children fussy eating

Most kids will display a fussy eating tendency at some stage.   

Even the best eaters out there will turn their nose up at a certain vegetable or family meal that’s not their favourite. In fact, food refusal in the toddler years is a very normal part of childhood development as children are still learning about the huge variety of foods out there.  

It can take at least 10 tastes of a new food until it becomes a readily accepted food. This applies to all children, whether they’re considered fussy or not.  

A true fussy eater generally has a limited range of accepted foods consisting of about 20-30 foods. Try offering them a food not in this range and you’re likely to be met with a battle, whether it just be an outright refusal or a full-blown tantrum.   

The thing about fussy eaters is that even though they have a limited range, they generally won’t go hungry and do a pretty good job of getting enough calories in to support growth, albeit from a select few foods.  

If you look at their growth charts, they typically track beautifully along the one percentile. Nearly half of all fussy eaters get more accepting of foods within about 2 years, especially if parents don’t let them dictate what foods are on offer and continue to expose them to a wide variety of textures and flavours.   

However, at what stage is it no longer just fussy eating and potentially the more serious issue of a problem feeder?  

What is a problem feeder?  

A problem feeder is a child who has an extremely limited range of foods that they are willing to eat – we’re talking in the range of 10-15 foods. They typically exclude whole food groups from their diet, and as a result have nutrient deficiencies and potentially impaired growth. Their behaviour around foods and mealtimes are so severe that they tend to not be able to eat in a social setting. Even family meals at home can be impossible.  

There can be a number of contributing factors to feeding problems. Children with significant medical issues can have an impaired ability to eat. For example, children with cardiac conditions can get breathless and tire easily, which can impact on their ability to chew and complete a meal. Often it can be the result of a skills deficit. Perhaps their oral motor skills are delayed, and they lack the ability to chew tougher textures.  

The main difference between a problem feeder and a picky eater is this: even if they are hungry, a problem feeder won’t eat because they lack the ability to. They generally have a history of poor growth, or have crossed percentiles on their growth charts because they simply lack the skill to get enough calories in.  

Problem feeding can be overcome, and these children can learn the necessary skills required to eat. The SOS (Sequential-Oral-Sensory) Approach to Feeding addresses all of the factors that may prevent a child from being able to feed.  

If you feel that your child may be a problem feeder then the sooner you take action, the better. The longer they stay problem feeders the poorer their growth and development tend to be. Learn more about the Division of Responsibility. 

Want to hear more?

Check out Michelle’s two-part guest appearance on The Daily Dollop podcast with Kate Freeman, where she discusses the difference between fussy eating and problem feeding in more detail.

If you’re looking for ongoing support and advice, Michelle Saunders is our Paediatric Dietitian who is trained in the SOS Approach to Feeding.