Children will have good and bad days but often still get enough nutrition to grow and to keep them healthy. Other children are often described as ‘fussy eaters’ and ‘picky eaters’. These terms are not always helpful. They tend to ignore the very real challenges that some people can face when it comes to mealtimes.
Eating and feeding problems can sometimes dominate family life. It is easy to be overwhelmed when eating problems are severe and are so closely tied to your child’s health and development. The fact that mealtime occurs at least three times a day, and families and children are not always able to eat at home, adds to the stress.
It is important to rule out any medical reasons for them not eating or having a restricted diet first.
Do they have chewing or swallowing difficulties?
Are they worried about their weight or shape?
If you or your child are worried about any of the above, discuss this with their GP.
Understanding the eating experience
Eating is a sensory experience
We use all our senses when eating and they all work together.
Eating starts with our eyes. We need to be able to see where the food is. We also look at the shape, colour and presentation of our food.
We touch the food with our hands, body and face so that we can move the food from the plate and into our mouths. We have to be able to feel the food as we put it into our mouths and chew it. Our sense of touch also tells us the shape and texture of the food and whether it is hot or cold.
As we smell food as we bring it towards our mouths.
As the food goes into our mouths we taste it.
We listen to how the food sounds as we eat it, particularly if we eat something hard.
We listen to how the food sounds as we eat it, particularly if we eat something hard.
We use this sense to help us keep our head upright and in the correct position when eating.
(how the body is feeling)
Some people find it difficult to read their body signals so they may not know when they are hungry or when they have had enough food.
If your child has a restricted diet, then the first step is to carry out some detective work.
Try to work out what, when, where and how your child will and won’t eat certain foods. Using a food diary might help you to do this.
If you are worried about your child’s dietary intake, it may be useful to keep a food diary. Use this to keep track of how much they eat and what they eat.
It is useful to note:
what they ate
the amount they ate
time of day they ate
where they ate
who was there
It may also be useful to note other factors like:
- Distractions – was the TV on?
- Did they eat off their favourite plate?
- Were they in a busy or noisy environment?
Although some children have a restricted diet, it can still be ‘good enough’. If they are eating from all the main food groups, then their diet could be ‘good enough’.
Reasons why a child might not eat particular foods
There are lots of reasons why your child might not eat particular foods.
Think about whether your child has had a traumatic experience with food. Did they choke on food or were they sick after eating something? This can affect how they feel about eating and how they take part in mealtimes.
You might want to think about whether they are worried about their weight or body shape. This could be affecting what they are eating too.
Some people dislike changes in their routine. This can affect their eating pattern. Foods given in a different way, at a different time or in a different place might be refused. Some people will notice a difference in food packaging, and this may result in them refusing to eat a food they previously ate.
Could it be a sensory processing difference? Are there patterns to the foods your child/young person likes/dislikes? Be aware of textures, heat, cold, smell and colour.
Once you know what, when, where, how and why your child will or won’t eat, you can develop a plan to increase the number and variety of foods your child will eat.
It is important to be calm and not controlling. Struggles and battles regarding eating can often make matters worse. Often the most successful experiences are when children are given some control over their eating.
It is important that children see others enjoying eating and trying different foods. Eating together is a great way for children and young people to learn about food.
If you can put the food on the table. You can then serve up to make sure everyone gets a little bit of everything. If you don’t have a table, can you all sit together.
Talk about what foods taste, smell, feel, look and sound like. Use words like ‘crunchy’, ‘chewy’, ‘sour’ or ‘sweet’ when talking about food. This will help your child a better idea of what the food might taste or feel like in their mouth.
Routine and structure
Have regular meal and snack times. Aim for 3 meals and two or three nutritious snacks a day. You want to discourage ‘grazing’ and encourage routine. Try to leave at least 90 minutes between meals and snacks. Try not to leave more than 4 hours between meals.
Try not to rush meals as children may be slow to eat but avoid letting meals last longer than 20- 30 minutes. Timers can be useful at mealtimes to show how long meal time will last.
Some children find it difficult to sit to eat a whole meal. Try short times sitting and build on this so that your child is successful. Don’t expect big changes after 10 minutes, an hour, or even a week. Patience and consistency with this process is key to success.
Remember it isn’t always easy, especially when you’ve had a long tiring day!
Give lots of time for taking part in messy play activities.
It is also important to let your child play with their food. Make sure you explain any behaviours that are not acceptable, such as throwing the whole plate of food on the floor.
Let them touch and feel the texture of the food. This helps your child explore the food with their touch sense before they use their sense of taste.
Involve your child
Encourage your child to help you with meal preparation. Children are more likely to taste something if they help make it. They could go to the shops with you, then select and buy ingredients, if they are comfortable with this. There should be no pressure to eat what they have prepared.
If they do not like to go shopping, you can plan a meal at home, look up a recipe and shop online.
If you have a garden, let your child help you grow fruit, vegetables, and herbs.
If age appropriate, let them help with cooking, mixing, chopping. Let your child put the food in the pan and help you to arrange food on each plate so it looks nice. If they have a chance to help prepare food, they are more likely to touch and smell it.
Give choice and control
Give children a sense of control. Let your child choose between chicken or fish, beans or peas, potato or rice when planning meals. Try to stick to two choices – any more and your child can become overwhelmed.
When choosing foods, encourage your child to make up a weekly menu and use pictures to illustrate what each meal will be. Visual timetables can be useful.
If you can, put the food out and eat ‘family style’, where you or your child serves up so everyone has a little bit of everything. Make sure you have food you know your child will eat as well as other food they might not have tried before.
If you can, get them to put a little bit of the new food on their plate (they don’t have to eat it if they don’t want to). You could try asking them to serve you the food. If this is too much, leave it and move on.
Children do not want to be tricked. Tricks such as hiding ‘extra’ vegetables in spaghetti sauce or supplements in a child’s favourite drink do sometimes work but can also backfire.
Sometimes, after finding ‘additions’ to familiar favourites, children learn to be suspicious of all foods and will limit their diet even further. This strategy probably works best when the sensory characteristic the child is focusing on is the ‘look’ of the food. If a child is more sensitive to the smell, taste or texture of a food, it may be harder to make ‘additions’ because they are usually easier for the child to detect. Be cautious when using this strategy. Do let your child try sauces with their food, if this helps them to accept and tolerate new foods.
Remove the pressure
Pressure and arguments usually only make children more resistant to new foods than ever and it’s a battle you are unlikely to win.
Make sure meal times are fun and not confrontational. If your child struggles with the social ‘chit chat’ of mealtimes, try putting on some music or an audio book.
Remember, try and keep the pressure off. The goal isn’t eating when you are exploring new foods, just play, and if your child happens to eat something new – bonus!
Introduce new foods slowly
It is important to introduce new foods gradually. Try introducing one new food at a time alongside a food you know they will eat. This will help your child to get used to the smell, look and feel of the food.
When texture is a known issue, try to introduce new foods in a similar way at first. For example, a new vegetable can be turned into a puree if chunky textures aren’t liked, or traditionally hot food can be served at room temperature.
Start with a food that has a good ‘sensory fit’. Chose a food that has similarity to the foods they like. If your child will eat chicken nuggets, try them with baked chicken strips. If they will only eat a certain brand of pizza, try a different brand.
Offer the food on a daily basis. Think of how your child might best accept a new food in their space. Using a small separate bowl or plate placed near to them might work. You then need to try to increase your child’s exposure to the new food. You can try gradually moving through the steps below:
1. Put the new food on the table
2. Put the new food on their plate
3. Encourage them touch it
4. Encourage them to lick the food
5. Encourage them to put the food in their mouth
6. Encourage them to chew the food
7. Encourage them to swallow the food
Be creative. Your child may be more willing to eat “rocks and trees” than meatballs and broccoli.
Fun arrangements such as some vegetable sticks and grapes or tomatoes placed in a smiley face pattern on a plate may encourage your child to taste something new.
Let them play with their food as much as possible. Make food fun!