A Paediatric Dietitian’s Guide to Navigating a Fussy Eater

A Paediatric Dietitian’s Guide to Navigating a Fussy Eater

By Alexandra Whiting   |  

When mealtimes are successful, as parents, we’re comforted (it’s a primal thing), but fussy eating has many, oft seen, guises. From babies who love to eat something one day and hate it the next, to toddlers who will refuse a meal because of the tiniest piece of onion. Here’s what to know about fussy eating.

As parents, feeding our children is one of our fundamental roles. So when our kids have hearty appetites for a range of healthy foods, it feels as if they are learning and growing before our eyes. Conversely, when they won’t eat, we worry that they won’t develop normally. Cue parent guilt and panic. As they get older, this food rejection can manifest as eating something one day then hating it the next, or refusing a whole meal because they’ve pulled out the tiniest piece of onion. This small realm of parenting hell is known as fussy eating. It’s tough, and very common. To determine exactly what’s normal, how to tackle it, and when to seek help, Shae Rickards, a paediatric dietitian and nutrition manager at Bellamy’s Organic, answered all our questions.

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What, exactly, qualifies as fussy eating?

“A fussy eater is defined as a child who refuses to try a new food at least 50 percent of the time. Almost half of all children will go through a fussy eating period in the early years,” says Rickards. More importantly, there’s a very good reason for it. “It’s normal for children to be uncertain of new tastes and textures. It's an evolutionary mechanism designed to keep us safe from danger. Fussy eating is also part of children’s development. It’s a way of exploring their environment and asserting their independence.” 

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What are some of the reasons they become more fussy with food?

“Growth slows in the second year of life so, because of this, their appetites go up and down depending on how much they’re growing and how active they are,” says Rickards. “It can also be common for children to refuse food if they have been drinking too much milk, or their mood – for instance when feeling tired, sick or upset, their activity pattern has changed, or are illness.” Rickards adds that we should trust their intuitions. “Healthy, typically developing children will never voluntarily starve themselves, even though sometimes it seems as though they are eating very little.”

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How do you know if your child’s eating is within the realm of normal behaviour or if it is a problem?

“Even if your child is a fussy eater, his or her growth is considered ‘normal’ if two things are happening. First, they meet their age and sex weight centile on the growth chart in their child health book and are gaining weight at the expected rate. Remember, this is best assessed using a few measurements over time, not just one.  Secondly, they are reaching their developmental milestones,” recommends Rickards. “It’s very common for children to be growing well but to simply be fussy! Remember a healthy child will never go hungry, and if they are energetic enough and thriving, they’re likely eating enough.”

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If your baby screws up their face at certain foods,  does it mean they don't like it?

“As new flavours and tastes are introduced, it is not unusual for babies to display an element of surprise or even disgust particularly with sour and bitter flavours. This is normal. It is important to focus on the infant’s willingness to continue eating rather than their facial expressions. It is also important to not react negatively, make fun of or show disappointment as these can reinforce undesired behaviour or put him off trying again. So, the next time he screws his nose up at broccoli, don’t make a fuss. Exposure and repetition are the keys to healthy eating preferences and habits.”

    Can you do anything to train your baby to be a good eater?

    “The crucial period of the hardwiring of the brain toward food preferences occurs in the early stages of the introduction to solid foods, around 4-7 months. So it's key to use this window to develop healthy preferences and make the most of every opportunity to do so,” says Shae. “Research suggests that giving your baby a wide variety of lumpy or chewy foods between the ages of six and nine months will broaden their food appreciation and reduce the likelihood of fussy eating later on.” It is also important that caregivers aren’t swayed by their own preferences. “Don’t get locked into your own preconceived ideas of what your infant will like or dislike. Responsive feeding also plays a vital role. Parents, and mothers in particular, are inclined to feed their children as often and as much as possible (it’s the survival instinct). However, these good intentions can actually lead to poor relationships with food and later fussiness.”

    When should parents worry or seek help?

    “Fussy eating is normal and common, but their are potential red flags that it’s important to look out for,” says Rickards. “Faltering in their growth milestones, rejecting entire food groups or only accepting particular textures, as well as often gagging or vomiting or having problems with chewing or swallowing. Also, if they display extreme fussiness or difficult behaviour at mealtimes, your GP or paediatrician are the best place to start. They may then recommend you to a dietitian or speech pathologist.”

    Shae's tips for dinner time with fussy eaters

    • Make mealtimes fun and present food attractively.  Offer a range of colourful foods and shapes on the plate.
    • Offer healthy foods repeatedly and regularly. Research shows children need to be presented with food 10-15 times before it flags in their brain as safe enough to eat. 
    • Give plenty of praise when they try a new food. If they're older than three, a star chart can be great. 
    • Support your child’s need for independence. Let them make some choices. limit the options to 2-3 things. For example, instead of asking your child to pick what she wants from the fridge, you could ask, ‘Would you like grapes or carrot sticks?’
    • Encourage self-feeding from a young age. Offer a mixture of finger foods and mixed textured foods, requiring a fork and spoon.
    • Don’t heap food onto your child’s plate. Have realistic expectations of how much they will eat. Children have small stomachs, about the size of your clenched fist.
    • Set a time limit of about 20 minutes for meals. If your child hasn’t eaten the food in this time, take it away and don’t offer your child more food until the next planned meal or snack time.
    • Ignore fussy eating (as much as you can). Sometimes children are seeking a big reaction and your attention. Keep calm and concentrate on making them enjoyable occasions.
    • Try not to overly pressure, force or trick your child into eating. This also means avoiding punishments or bribes. 
    • Be a good role model. Eat a wide variety of foods yourself and eat with your child.

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