Having a fussy eater in the household can be a stressful experience (1). And when you first implement strategies to overcome fussy eating, it can be hard to measure whether they are working. We often look to what the child is eating and can feel as if nothing that we try is working, especially if they still aren’t devouring all their veggies at dinner.

So how do we know if what we are doing is helping and will reap benefits in the long term? Well, we need to change what we measure.

CHANGING EXPECTATIONS

As parents, we often expect that our kids will just pick up a new food and try it if we are doing everything ‘right’. And it’s easy to feel this way, especially if you’ve been reading the myriad of blogs and advice out there on how to deal with fussy eating. They can often set you up with unrealistic expectations.

However, if your child has lots of anxiety around food and eating and a history of difficult mealtimes, it can take time for them to adjust to the new way of doing things and for their anxiety to decrease enough that they can confidently approach the big job of trying new foods.

Building this confidence comes in three stages (2):

1. Decreasing stress or anxiety at meals

The first step is to be able to come to the table without feeling overwhelmed or stressed by the experience. If your child has had a negative experience with mealtimes, it will take time for them to learn that this isn’t going to happen anymore, and that it is safe for them to come to the table. Notice whether their stress is decreasing. They may be:

  • Putting up less of a fuss about coming to the table
  • No longer crying or throwing a tantrum about meals or what food is on the table
  • Able to tolerate being near foods without pushing them away
  • No longer asking for screens, toys, or other distractions as much
  • Behaving better at mealtimes

Stress and anxiety can increase fussiness (3), so this first stage is important.

Note how your child is doing with this stage. If they are still exhibiting any of the behaviours above, slow down and consider how you can reduce mealtime conflicts to help them to feel less anxious about coming to the table (4). For example, is there pressure to try something they aren’t ready for, or to eat more than they are hungry for, or to behave a certain way at the table (3, 4)? Do they have the skills to eat what is being offered or do they have a sensory aversion to a food (5)? These and other factors can make meals stressful, so consider whether one of these might be at play. 

2. Feeling more comfortable at meals

Decreased stress or anxiety doesn’t necessarily mean increased comfort, but it does pave the way for that to happen. Notice whether your child appears comfortable with being at the table and around foods. They may be (2):

  • Better able to say when they are hungry or full
  • Able to happily serve themselves or others
  • Starting to play with their food, such as creating shapes, pictures, etc
  • Appearing happier and more engaged at mealtimes
  • Building the skill of using utensils if they are old enough
  • Getting excited about food
  • Being more open to trying easy-to-like foods or foods that are similar to their accepted foods
  • More comfortable interacting with foods, for example helping with preparing foods or helping to serve another family member or themselves (even if they don’t eat it yet)

If your child is no longer anxious about coming to the table or being around foods, but they still don’t seem comfortable, consider what you can do to help them to increase their comfort levels. This means making meals a pleasant experience that they can look forward to (3).

3. Increasing confidence with food

Once a child is comfortable and happy at mealtimes, they start to feel confident about trying new foods. They might (2):

  • Have a bigger appetite at meals more often
  • Develop a relaxed attitude to foods
  • Be able to say “no thank you” without any fuss
  • Be starting to try new foods

This confidence may not lead to a dramatically different diet straight away, and it may vary depending on a variety of factors. Be patient and keep on with the strategies you used to get to this point.

If you see them trying something new from time to time – great!

MEALTIMES STILL STRESSFUL?

If you’re not seeing your child progress through the stages above, check in with the strategies you are using.

First, note whether you are following the Division of Responsibility (7), and that everyone is doing their job. In the Division of Responsibility, the parents are responsible for what, when, and where food is provided. The child is responsible for whether to eat the food that is provided, and how much of that food to eat. You can read more about this here and here.

Next, notice if there is any subtle pressuring happening. Pressure can be overt, such as insisting on a certain number of bites, or subtle, such as encouragement to ‘just try it’. We have the best intentions, but to a small person this can be very overwhelming, leading to mealtime stress and a decreased appetite as well as increased fussiness (3-6).

If you are confident that you are following the Division of Responsibility and that there is no pressure, it might be worth getting some extra advice from a professional.

A dietitian can assess for mealtime behaviours and provide individualised strategies for helping a child through the stages above. Others, such as a speech pathologist, can assess to see whether there may be an oral-motor or sensory issue that is impacting on your child’s ability to eat.

And finally, remember that it can take time. Fussy eating is a normal developmental phase for many children, and they often do grow out of it as they develop further (6). Know that if you have provided them with the right environment to feel happy and confident coming to the table and are exposing them to a variety of foods (6), then the last phase of trying new foods and expanding their food preferences will come with time.

Don’t know who to talk to?

Meet our Paediatric Dietitians

References:

  1. Wolstenholme, H., Kelly, C., Hennessy, M. et al.Childhood fussy/picky eating behaviours: a systematic review and synthesis of qualitative studies. Int J Behav Nutr Phys Act 17, 2 (2020). https://doi.org/10.1186/s12966-019-0899-x
  2. McGlothlin, J, Rowell, K. Helping your child with extreme picky eating: A step-by-step guide for overcoming selective eating, food aversion, and feeding disorders. New Harbinger Publications. 2015.
  3. Taylor CM, Emmett PM. Picky eating in children: causes and consequences. Proc Nutr Soc. 2019;78(2):161-169. doi:10.1017/S0029665118002586
  4. Lepinioti M, Specht IO, Rohde JF, et al. Associations between Child Mental Well-Being or Conflicts during Mealtime and Picky Eating Behaviour. Int J Environ Res Public Health. 2021;18(11):5621. Published 2021 May 25. doi:10.3390/ijerph18115621
  5. Chilman, L.; Kennedy-Behr, A.; Frakking, T.; Swanepoel, L.; Verdonck, M. Picky Eating in Children: A Scoping Review to Examine Its Intrinsic and Extrinsic Features and How They Relate to Identification. Int. J. Environ. Res. Public Health 2021, 18, 9067. https://doi.org/10.3390/ ijerph18179067
  6. Kimberley M Mallan, PhD, Elena Jansen, PhD, Holly Harris, PhD, Clare Llewellyn, PhD, Alison Fildes, PhD, Lynne A Daniels, PhD, Feeding a Fussy Eater: Examining Longitudinal Bidirectional Relationships Between Child Fussy Eating and Maternal Feeding Practices, J Ped Psych, Volume 43, Issue 10, November/December 2018, Pages 1138–1146, https://doi.org/10.1093/jpepsy/jsy053
  7. Satter, E. The Satter Division of Responisibility in Feeding. Ellyn Satter Institute. 2022. Available from: https://www.ellynsatterinstitute.org/wp-content/uploads/2021/12/sDOR-tasks-cap-2022-Ellyn.pdf