Do the following statements sound familiar to you?
"My son refuses to eat any vegetables on his plate. I have tried to disguise the vegetables in his food, but he manages to pick them out."
"My daughter can finish a burger and fries at the fast food place in a jiffy, but does not finish her meals at home."
"He takes 1 hour to finish 2 tablespoons of noodles."
If any of the above statements sound familiar, then welcome to the world of fussy-eaters.
It is natural to get caught up in a whole mix of feelings when your child is not eating well. Your first worry is that your child may not be getting enough nutrition for his growth and development, so you would resort to all ways and means to get him to eat (i.e. scolding, bribing or threatening). These anxieties may soon turn into anger and aggravate the situation. So, let us look at the possible reasons for a child being a fussy eater.
There are a small percentage of these fussy eaters who may have an underlying medical and/or physiological cause for finding it difficult to feed, so they are not technically-speaking fussy eaters. For example, prematurity may predispose to problems sucking and swallowing if not addressed early, a history of invasive procedures to the oro-facial region may result in oral hypersensitivity, severe regurgitation may result in discomfort associated with feeding.
However, the majority of fussy eaters exhibit food refusal. It is usually part of their growing up as they learn ways to assert their independence or use it as a form of manipulative behaviour to gain attention from their parents or other caregivers. They may also develop "food jags", in which the child might refuse previously accepted foods as a result of consuming the same food, prepared the same way, every day (or on a very consistent basis). It is important to understand that food refusal or a child having negative attitudes towards food is very common, especially in the toddler and pre-school years.
Nevertheless, here are some strategies to make meal times relaxing for both you and your child, as it is important to provide a positive feeding environment as a baseline.
Strategies to improve feeding environment and behaviours
- Avoid stressful feeding environment such as forcing your child to eat by threats or bribery or scolding the child while he is eating. Use positive encouragement instead, so praise or pay attention when your child tries new foods, or eats.
- Allow your child to eat with the rest of the family whenever possible as children are great imitators and are also curious, so they will be more likely to try a food if they see others eating. Interaction with other children and peer modelling may also help.
- For younger children, allow your child to feed himself. However, this could be messy as they attempt to feed themselves, which is part of their learning.
- Discourage your child from eating while walking or standing. Get him a high chair to sit through mealtimes with the family.
- Avoid discussing food dislikes in front of your child.
Some practical tips to encourage intake in fussy eaters
- Serving small and frequent meals and snacks may be the way to go rather than 3 main meals a day. Choose healthy snacks like bread, plain biscuits, cereals, fruits, yogurt, cheese or a hard-boiled egg between meals.
- Be realistic about the amount of food your child can eat at one time. Start with a small portion and praise him when he finishes his food or if he asks for a second helping.
- Toddlers often are more acceptable of finger foods where they can pinch and feed themselves, than having to maneuver food on a spoon. This helps to improve their motor skills too!
- Try serving food in different ways. For example, you can use garnishing to stir interest in your child or use shapes and colours to make meals look attractive. You can also try using attractive serving plates, bowls, and cutlery. One bowl for cereal, one plate or tray, and perhaps a smaller bowl for desserts are usually sufficient, with appropriately-sized cutlery.
- Children are usually fascinated with the kitchen and will amuse themselves for hours with your pots and pans and various other cooking utensils. Get them involved in food selection and preparation by giving them little tasks to help. This helps to create an interest in food. You can develop this line of play by buying some plastic food and tea sets, or you can allow them to help make real food i.e. spreading butter on bread etc.
- Make food fun and interesting for them. Teach him the names of foods through picture books, videos, and songs. Recognising on his plate the food he has seen in the book can be fun for them too.
- Make up funny names for your child's favourite dishes. Your child may like "Ah Meng's banana delight" etc.
- Have meals outdoors sometimes. Food always seems to taste better when eaten outside, even if it is just on the balcony. A picnic lunch at the park or seaside will be a refreshing change from the usual lunch eaten indoors.
- Avoid filling up on excess fluid intake between and immediately before meals.
- Limit meal times to 30 minutes. Remove his food from the table after that and do not show signs of anger. Do not offer milk or preferred snacks immediately if meals are unfinished.
Avoid showing your anxiety if your child’s intake is poor as this will, in turn, stress the child. Keep the feeding environment as enjoyable as possible for your child!
Nutrition and Dietetics Department and Speech Language Therapy Service, KK Women’s and Children’s Hospital