemia.
Fear of new foods is common in the second year of life. This may be a survival mechanism to prevent increasingly mobile toddlers from poisoning themselves by eating everything and anything.
Toddlers have very little control in their lives but the one thing they can control is what goes into their mouths.
As with adults, a toddlers appetite alters through the day and through the week. It is important to keep portions small enough to be manageable. At one year a toddler should be offered 3 small meals and 3 snacks plus milk.
As they grow the snacks are reduced to 2 plus milky drinks.
A toddlers plate should be something like;- 1 tablespoon of meat/chicken/fish, 1 tablespoon of potato/pasta and one of vegetables. Only two tablespoons of a desert such as custard, is quite enough as part of a complete and varied diet.
At around 18 months the fussy toddler tends to become more fussy. Often there is nothing medically wrong and the child may also be “texture defensive” preferring only one texture or colour of food.
They may also be sensitive to touch, sounds and smells. Sometimes they grow out of this by the time they are 5 years old, and sometimes they need help.
Most children will not starve themselves. They will decide what they are prepared to eat and the diet they choose may be very boring. Given time they will extend their repertoire.
What can we do to support a fussy eater?
The first step is to try to understand what has caused this. Sometimes there may be no discernable reason.
- If this is behavioural, and about exerting control then setting times for feeding opportunities and making these short can help. Allowing 20/30 minutes for food to be eaten or it is removed without comment.
- If this is about smell or taste, work with the child to find out what smells good/bad and use this as s cue to preparing food.
- Involve the child in preparing the food. Making a sandwich, choosing the utensils to eat with.
- Consider finger foods and allowing a texture defensive child to play with different textures with their hands. It’s a short step from there to licking fingers and tasting things.
- If you are going to offer choices then only offer a choice of two things, both of which are acceptable to you as a parent.
- Consider having friends of a similar age round, offer snacks and see how your child reacts. Some children eat better in the company of other children.
Avoid
- Following the child round trying to get them to eat.
- Insist that the toddler eat everything on the plate.
- Take away food that was refused and offer something else.
- Large drinks before a meal.
- Offer a snack soon after a meal which was not completely eaten.
- Assume that because one food was refused it will never again be eaten.
Occasionally there is a medical or a physical problem. For further help, if the food refusal is of long duration, see a Consultant Paediatrician, a Paediatric Dietician and a Speech and Language Therapist. The Speech and Language therapist will conduct a “Swallowing Assessment” which will look at oral motor function.
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