“Pleeeassse trrry this darling, pleeeasssse eat just this tiny bit, just one tiny bite for mummy”… please…?
Are you often repeating these phrases at mealtimes? If you are struggling with a fussy eater or even just want to keep that picky eating at bay you are in the right place to read all about why you may have a fussy eater and how to deal with the situation.
Now remember this because this is a key element in your child’s journey to eating. Not rocket science! CHILDREN WILL EAT WHEN THEY ARE HUNGRY. Makes sense right, not like us adults who can mostly eat any time of the day even when not hungry and for me this is especially true when there is chocolate within a 10 mile radius! We all have hormones that control appetite and hunger called Leptin and Ghrelin and they will impact on sleep. GHRELIN: Secreted from the stomach, Responsible for telling the brain you are hungry. LEPTIN: A hormone produced by the fat cells in the body. Responsible for telling the brain you are full. ENOUGH SLEEP Low Ghrelin/ Normal appetite High Ghrelin/ More hungry NOT ENOUGH SLEEP High leptin / satisfied after eating Low leptin/ Unsatisfied, even after eating Fussy picky eating may start to show around the age of 1 year. At this age growth slows down considerable, and energy levels decrease a lot so do not worry if your child seems to suddenly eat a lot less than they once may have done. Nutrition is regulated over the course of a week and not in a single day. Of course food and sleep goes hand in hand and when I work closely with families I always look at the child’s diet, times of and what their child is eating. Low levels of iron and magnesium will effect sleep, a dip in low blood sugar will cause a child to wake and have fitful sleep. But what can we do when it comes to fussy eating? Well we indirectly encourage your child to eat or at least try a food and REMOVE THE PRESSURE to do so. It is our job as parents and carers, to take the pressure out of mealtimes, as not to “feed” the fussy behaviour and make the situation worse and stressful for everyone around. Fussy eating is BI DIRECTIONAL. This means when it does start to happen, it may “make” the parent act in a way that in turn “feeds” the problem. Pressure creates anxiety in a child and a negative association begins towards food and meal times. If a child sees parents argue over the food or cry and stress at meal times this will affect the meal time. It feeds a fussy eater. The meal times are then seen as fear... and in turn puts a child in a state of fear. FACTS 40% of parents will report they have a fussy eater 25% of parents report their child will refuse at least one food a day 79% of parents are over feeders What is a fussy eater and what are the signs? Fussy eating will typically happen in some shape or form at some stage of your child’s development. It is very normal and expected. If your child point blank refuses to eat anything, even try it, be near it or touch it, this is not a fussy eater. This is what is recently more known as ARFRID. (Avoidant Restrictive Food Intake) This is very different from a fussy eater. The signs
Refuse unfamiliar foods
They may eat only a couple of foods for a couple of weeks and then stop eating it only to decide they actually like it again a couple of weeks later. This is called “food jagging”. You child may look for more treat and junk foods other than the “healthier option on the table
Prefer certain types of foods such as carbs like bread and pasta only
They will eat outside of the home but not at home
Why is my child a fussy eater?
To list a few,
Medical reasons such as a tongue tie that has not been addressed, a long hospital stay, recurrent illness or perhaps a chocking experience.
Reflux. This is a huge drive for fussy eating your child may have been in pain when they were taking a feed and they have grown used to eating small quantities often throughout the day. Therefore they have no pattern to their daily diet or eating times.
Chewing and swallowing issues may cause your child to be cautious of what they put in their mouth and they may only prefer a certain texture of food
Sensory issues such as Autism or a sensory processing issue will have an impact on eating habits
A child may show from a very young age they just want more control over their life and who can blame them to be honest! They may push back at meal times and start to dictate when at they want, when and how
Food Neophobia - an eating behaviour trait in which a person refuses point blank to taste and eat food items or foods they are not familiar with
A preference to “junk food” may start to show from an early age
Junk food is a very easy fall back so offered more often than not
Your child may be taking too much milk and becomes reliant on it as much as you. They fill up on milk and have little space for anything else and they have a control over you with this. Much less milk is actually needed than you may think
Information from NHS England, 2022
Full fat milk required until the age of 2 years. Nothing wrong to continue with full fat but did you know there is more calcium in semi skimmed!
Limit intake to a maximum of 300-400mls a day or it will most likely impact mealtimes and your child’s appetite.
A fortified alterative is good if you are not giving cow’s milk to your child. However NOT organic as it has no minerals in it. Vegan cheese is not a calcium source. Nut milks do not have a lot of protein in them nor do plant based milks such as soy or oat.
So what is the solution to your child’s fussy eating?
REMOVE THE PRESSURE!
Pressure creates anxiety, stress, and arguments. Parents shouting at mealtimes will cause stress. Tantrums may occur.
Your child may only eat 1 – 2 meals a day and that is OKAY. Remember nutrition is measured over a week not a day and if your child is following their growth line, gaining weight and developing then there should not be anything to be overly concerned about. Of course if you are, please do go see your paediatrician.
What does pressure look like?
Bribes. Eat this and you will get pudding…
Making your child stay at the table… they may only be able to do 10-20 minutes
Offering rewards when they try/eat food
Watching the child eat, would you like someone to be watching every mouthful you eat?
Talking about the food like it is a hero/tastes great/amazing makes you stronger like daddy...
Putting the food in child’s mouth for them
Begging/pleading child to eat
Punishment. Child did not eat so...no TV...no story...no pudding
Shouting at mealtimes about not eating
Only talking about and enticing your child to the food at mealtimes...”come on eat it” as opposed to “wow this broccoli is green….”
Look at the amount of food you are putting on your child’s plate. If you are piling the food high this may put your child off instantly and they may feel like they can’t even start let alone finish!
Here are some graphics for you to see suitable for 1 – 5 year olds. You may only need to put 2-3 food groups on one plate. Start small, don’t over fill, you can always offer more if they finish!
¼ - ½ half a bagel
1 – 4 broccoli florets
2 – 5 tablespoons of pasta
¼ - 1 salmon fillet
2 – 6 carrot batons
¼ - ½ meatballs
Try these simple solutions
First of all let’s break this down to be really simple.
Your responsibility as a parent is to decide
Where the food will be served
It is your child’s responsibility to decide
Whether to eat or not
How much to eat
Never force your child to eat
Do not use the pressures above at any meal or snack time
Do not negative reinforcement at mealtimes
Talk about other subjects at the table other than the food
Ensure all care givers are on board. If not this will hinder a child’s thought procession eating and days/weeks or months of encouragement may all come undone in the matter of moments
Make mealtimes happy!
Ensure your child is seated comfortably. Children have very low muscle tome so they must be comfortable. This can have a huge impact on how they eat. Your child should be seat at right angles and often having a foot support can be hugely helpful and more comfortable to your child. Like you would sit on a chair. Imagine sitting on the floor or a seat that was not designed for you and how uncomfortable you would feel eating.
Ensure you are all facing each other and not a wall, TV or screens.
Keep offering a varied selection of foods but always have something on the table that you know your child will eat, even if it is crackers! I know this sounds mad but your child will eat them. They will feel engaged in mealtimes with the family and not push away the plate and be upset they don’t “like” anything on the table.
Think out the box on how different ways food can be presented. So if your child like carrots, you can make carrot soup, carrot cake, carrot muffins, grate or boil, cut in different shapes….
You need to capitalize on your child’s hunger so ensure you have a schedule of mealtimes, breakfast, lunch and dinner with 2 snacks through the day. No grazing or your child just won’t be hungry at mealtimes. If your child comes to the table hungry then you have more chance to see them actually eating!
Turning your child’s eating habits around will be a long process. It will not happen overnight. Be calm and patient and as always like sleep be consistent!
And remember always have something on the table you know your child will eat even if a bowl of crisps!
Please do share this blog with any friends you know who may also be experiencing some mealtime battles and as always,
If you would like to hear more about eating, weaning and how to handle the tricky mealtimes please listen HERE to my podcast I recorded with Naomi O'Connor, nutrionist and weaninng expert.
I hope you have peaceful nights,
Your Paediatric Sleep Consultant