Nicki Coates from Learn Play Eat talks to us about her experiences with her son’s fussy eating, and how she now supports other parents struggling with fussy eating in their families.
What is fussy eating?
“Fussy” or “picky eating” can be a difficult term to use. It can mean so many things. A certain level of fussiness in most small children can be expected and may even be a normal part of development. But for some children, they can’t just “grow out of it” and it can become a challenge for the whole family. I’m a mum in Sydney, I have personal experience of my son’s fussy eating, and I have started working in this area with health professionals.
What causes fussy eating?
My son has always been a fussy eater. When he was born, we had problems with tongue-tie, reflux and food intolerances. After speaking with many health professionals, I believe this early association between feeding and pain may have been a trigger for his eating issues. After some attempts at purees, he found 2 types that he liked around 7 months old, and wouldn’t eat much else. We kept trying with solids but at around 2 years old he could only eat around 5 or 6 things, including plain pasta, bread, crackers, yoghurt and luckily a bit of fruit. It was like he was truly scared of foods which weren’t ‘safe’ in his eyes. This is the more extreme end of fussy eating and is sometimes referred to as Selective Eating or Avoidant Restrictive Food Intake Disorder (ARFID).
It is such a stressful situation. As a parent you feel like you should be able to do this most basic and important job of feeding your child; so when it’s not working and you see others not having any problems, it’s easy for guilt and self-doubt to creep in.
Studies say somewhere between 20 and 50% of kids experience some level of fussy eating, but it’s not talked about much so it can be hard to know where to go for help. ARFID has been added to the standard list of mental health disorders, but only in 2013, so some doctors may not be aware and some parents I’ve spoken to have felt their worries dismissed by health professionals.
How can we help at home for children who are fussy eaters?
There are several options to help a child with fussy eating. What worked in our case was starting some feeding therapy with a wonderful paediatric occupational therapist when my son was 3. She was also able to evaluate for related developmental or physical challenges such as underdeveloped oral motor skills and sensory processing disorder, which would also need to be addressed. The therapy is based on a psychology technique called ‘systematic desensitisation’ which is also used to help phobias and anxieties. In this case, it involves a lot of fun, kids learn how to explore new foods using all of their senses and start to use the foods in play to become more comfortable with them, and eventually get to the stage where they are able to try eating them.
We combined this therapy with using the “Division of Responsibility” (DoR) at home, an approach developed by Ellyn Satter, which says that it is the parents’ responsibility to provide the food, and the child’s to decide if they want to eat it. We realised that the more we tried to pressure or even just encourage our son to try food, the less he wanted to. This technique does take the pressure off parents and kids. It can help the child to come around to their own decision to try new foods over time, while still seeing and experiencing the food others at the table are eating. We serve all food on the table family-style with each component in its own bowl, so that everyone can choose what they like, and we include 1 or 2 easy sides which we know our picky eater likes to eat such as bread and butter or yoghurt, so that they won’t go hungry.
The Division of Responsibility was initially worrying to me: what if he would only eat his ‘safe food’ all day for weeks?! We discussed this with our GP, did blood tests and started to give my son protein shakes and iron supplements so that we knew he was getting the right nutrition. And we do sometimes still include meals during the week which I know he likes and can easily eat, especially if we’re getting home late or tired after school.
I think the key to it for us was removing all pressure, and helping my son develop a more positive relationship with food through play and fun experiences such as helping us cook, and growing our own food. He’s now 7, and while he still has trouble with some foods, or foods he hasn’t seen before, he now eats a wide variety of food, doesn’t depend on supplements, and knows he can try without having to eat more if he doesn’t want to. It does take time, and trust in the approaches, but you can get there in the end!
What professionals help with fussy eating?
We’ve been incredibly lucky to be able to find a qualified feeding therapist near us. Other health professionals who also may offer this type of play-based therapy include Speech Therapists, Psychologists, Dieticians and Nutritionists. To find a similar therapist near you, try searching for “SOS Feeding Therapy”.
Because we realised that not everyone was able to access face to face therapy, I have been working on a mobile app with our therapist that provides many ideas for sensory and food play activities for families to do at home. Using fun, play-based activities at home, guided by our mobile app, you can help your child develop a healthy relationship with food.We also have also just put together a free “Food Explorer 30 Day Challenge” printable activity pack available now for those who want to try out this kind of approach.
About the author
Nicki Coates is from Learn Play Eat, which helps families to overcome picky eating. For some picky eaters, even touching a food can be tricky. Nicki has created an online Facebook Support Group, The Parents with Picky Eaters Support Group for families with kids who have fussy or picky eating habits. In the Group Nicki shares tips and stories, and recommends what has helped her family. It is a supportive group where you can connect with other parents who have been through it!
Disclaimer: The information provided in this blog is intended as a general educational aid. It should not replace advice given by a qualified healthcare provider in relation to your own unique circumstances and those of your family. Always consult your doctor regarding medical or mental health concerns that you or your family may have.