This is the second part of an article written by Dr Gillian Harris, Consultant Clinical Psychologist, click here for part one.
Stage 3
The third stage is one of showing disgust responses, and about showing rather odd and sudden rejections of food. Very little research has been carried out into why children suddenly refuse a previously accepted food, but we can come up with some ideas about why they might do it.
Many suggest that children refuse previously accepted foods to ‘challenge’ their parents, to establish autonomy and their right to choose, and this is likely to be a small part of the problem. But when we watch and listen to children as they refuse food, then we seem to get other reasons for the refusal.
Quite often the previously accepted food looks different at subsequent servings and parents say that the most frequently rejected foods are fruit and vegetables and mixed recipes (spaghetti bolognese for example) – these foods are all likely to change in the way that they look from day-to day.
As children make and remake categories of accepted foods, so they also learn about how those foods relate to the world around them. They learn about which substances are disgusting and not meant to be eaten. And sometimes children see similarities between substances that disgust them and the food that they are eating. Pasta becomes “slimy”, and scrambled egg has “funny bits in”.
Children who are ‘sensory sensitive’ tend to make more of these judgements about food1 and tend to have very strong disgust responses. This means that we can end up with a child that will eat nothing that is in a sauce, or that has mushrooms in it, or has eggs that are too runny, or fish that “smells horrible”.
Parent’s strategies in dealing with these problems may not help. We know that parents need to support children in eating a wide range of foods, but if parents force children to eat a ‘disgust’ food then the disgust response will worsen.
Parents at this stage have to tread a fine line between modelling good eating to the child, and prompting good eating, but never forcing or coercing their child to eat a food that they don’t like.
Similarly putting a food that the child doesn’t like on the plate next to a liked food means that the liked food becomes ‘contaminated’ by the other, and is likely to be rejected as well.
What can go wrong at this stage?
Some children tend to be more ‘sensory sensitive’ than others. These children are more aware of differences in the way that food looks, tastes and smells. They also dislike getting their hands and face dirty and may have worries about changes in routine. They are more anxious children and such children will always be more difficult to wean onto a wide-ranging diet. This sensory sensitivity may appear when solid foods are first introduced – these children will have more difficulties with lumpy textured foods. Or the problem may first appear at around 18 months – the child’s diet might narrow and the child will insist on eating relatively few foods. The child might gag or vomit at the sight or smell of ‘disgust’ foods.
- Very rarely, and mainly with boys, a child’s diet will narrow at this time until only a few foods are accepted. Because the child is very sensory sensitive, and has problems making generalizations about food, the diet will remain very rigidly adhered to until late childhood2.
- Parents may try and force or coax a child to eat and make the problem of refusal worse.
Action points
- Remind parents never to force feed a child.
- Reassure parents that some children are more neophobic and more sensory-sensitive.
Some good tips for you to give to parents
‘To dos’ for parents:
- Tell parents that foods that they want their child to eat should be introduced in the first year, and don’t have to be bland in taste.
- Parents should not totally rely on commercial baby food; they should get some home prepared food in when they can; parents will then be able to carry on with home prepared foods into the second year. Of course when home prepared foods are not routinely offered, or are unsuitable (pureed chips or pureed sweets have been offered by parents), then commercial baby food is a far better option.
- When giving finger foods suggest that the parents let the child handle, and hopefully try, different fruits and vegetables in their more or less complete form. Suggest whole strawberries, sprigs of broccoli, slices of tomato, and chunks of peach. In this way the child gets used to the texture of each food, and associates it with the colour of the food. To begin with, some textures might be easier than others, strawberries are a single texture, and tomatoes are a mix of textures. Suggest the single textured bright coloured foods to start with, try with the multiple textures when these are accepted.
Remind parents:
- To get different colours and different textures into the diet as soon as possible. To get different tastes in by at least six months, get the more solid textures in by at least nine months.
- That meals for toddlers should be small, mealtimes short, but frequent.
- Children copy adults, so parents must be eating a healthy diet too.
- Children will usually (but not always) widen their diet by copying other children who eat well, so suggest that parents take their children to playgroups and nurseries or to eat with relatives.
For parents of food refusers:
- Reassure parents that children are different, and some will be more reluctant to try new foods and more likely to reject known foods, than are others.
- Reassure parents at this stage that growth is more important than dietary balance. That the children are eating something is more important than what they eat.
- Reassure parents that very fussy eaters usually grow well, usually remain healthy, and get less fussy as they are older.
- Remind parents that these children are less likely to imitate other children eating and change their diet in that way, so nurseries and playgroups might not help here.
- Suggest the child is given frequent small meals. This reduces anxiety in child and parent. Leaving the child to get hungry in order to make them eat doesn’t work and may make the child lose weight.
- Prompt the child to eat, give them attention when they do eat, but remind parents not to force children to eat foods that they don’t want.
- Remind parents not to spend long periods trying to coax them to eat, mealtimes should be no longer than 20 minutes or so3.
- Suggest that parents don’t put disliked food on the plate next to liked food, it won’t work!
- Don’t encourage parents to waste time with a fussy child.
For more information visit: The Infant and Toddler Forum website – www.littlepeoplesplates.co.uk
The information in this article is correct at date of publication: September 2011. Opinions expressed by the author are not necessarily those of the publisher or editorial staff.
