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Tackling fussy or picky eating

Published 25th May, 2018
Danielle CottamWritten by Therapy Focus Team Leader and Speech Pathologist, Danielle Cottam. 

Sometimes mealtimes can be the most stressful part of a parent’s day. Especially for a parent of a child with special needs. 

Fussy and picky eating can be typical in the preschool years when children are developing a sense of autonomy. They may be particularly choosy around fruits and vegetables or bitter foods. Most children go through a stage of rejecting foods and it is important to recognise that fussiness is a normal stage of development.

Many picky eaters outgrow their aversions and develop into curious eaters. However, if meal times seem a constant battle, or if you’re worried about the amount or variety of foods that your child is eating, there may be other underlying reasons for their selective eating.

Danielle teaching a client
Pictured: Danielle teaching a client and his mother new strategies

Signs to look out for include:

  • Feeling that you frequently have to bribe your child to eat
  • Refusal to eat and drink
  • Persistent anger, tears and tantrums at meal times
  • Difficulties with chewing certain foods, mouth stuffing or swallowing foods without chewing
  • Constipation
  • Meal times taking longer than 30 minutes
  • Significantly restricted range of foods
  • Frequent coughing or vomiting around meal times
  • Strong preference for packaged or highly processed foods
  • Strong preference for smooth pureed food options or liquids
  • Ongoing avoidance of fruit, vegetables and meat/alternatives

If you notice any of these signs in conjunction with fussy eating, consider having a health professional conduct an assessment to determine the root cause of the issues. Causes may be multifactorial and it is important to ensure you are working on the right things to make mealtimes safe and enjoyable for all. There may be more going on than the child just being fussy.

Danielle working out an eating plan with a client
Pictured: Danielle discussing an eating plan with a client

Helpful strategies to consider:

Talk about the food 
Focusing on what and how much the child is eating can alter the social aspect of a mealtime. Try to engage your child’s curiosity by talking about how the food looks, smells, feels and describing what you are doing with food E.g. I’m going to put some gravy on my carrots, I’m going to mash my potatoes with my fork. This can take the pressure off our children or teens and give them the room and confidence to experiment.

Create a mealtime schedule
Stick to 30 minutes maximum for mealtimes. It’s unlikely that a child will have the energy and desire to eat much more after this time period if they have already expressed dislike of the foods. Plan regular meals and snacks throughout the day 1.5-2 hours apart so that the child has the opportunity to eat more next time. Remember our appetite can change throughout the day for a variety of reasons.

Experiment with buffet style meals
Children need up to 15 exposures to new foods before we can expect them to take them. This means opportunities to see and talk about foods before we eat them. Offering some meals in a buffet style e.g. having the pasta, meat, sauce and cheese separate for a bolognese means that the child can serve themselves and take just the amount of new food that they feel comfortable with or at a minimum can get used to the smells and sight of having it near their plate.

Try an ‘all done bowl’
Give your child an extra bowl that they can use if they want to finish eating something or do not want it on their plate. This gives the child an opportunity to try a food without the pressure that they have to finish it. It also gives the opportunity for them to touch foods that they wouldn’t otherwise tolerate – even if it’s just to move it to the all done bowl.

Overall, we want to work towards a mealtime where the adult is in control of what is served, where and when and the child is in control of whether they eat or not and how much they eat.

Danielle Cottam

The strategies above are a way of reducing pressure and cajoling at mealtimes and it may take time for the child to develop a sense of comfort and confidence with them and to expand the range of foods that they will eat. Observe for changes in your child’s comfort with mealtimes and exposure to new foods as opposed to how much more they will eat.

If in doubt or if you are worried about your child’s growth and eating habits visit your GP or health professional and ask for a mealtime assessment. The best assessment considers a range of perspectives and may include observation from a range of health professionals to identify the underlying cause.

If you would like to access a comprehensive mealtime assessment from Therapy Focus please ask for more information from our MEAHLS team or by contacting the team.

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