Fussy eating in childhood is a common theme and problem I have noticed especially amongst young parents. Many people reading this article will already be aware what a varied diet is, and hopefully will be aware of the mantra “5 portions of fruit and veggies”. And so, this article does not set out to address food content, but rather, food fussiness.

Fussy eating is described in a child who is medically well, but simply is very picky about their choice of food, has a lack of appetite, is a slow eater or simply not interested in food.

Each and every child is unique. Most babies will be ready for solid foods by the age of 6 months and will show signs of being interested in and being able to eat the foods they see. However, while some will readily devour anything that comes close to their mouths, others will refuse and out rightly spit out any new things their parents try. This can be very frustrating for some parents. Fussy eating can occur at any age and is not necessarily restricted to toddlers. I know of parents who have given children all sorts of multivitamins in the hopes that the child will develop an appetite. Keep calm, there is good news for you!

You are not alone on this journey. In the UK, about 8 in 10 children are fussy eaters. As many as 1 in 10 parents admit to spending up to an hour trying to feed their kids, and many admit this sometimes feels like a battle! When parents don`t succeed to get kids to diversify their diets, the result is kids growing up with multiple nutrient, especially micro nutrient deficiencies. In the western world, nutritional deficiencies are so common that these have become a public health problem. Refusal to eat vegetables and fruits contributes to constipation, replacing milk with juices leads to rickets and a diet consisting mostly of cow milk can lead to anaemia. Of course, obesity can result as well.
Parents have a significant role to play in helping kids diversify their diets.

I`ll outline a few tips that could be helpful:

1. Introduce bitter foods early

You may not find this helpful if you’ve got older kids, but this will certainly help prepare you for the younger ones. Almost everyone is born with a natural “sweet tooth”. Babies have abundant sweet taste buds but still need to develop the bitter ones. Introducing vegetables first has been shown to make babies accept vegetables and other foods more easily. Do not introduce salt before 1 year and sugar before 1-2 years of age. Babies kidneys cannot handle extra salt, and sugar can enhance tooth decay. Use fresh whole fruits rather than juice, plain cereal rather than sweetened ones, plain water or milk instead of sugary juices.

2. Be persistent and innovative.

Keep introducing new foods. Recent evidence shows that offering a greater variety of foods to kids increases the chances of them accepting, especially veggies. Research also shows that sometimes foods will need to be offered to kids 10-20 times before kids accept them. A solution is to keep offering these.

3. Lead by example

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Kids will not eat veggies and fruits if you don’t eat them. Kids are not just small, ignorant adults, they are smart asses! They will want to copy you. If you observe good table manners during meal time, they will tend to copy you. If you eat ice-cream all the time, they will want that too and will make a huge fuss if you point rather to their left-over broccoli.

4. Shop healthy foods

Food shopping for me is always an enormous task. Not only do I try to ensure I get the best deals in terms of price, I tend to read the content of each item I purchase, sticking to those with healthier nutrient content (Figure 1). For those living in Europe, nutrients are labelled green, orange, red from low to high. Important to note that Low fat content don`t always mean the healthier option. These oftentimes contain more sugar, which is even more harmful.

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Figure 1

 

5. Focus on anything other than the food

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During mealtime, you can ask questions about their day, focus on getting them well seated in their chair, or talk with someone else. The moment you put all the focus on the food, children tend to act up and will refuse to eat, to make a point. Mealtimes shouldn`t take ages. Better to keep them as short as possible to avoid less stress.

6. Sticking to a routine may or may not be helpful

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Go with the flow. Parents do sometimes think that their kid has to finish the amounts put before them. However, this will only make things more stressful. Keep portions small, if rewarding them for finishing their food portions will make them happy, by all means do. If they only eat a spoonful, let them be. The less they eat, the hungrier they`ll become. Some parents will be tempted to let them snack on unhealthy foods like crisps, sweets. This will only make them less likely to eat their foods.

7. Be creative

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A mix of colourful vegetables looks more attractive than all green, for example. Incorporating various flavours and shapes may make meals more palatable. Use a role model eg their favourite cartoon character, or human example their dad, for boys or an older cousin. Explain to them that to be like this person, they will have to eat broccoli and milk to grow strong bones.

8. Make it Fun

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Engage kids in the process from using pictures in cookbooks or the internet to decide what to cook, engaging them in food shopping and cooking will make them feel like their opinion matters. They will be more likely to eat when they feel this way.

Invest time and effort. It’s not a mommy’s thing. Its a family thing. Some kids may be encouraged seeing others eat, and so seating down to eat as a family could be encouraging for some kids. Its important to be patient, otherwise kids see food time as battle ground. This will simply reinforce the vicious cycle.

No one method works, the key is consistence and persistence. This is by no means an exhaustive list. Remember that you don`t need to worry about daily intake, but what the child ends up taking over say, a week. To be honest, most kids of middle-class parents eat adequately and grow along their centiles (see links to growth charts below) but sometimes, parents just have to be parents!

 

Growth Chart for girls
http://www.who.int/childgrowth/standards/cht_lhfa_girls_p_0_5.pdf?ua=1

Growth Chart for boys
http://www.who.int/childgrowth/standards/cht_lhfa_boys_p_0_5.pdf?ua=1

References
1. https://www.nhs.uk/conditions/pregnancy-and-baby/fussy-eaters/
2. https://www.paediasureshake.co.uk/fussy-eaters/what-is-fussy-eating

JAN currently works as a Paediatric doctor in East Midland, England. She enjoys mentoring people towards getting scholarships, jobs/careers and settling abroad. In 2014, prior to moving to the UK, she worked with refugees in eastern Cameroon, a project run by Medecins Sans Frontières. Her hobbies include: travelling, reading and cooking. Some countries she has visited include: Israel, Zimbabwe, France, USA, Germany, Sweden, Norway, Denmark and in the future, she looks forward to see more of the world.

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