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Understanding and Managing Fussy Eating in Children

Source: Getty Images

Understanding and Managing Fussy Eating in Children

Last updated: Friday, September 6, 2024 | 6 min reading time
Jennifer Shim Poh Swan
Jennifer Shim Poh Swan

Dietitian

Discover how to differentiate between typical fussy eating and more serious issues, effective strategies for managing mealtimes, and when to seek help.

Fussy eating in children is a common concern for many parents. It is a phase that typically emerges during early childhood and can be both challenging and perplexing. Children often display selective eating habits, resisting certain foods and showing strong preferences for others.

Understanding the underlying causes and implementing effective strategies can help parents navigate this phase more effectively.

What is fussy eating?

Fussy eating, also known as picky eating, describes a range of behaviours in children related to food. It typically involves:

  • Selective food choices: A child may eat only a limited variety of foods and consistently refuse to try anything outside this range.
  • Strong preferences: A marked preference for specific textures, flavours, or food types, often accompanied by aversions to foods with different textures or tastes.
  • Reluctance to try new foods: A significant resistance to new foods or changes in food preparation, often coupled with a tendency to reject unfamiliar items outright.

While many children go through phases of fussy eating, it is important to learn how to distinguish between typical selective eating and behaviours that might warrant further intervention.

Distinguishing typical fussy eating from problematic feeder

Fussy eater refusing food

Typical fussy/picky eater Problem feeders
Food variety and acceptance Consumes at least 30 different types of food Have a limited variety of foods they eat, usually fewer than 20.
Response to food jagging Will generally accept the food again after a break, even if they avoided it for a while Are unlikely to accept that food again, even after a break, resulting in a steadily decreasing range of acceptable foods
Response to new foods Can tolerate having new foods on their plate and may touch or taste them, even if they’re hesitant May cry, resist, or become very distressed when new foods are introduced, refusing any interaction with the food
Dietary diversity Eats at least one food from most food texture and nutritional groups May completely reject entire categories of food based on texture or nutritional group
Mealtime dynamics Often eats different foods from the rest of the family but usually joins family meals Almost always eat different foods from the family and often do not join in family meals
Acceptance of new foods Typically needs 20-25 steps in a gradual process to accept a new food Require more than 25 steps in a gradual process to accept a new food
Frequency of being identified as a picky eater during well-child check-ups Sometimes reported as a ‘picky eater’ during check-ups, with picky eating behaviours lasting less than 2 years. Consistently identified as a ‘picky eater’ across multiple check-ups, with these behaviours persisting for more than 2 years.

The causes of fussy eating

Fussy eating can stem from various factors:

  1. Developmental stages: Young children are often wary of new experiences, including new foods. This cautious approach can be linked to evolutionary survival mechanisms where unfamiliar foods were once perceived as potentially harmful.
  2. Sensory sensitivity: Some children are more sensitive to the texture, taste, or smell of certain foods, making them more selective in their food choices.
  3. Parental influence: Children may model their eating behaviours based on their parents’ habits. If parents are picky eaters or express strong dislikes for certain foods, children may adopt similar behaviours.
  4. Behavioural and psychological factors: Fussy eating can sometimes reflect broader behavioural or psychological issues, such as using food preferences to assert control or independence. It may also involve food sensory sensitivities, where a child has strong reactions to the sensory aspects of food, including its taste, texture, smell, or appearance.
  5. Medical issues: In some cases, fussy eating might be linked to medical issues, such as food allergies, gastrointestinal problems, or oral sensitivities. For instance, gastrointestinal issues like gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), celiac disease, or lactose intolerance can cause discomfort or pain during eating, which may lead to selective eating behaviours. If the behaviours are affecting growth adversely, or if the fussy eating is severe or persistent, it’s important to rule out any underlying medical causes.

Strategies for managing fussy eating

Creative presentation of food

Fussy eating is often a normal part of childhood development, but several strategies can help parents address it more effectively:

  1. Offer a variety of foods: Introducing a wide range of foods and flavours can help children develop a taste for different types of cuisine. Presenting new foods alongside familiar ones may encourage gradual acceptance.
  2. Create a positive mealtime environment: Making mealtimes enjoyable and relaxed can help reduce food-related stress. Avoid pressuring or bribing children to eat certain foods, as this can create negative associations with mealtimes.
  3. Involve children in food preparation: Engaging children in cooking and food preparation can increase their interest in trying new foods. Allowing them to help with age-appropriate tasks can also give them a sense of control and investment in the meal.
  4. Be patient and persistent: It may take multiple exposures to a new food before a child is willing to try it. Continuously offering new foods without forcing them can help children become more open to expanding their food preferences over time.
  5. Model healthy eating habits: Children often mimic the behaviours of adults. By demonstrating healthy eating habits and showing enthusiasm for a variety of foods, parents can encourage their children to follow suit.
  6. Use creative presentation: Making food visually appealing can sometimes encourage children to try new items. Fun shapes, colourful presentations, and creative arrangements can make mealtimes more engaging.
  7. Respect individual preferences: While it's important to encourage variety, it’s also crucial to respect a child's individual preferences. Forcing a child to eat foods they genuinely dislike can lead to more resistance and anxiety around mealtimes.

When to seek intervention

Although fussy eating is common in childhood, there are instances where it might raise concerns. Knowing when to seek professional help is crucial. These situations include:

  • Nutritional deficiencies: If a child’s selective eating leads to deficiencies in essential nutrients, professional advice may be necessary to ensure they receive balanced nutrition.
  • Extreme food refusals: If a child is refusing almost all foods and is consistently eating very little, it may be a sign of a more serious issue that requires attention.
  • Behavioural concerns: If you suspect your child’s fussy eating might be part of broader behavioural issues or is adversely affecting their growth, consulting with a child psychologist or counsellor could be beneficial.

While fussy eating generally resolves with time and patience, understanding its causes and applying effective strategies can help ease the process. However, if you're still unsure whether your child's behaviour is a cause for concern, it's important to consult a paediatrician for guidance and support.

A paediatrician will be able to evaluate your child’s overall health and development and, if necessary, refer them to a psychologist or dietitian for further assessment and care.

Article Tags

Children's health Food & nutrition
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