Fussy Eating

 

Introduction

It is ironic that we live in a society where 30% of children are deemed to be overweight, yet mealtime battles are one of the most common concerns amongst parents. This is not helped by comments from well meaning friends/relatives who think a (healthy) child is ‘too skinny’.

Toddlers and children require macronutrients, which include fat, carbohydrates, and protein. They also need micronutrients including iron, other minerals and essential vitamins. These are found in ample quantities in the ‘ordinary’ diet. With few exceptions children in suburban Australia are consuming adequate calories and micronutrients.

If concerned about your child’s growth check your child’s height and weight and ensure they are in the same position on the percentile charts. For example a child who is below average in height (a normal variant) should be on the same position for weight. Percentile charts are available to plot your child’s growth. Online growth chart. So the first step is to decide whether this is a battle about nutrition or simply a battle of wills.

Fussy eating

1. Toddler

Fussy eating is a common parental concern and is often due to unrealistic parental expectations. Here are a few facts regarding toddlers

• The growth rate of a toddler slows dramatically as they approach 2years, so their calorie requirements will drop.
• Toddlers often like control. They want to dress themselves and feed themselves. This can translate into a battle of wills at the dinner table.
• Some toddlers have a large percentage of their nutrition in the form of either formula or milk. This will limit their eating significantly. 200-400mls of cow’s milk per day or equivalent provides ample calcium and vitamin D. Too much cow’s milk can result in Fe deficiency in some toddlers and will prevent them eating other foods.

2. Child

• Fussy eating in this age group is generally due to parental expectations versus the child wanting some control
• If the child receives lots of attention for ‘not eating something’ he will quickly add this refusal to his ‘armoury’
• Is the issue over the food or being oppositional to parent’s desires?  This is a battle that should not be fought.

Old Fashioned Parenting Tactics

Many parents will try old fashioned parenting and tactics to increase their child’s eating or fussiness. This can result in an unpleasant scene or argument, and meal times become tense and difficult. This is not worth fighting.

• You will not leave the table until you finish what’s on your plate (Control issue)
• If you finish this you can have some dessert (rewarding eating with more eating! Not a good message)
• Few more mouthfuls please before you go

Ending the meal time battle

1. Firstly is it medically important that a child sits and eats his or her dinner ? Not really. Many children graze through the day and this is nutritionally acceptable. There are no dietary guidelines stressing three meals per day. Five meals is probably more physiologically appropriate, so smaller portions more frequently. There is no medical need to eat an ‘evening meal’.
2. Is your child healthy, active, and growing, and functioning well ? If the answer is yes there is no need to pursue a medical cause for being fussy or not eating.
3. At dinner time provide simple quick healthy meals based on healthy food guidelines.  Prepare the meal, dish it out and then make little comment. Do not discuss the food and ignore any protests. If the child refuses to eat or complains, ignore. If the child escalates his or her behaviour, by pushing the plate or yelling, then calmly remove the food and allow the child to leave, but ensure he or she understands there is nothing else to eat. Do not get cross at the child. If there are other children at the table then direct your attention to them.
4. Be prepared to stand your ground. If the child comes back later and demands food then return the evening meal. Place it on the bench/table and walk away. Remain calm and do not reason or negotiate. (Do not give high calories drinks as substitutes. If the food has been binned then offer a cut up apple/carrot. ) If there is ongoing complaints remove the food with a simple calm “that’s ok. You don’t have to eat it. But there is nothing else”.
5. Change shopping habits. Don’t buy the ‘treats, biscuits and sweets’. If they are not in the house, there is no issue.
6. Present a small fruit platter to cope with the ‘bored eating’. (I am bored therefore I eat. We are all guilty of this at times!)
7. Finally remember that the parent should decide what food the child eats and the child decides whether to eat it.

The key here is to remain calm and do not argue, negotiate, or lecture.  These new guidelines will take a few meals before things become smooth again.

Few more tips about food.

• For daytime snacks offer cut up fruit and vegetables. Do not buy processes high sugar snacks such as muesli bars biscuits etc. If they are not in the house then they cannot be found by inquisitive fingers.
• Change your reward system for good behaviour. For toddlers use stickers and stamps, and for older children  purchase colouring books or a cheap toy that is often the same price as the foods that are traditionally used as reward.
• Finally do not worry if your child does not eat anything for dinner. Socially this is deemed the biggest meal of the day but biologically there is no need for a large evening meal.

Trying new foods.

•  If your child likes a food at a particular temperature, texture, or flavor, try adding foods with similar qualities to the diet. For example, if your child won’t eat carrots but enjoys juices, try carrot juice (or apple-carrot juice). If your child likes mashed potatoes but not corn, try creamed corn.
• Studies show that people think food tastes better when it is eaten in a pleasant and sociable setting. Because some children become easily wound up, they are better able to focus on eating when mealtimes are calm. This calm setting will increase the child’s willingness to try new foods.
• Your example as the parent is helpful. Friends and classmates are more powerful examples. If your child has the opportunity to eat meals with other children (such as in preschool), that may be an opportunity to expand his or her menu of foods. Older brothers and sisters can also be great models.
• Enforce the “try one bite” rule with care  –  The “try one bite” rule has been shown to increase children’s willingness to try new foods. If, however, your child has a difficult temperament, and requiring her to try a bite disrupts mealtime or upsets her (or you), stop this approach! With a child who has an intense or stubborn temperament, some battles are not worth fighting.  Repeated battles to force a resistant child into eating rarely work.
• Offering an unfamiliar food, such as a meat, in combination with a preferred food, such as tomato sauce. This increases the likelihood that your child will try the new food. If dipping carrot sticks in tomato sauce makes your child more willing to eat the carrots, let her do it instead of forbidding it because it is “bad manners.”

Most important, give it time

Young children are well known to be picky eaters, but most of them grow out of it, eventually. All of the methods in the world may not be as helpful as patience and time. While you’re waiting, make life easier for yourself and your child. If your child prefers two flavors of soups, stockpile them. Try freezing child-size portions of his favorite foods and popping one in the microwave before the big family dinner to avoid having an upset child disrupt the meal. If your child remains a picky eater into the older school years, it may be time to simply accept it as part of the child’s personality.