Dealing with the picky business of fussy eaters

Her observations chime with the findings of a new study from University College London, King’s College London, and the University of Leeds, which found that fussy eating is influenced by genes and is a stable trait from toddlerhood to early adolescence.

The research compared survey results of parents with identical or non-identical twins — from 16 months to 13 years — in England and Wales and found that fussy eating peaks around age seven and declines slightly after that. O’Connor says previous research has shown similar findings. “We know, for a while, that genetics play a role in fussy eating. It makes a lot of sense: Some kids are naturally more cautious about new foods, and we’ve long known that temperament has a role in eating habits. That said, genetics is just one factor.”

In O’Connell’s experience, other factors — early feeding experiences, parental approach, and family mealtimes — can influence whether fussy eating is a phase or becomes a long-term problem. “For example, if a child feels pressured to eat, or food becomes a battleground, it can escalate their natural caution in to outright refusal.”

Health psychologist Dr Colette Reynolds, founder of Growing Healthy Eaters, says the role of genetics in fussy eating is not as clear-cut as eye colour. “Behaviours such as fussy eating are a lot more complex. And the problem with focusing on genetics is we don’t make much effort to deal with the issue. We say, ‘I was a fussy eater, and that’s just how it is for my children’.”

Reynolds meets parents who can’t get their child to sit at the table, or who are not hungry for dinner and, “at 6.30 they’re looking for toast”. She says fussy eating can be gradual: “They lose interest in dinner and they snack in the evening. Maybe they were sick [with any kind of virus] and got in to a habit of having toast instead of dinner, or eating in front of the TV. Those kinds of habits can continue, or worsen, after the [initial] event is over.”

O’Connor says fussy eating occurs on a spectrum. “Maybe a toddler eats very well at crèche, but really struggles at home or at the weekend. Or breakfast and lunch are fine, but dinner’s a struggle. At the extreme end of the spectrum, you get avoidant/restrictive food intake disorder, a diagnosable condition, where children only eat a handful of foods; perhaps just drinking milk and eating bread rolls.”

Up to 75% of parents struggle at some stage with fussy eating. “It usually starts around 18 months to two years, coinciding with a developmental stage, where toddlers become more aware of their surroundings and cautious of new experiences.

“It’s actually an evolutionary safeguard, helping protect them — when becoming more independent — from eating something harmful. For many, this phase peaks around three to five years, but can last longer if not managed in a positive, low-pressure way.”

A problem to chew over

So, what can parents do to guide their child toward a more adventurous relationship with food?

Let go of the idea that you need to ‘fix’ fussy eating overnight. Instead, see it as a process. “Focus on creating a positive mealtime environment, where there’s no pressure to eat. 

Sometimes, from a place of love, parents use unhelpful strategies that carry pressure,” says O’Connor. 

“These include ‘forcing’ a child to eat: For example, putting the TV on, or the iPad on the table, to distract the child while you feed them, even though they can feed themselves.”

Other techniques include:

• Bribes — ‘If you eat your dinner, you can have dessert’;
• Pleading — ‘Just one bite for me; I’ve worked really hard on dinner; will you just try it?’

O’Connor encourages parents to see a “division of responsibility in feeding”. 

The parent provides: They are in charge of when, where, and what foods are served. And the child decides: They are responsible for whether to eat at meals or snack-time and also how much to eat.

Tap in to children’s natural curiosity. “When you take away the pressure, children are naturally curious: They have a need to try things for themselves.”

She prefers to serve meals, particularly dinner, family-style, where instead of plating up the dinner, all foods are put on the table; each person is given an empty plate and serves themselves. 

“Always have one or two foods, acceptable to them, on the table. It’s a low-pressure way of exposing children to new foods. Initially, they won’t eat them: Toddlers like taking food and putting it on the plate, even if they’re not intending to eat it. But it still helps towards food acceptance. Keep offering a variety of foods; no fuss if they don’t eat them. Exposure matters: It can take 15, 20, or even more tries for a child to warm up to a new food.”

Family-style meals, she says, give children control, thereby reducing resistance. “Whereas, plating up food and including food on the plate they don’t like immediately starts the meal off on the wrong foot.”

Structure around eating — especially for toddlers — is important. “Ensure enough eating opportunities each day: Three meals and two to three sit-down snacks. Keep away from grazing: A child going to the cupboard, taking food out and eating whenever they want. This doesn’t help them tune in to feelings of hunger and fullness, because they’re always a bit full.”

When to seek help?

Reynolds urges parents to avoid labelling their child ‘a fussy eater’ or comparing them to siblings: ‘Why can’t you be like your brother? He’s a great eater.’ 

Such practices reduce the likelihood of improvement. “Meet children where they’re at. If they won’t tolerate peas, step down from that. 

Get them to play with frozen peas away from the table and during eating time. Many children don’t like the soft texture of vegetables: They’re ‘too mushy’. Cold is more acceptable. I know children who eat frozen vegetables; it could be a good place to start.

“Or if a child eats some fruit, but nothing green, expose them to a food that could change their minds: You might get them on board with green grapes. You’ve then gone in to the territory of green and they think, ‘Oh, some green foods are OK’.”

While Reynolds agrees that camouflaging ‘unacceptable’ foods in sauces or soups can be good nutritionally, she is not a fan of the practice. 

“You’re kind of tricking the child and could lose their trust. And some won’t accept these foods. They prefer single foods — like plain pasta — and won’t eat wet or mixed textures. So it isn’t always an option.”

For children who struggle with protein, she recommends more acceptable forms: Pancakes, if they won’t eat eggs. 

“Get them to help you make them. Show them the eggs in it. Then, build up to an omelette. Put [egg] in a muffin, along with other things they like: Potato, pasta. It’s about gradually exposing them to the goal food.”

For non-meat eaters, she looks at the obstacle, whether texture or smell. “You could add beef stock to rice to get them used to the taste. Or give mince rather than a piece of meat, or moisten with gravy to make it easier to chew.”

Asking for children’s input gives them more say about what they eat, says Reynolds. “Is there something we can add to the porridge, like cocoa? Offer choices between foods they like equally well: ‘Would you like porridge or Weetabix?’ ”

When should you seek help? “If their diet is very limited, when they’re eating very little or none of some food groups. And if it’s ongoing more than six months and getting worse,” says Reynolds.

O’Connor says: “If your child’s fussy eating is causing stress for your family or you’re worried about their growth, it’s worth seeking support.”