One of the hardest things to handle as a parent can be a fussy eater, especially if you eat healthily and have always offered healthy foods to your family. One of my children would only eat vegetables if they were pureed or hidden in bolognaise from the age of two until recently. Whereas one of my other kids eats only vegetables and refuses meat!
For some children, fussy eating can be present from infancy.
These kids were difficult bottle or breast feeders and were never very interested in solids. For others, fussy eating develops later or may be triggered by an illness or stay in hospital.
As a parent, one of our fundamental roles is to feed our children. When our kids don’t eat well, we worry that they won’t grow or develop normally.
So how do you know if your child’s eating is within the realm of normal behaviour or if it is a problem?
Even if your child is a fussy eater, his or her growth is considered ‘normal’ if they:
- follow their age and sex weight centile on the growth chart in their child health book and are gaining weight at the expected rate. This is best assessed using a few measurements over time, not just one. Some children may be less than the lowest centile for their age (third centile) but may still be within the normal growth limits and just be small babies or children.
- follow a different centile to their birth weight. Children can follow higher or lower centiles after they are born according to their genetic potential ie. how big their parents are.
- are reaching their developmental milestones.
It’s very common for children to be growing well but to simply be fussy! Healthy, typically developing children will never voluntarily starve themselves, even though sometimes it seems as though they are eating very little.
Some reassuring things to know about fussy eating are:
- In toddlers, it is very common and a normal stage of their development. It’s one way young children explore their environment and assert their independence. Their appetites will go up and down depending on how much they’re growing and how active they are. This is also true for infants. Typically, children actually eat less in the second year of life despite being more active as they are distracted by their new-found freedom and their environment.
- Children’s eating can be very unpredictable. It is normal for kids to refuse a new food or dislike a food one day having eaten it the day before. Some kids won’t eat food of a particular colour, shape or texture or they just refuse a whole category, such as fruit or vegetables!
Try these strategies to help your fussy eater:
- Make meal times fun: Turn off the TV and try to make the food interesting. Fruit is always more appealing when cut up and displayed on a plate and you can cut sandwiches into fun shapes. You can also boost favorite recipes with vegetables and fruit (I’ve suggested some books and further reading at the end of this blog).
- Offer healthy foods repeatedly and regularly: Temember, you are the boss, so don’t give into demands for large volumes of milk, sweet foods or salty snacks because “that’s all they will eat”. Try not to offer dessert as a reward as this only makes treats more appealing.
- Give plenty of praise when they try a new food! Maybe try a star chart for kids over three years of age for two weeks to encourage them to try new foods.
- Support your child’s need for independence: Let them make some choices and let them get involved in the food preparation. Kids love to cook so let them help.
- Encourage self-feeding from a young age: This fosters an early interest and willingness to explore different foods.
- Don’t heap food onto your child’s plate: have realistic expectations of how much they will eat. Also remember most toddlers won’t sit at the table for more than 15 minutes so limit mealtime!
- Try to ignore fussy eating as much as you can: Sometimes children are seeking a big reaction and your attention. Try not to get upset with mess and spilled drinks.
- Try not to overly pressure, force or trick your child into eating: This can create new problems, particularly anxiety or anger issues.
If you are concerned about your child’s growth, have them weighed and plotted on a growth chart (along with previous measurements). If your child’s weight is tracking downwards on the centile charts they may have poor growth and should be seen by your GP, your child’s paediatrician or maternal and child health nurse.
A dietician may also be helpful, especially if you need some high energy eating tips for infants and toddlers. If your child is very restrictive in what they will eat or will only eat foods of a certain colour or texture, seeing an occupational therapist for sensory issues may help. If your child is gagging, vomiting or choking or is refusing most or all food, they may have an oral motor difficulty or an oral aversion and should be assessed by a speech pathologist and paediatrician or be seen in a multi-disciplinary feeding clinic.
Some helpful information can be found at:
- Books: Feeding Fussy Kids, by Antonia Kidman and Julie Maree Wood
- Raising Children Network: http://raisingchildren.net.au
- Better Health Channel: http://www.betterhealth.vic.gov.au
- Nutrition Australia: http://www.nutritionaustralia.org
- Dieticians Association of Australia: http://daa.asn.au/for-the-public
Please note: Dr Margie is no longer monitoring this blog. If you are concerned about your child, please contact your paediatrician or GP for advice.