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Sarah Connellan offers parents advice on how to broaden their child’s eating habits.
What is Fussy Eating?
Fussy eating (also known as picky eating or food fussiness) is an unwillingness to eat familiar foods or try new foods, as well as having strong food preferences. This can apply to particular tastes and foods (such as bitter foods or vegetables) as well as food textures (such as pureed or crunchy foods). Fussy eating is very common in young children, particularly two to six year olds, with up to 50 per cent of parents describing their young children as fussy eaters.
What Causes Fussy Eating?
Fussy eating is a normal part of growing up and is influenced by both genetic and environmental factors. It may reflect your child’s growing sense of independence as refusing food can be a way of asserting themselves. Additionally, children naturally become more fearful of new foods (food neophobia) from two to six years. This is thought to be an adaptation to help survival, as it stops children eating foods that could be potentially poisonous. From birth, infants also have a natural preference for sweet tastes and tend to reject bitter or sour tastes, such as green vegetables or citrus fruits. Most children eventually lose this taste aversion, and learn to like bitter and sour foods, but every child is different and some require more exposure to these foods before they learn to accept them. While food fussiness has a genetic basis, a child’s behaviour is also influenced by their environment and experience and there are many ways fussy eating can be prevented and managed.
How Can Fussy Eating be Prevented?
Some fussy eating is normal and children usually grow out of it but there are many ways to expand a child’s diet from the very start.
- Pregnancy & Breastfeeding: infants are exposed to lots of different tastes both in utero and through breastmilk. Having a healthy varied diet during pregnancy and breastfeeding can help your child accept a variety of foods.
- Complementary Feeding (starting solids): waiting to start complementary feeding until six months of age is advised for many reasons and can also reduce the risk of fussy eating. It’s important to include bitter-tasting vegetables, like broccoli, among your child’s first foods so they become accustomed to these tastes early on. The more foods your baby tries before food neophobia sets in the better! Finally, it’s important that your child is eating a variety of textures, including lumpy foods, by at least nine months of age.
- Modelling Behaviour: Children learn from, and respond to, what they see. If they see the people around them eating a variety of foods they are more likely to do the same. Try to eat healthy balanced meals with your child as often as you can and model the behaviours you want them to copy.
- Rewards: If we use ice-cream as a reward for eating vegetables, vegetables become bad and ice-cream becomes good. Using food as a reward also encourages children to associate specific foods with love and praise which can lead to them overeating foods that are high in sugar, fat and salt. Instead of food, try using story time, a game, stickers or a trip to the park as a reward for good behaviour.
- Fresh Foods: Some studies suggest that providing fresh food to infants, and avoiding the use of ready-made baby foods, is protective against later fussy eating.
How Can Fussy Eating be Managed?
If your child is a fussy eater there are lots of ways you can positively manage this normal part of growing up, such as;
- Meal Timing: offer three meals and two-three healthy snacks every day at approximately the same time. When you have regular meal and snack times your child will have a more predictable hunger pattern and is less likely to refuse food.
- Praise, Not Pressure: it’s important to encourage your child to try foods and to praise them when they do, but pressuring your child to eat can lead to them associating mealtimes with stress and anxiety and may cause them to eat even less. Offer small portions, praise them when they finish it, and then offer some more.
- Don’t Make a Fuss: it’s normal to worry when a child refuses to eat but children can easily pick up on any tension or anxiety and this can make the situation worse. How much your child eats in one meal or even in one day is not important. It’s more helpful to think about what they eat over the course of a week to see if they’re getting a balanced diet.
- Exposure: Some children need to be offered a food up to 15 times before they finally accept it. Try offering a new food alongside accepted foods so the meal still looks familiar. Sometimes changing the way you serve it can help too, for example a child may reject cooked carrots but enjoy raw grated carrot.
- Eat Together: your child learns that different foods are safe and enjoyable by watching others. Sometimes a child will eat for someone they like or look up to, such as a friend or grandparent, without any fuss so invite others to eat with you. Give your child the same foods as the rest of the family (but without salt) and make mealtimes an enjoyable experience by getting rid of distractions (such as TV and mobiles) and chatting together.
- Offer Choice: as fussy eating is sometimes due to your child’s increased sense of independence it can be helpful to offer them some control over their eating. For example, you can offer them a choice of two options (such as a yogurt or a piece of fruit) for their snack. Limit the choice to just two options so they are not overwhelmed and make sure both choices are healthy.
- Self-Feeding: although it can be messy your child may eat more if they have more control so encourage them to feed themselves from a young age with finger foods such as vegetable sticks, chopped fruit, crackers and sandwiches.
- Meal Preparation: children are more likely to taste foods if they’ve helped prepare them. If age appropriate, involve your child with shopping, meal planning, chopping, mixing, cooking and even growing herbs or vegetables if you have a garden. Making meals colourful and interesting can also make the meal more appealing and fun.
Is it Important to Address Fussy Eating?
Most children grow out of this stage quickly and it has no effect on their long-term health and growth. However, fussy eating can be a burden on families as it can cause mealtimes to be stressful and parents are often concerned about their child’s diet. “Fussy eaters” are more likely to be deficient in some micronutrients, such as vitamin C and folate, and many don’t get enough fibre, which can cause constipation. Prolonged fussy eating can also influence diet in adulthood and, if severe, may lead to issues with weight.
If your child is eating foods from the four main food groups (fruit and vegetables; starchy carbohydrates such as bread, rice, pasta and potatoes; dairy or dairy alternatives; and protein foods such as meat, fish, beans, pulses and eggs) they have a balanced diet and if your child is happy, active and gaining weight, they’re eating enough.
If, on the other hand, your child is not gaining weight or is lethargic, weak or irritable you should speak to your doctor. It’s important to first rule out any medical or behavioural reason for them not eating as, very occasionally, there may be an underlying problem. A dietitian can also offer support by evaluating your child’s diet to see if it is deficient in any nutrients and give appropriate recommendations and advice to resolve any issues. If you are unsure, make an appointment with your GP.
Sarah Connellan is a registered dietitian at Central Health Medical Practice.