Fussy Eating in Young Children

Fussy eating is a prevalent phase that many children go through. This behaviour can range from refusing to try new foods to a reluctance to eat anything at all (1). Up to a third of toddlers can exhibit fussy eating, but rest assured this is an entirely natural behaviour. Choosing what they want to eat is all part of growing up and learning to explore the world on their own terms (4).

A healthy child is unlikely to cause any long-term problems from fussy eating. However, if this behaviour persists or you notice a decline in their growth, it may be time to seek help from a healthcare professional. Persistent fussy eating can negatively affect your child's social development. For example, they may be embarrassed to attend birthday parties or sleepovers due to food anxiety (3). If this behaviour continues into adulthood, it can increase the risk of developing diet-related diseases such as diabetes and cardiovascular disease. This is why it is vital to manage this behaviour at a young age (5).

As a parent, it is only natural to worry about your child's health. Generally, as long as they are active, gaining weight and seem their usual self, they will be getting enough to eat. Try to focus on what your child has eaten over a week instead of individual meals (6). Children's taste and perception of foods will change over time. Just because those tomatoes were initially rejected doesn't mean they always will be. Evidence suggests it can take up to 15 attempts before a child eats an unfamiliar food (1). Children should be offered food from each of the four main groups to ensure they meet their nutritional needs. These include fruit and vegetables; starchy carbohydrates, such as pasta or bread; dairy or dairy alternatives, such as milk and yoghurt; and protein from various sources (6).

Children can quickly learn what behaviour generates a reaction, whether good or bad. They may use fussy eating as a way to get your attention (2). By overreacting, you may negatively reinforce this undesirable behaviour. As a parent, your best approach is to recognise the behaviour without reacting to it. By remaining calm, you will be in a better position to effectively implement solutions. You may also find it reassuring to talk to other parents who dealt with this behaviour before (5). Rest assured that most children will naturally grow out of fussy eating. In the meantime, here are some steps you can take to ensure mealtimes have the best chance of success:

• Establishing an eating routine will make the whole process much easier for all involved. Try to ensure meals are offered at the same time each day. For young children, this should be three main meals and two snacks (1).

• Try to avoid letting your child graze throughout the day as they are unlikely to be hungry when it is time for a proper meal (1).

• Self-feeding is an effective way to get young children interacting with food. This is a great time to start introducing finger food such as small sandwiches, chopped fruit or breadsticks. Try to gradually introduce new textures and tastes as your child makes progress (4).

• Start out with small portions. Praise your child even if they only eat a small amount. If they do finish everything, you can always offer more (4).

• Avoid using food as a reward, such as offering dessert if they eat their vegetables. Instead, offer a trip to the park or other healthy activities (6).

• Don't let mealtimes go on for too long, 30 minutes should be long enough. If there is any food leftover at the end just remove it without comment (6).

• Create a fun environment by sitting together around a table and using colourful plates and bowls (2).

• Spend time talking about things your child enjoys and avoid focusing too much on the food. If they have any friends that are good eaters, try inviting them over (2).

• Lead by example. Children learn best by copying what we do. Make sure they can see you eating the foods you want them to try (3).

• If a particular food always gets left behind, you can try preparing it differently next time. For example, boiling carrots changes the texture and taste whilst allowing them to get used to eating something orange (3).

As with many aspects of parenting, a persistent and patient approach will offer you and your child the best results. Remember to provide lots of praise and encouragement throughout this process to keep your child motivated. Further information can be found in the leaflet, 'HELP My child won't eat!' – available from the BDA, online and from your health visitor.

References

1. British Dietetic Association Paediatric Group (2014) Help, My Child Won't Eat!. Available at: http://freestyle.oxatis.com/Files/116307/HCWE.pdf (Accessed: 23 April 2020).

2. Central London Community Healthcare (2011) Advice for Parents of Fussy Eaters. Available at: https://www.rbkc.gov.uk/pdf/fussy_eaters.pdf (Accessed: 23 April 2020).

3. Family Lives (2018) Coping with Fussy Eaters. Available at: https://www.familylives.org.uk/advice/early-years-development/health-and-development/coping-with-fussy-eaters/ (Accessed: 23 April 2020).

4. Great Ormond Street Hospital (2009) Fussy Eaters. Available at: https://www.gosh.nhs.uk/conditions-and-treatments/general-health-advice/food-and-diet/fussy-eaters (Accessed: 23 April 2020).

5. Jones, L. (2014) 'Tackling Fussy Eating in Young Children', Complete Nutrition, 14(1), pp. 50-52.

6. National Health Service (2018) Fussy Eaters. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/fussy-eaters/ (Accessed: 23 April 2020).