Feeding selectivity, more commonly known as “Picky Eating”, refers to a tendency of selective eating habits where the children usually display a strong food preference. It is a common challenge for children, and this could be concerning for their families as children require a healthy and balanced diet to support their overall body development and growth.
What are the signs of fussy eating?
- Limited food preferences. Children with fussy eating often have a very restricted range of preferred foods such as only eating white or crunchy food, which is why they may consistently request the same type of foods.
- Avoidance of certain types of food. Fussy eaters may tend to avoid some food groups such as sticky or crunchy food.
- Refusal to try new food. Children could be resistant to trying unfamiliar food. They may also be reluctant to explore new food through touch, smell, and taste.
- Sensory sensitivities. Some children are very sensitive to certain types of textures, smells, or flavours. For example, some children are sensitive to mushy food such as mashed potatoes, avocado, soft bread, cooked peas, and applesauce. They may also avoid participating in mealtimes with their family due to their sensory over-responsivity, such as avoiding having dinner with family as they can see or smell one specific food.
Why should we be concerned about fussy eating?
In the long term, selective eating could potentially lead to some negative impacts on children’s nutrition and development. It could first cause an insufficient variety of food intake and further reduce essential nutrient intakes such as calcium, iron, and zinc, negatively impacting the development and growth of the child, including underweight.
How do Occupational Therapists and Parents Help with Selective Eating?
- Food exploration. Occupational therapists (OT) can incorporate some food-based sensory activities such as food play activity to help children. OTs could guide the children through gradual exposure to a new food, starting with doing some ‘experiments’ to provide a fun opportunity to allow the child to observe how it looks, feels and smells. This approach can help children become more comfortable with unfamiliar foods and increase their willingness to try them.
- Goal setting with children and parents. Setting up a realistic goal is essential when introducing new food to the children for the first time. It is common for children to feel unsure or hesitant when they have to try something new. Therapists and carers can identify which food or group of food the child is more likely to tolerate and also set up a reasonable amount, rather than presenting a big quantity or variety of food all at once.
- Providing education on the steps of introducing a new food. OT can also support parents by brainstorming strategies and initial steps to introduce new foods. For example, they could first introduce a new food through food-play activities such as making a funny face on a paper plate using vegetables. This allows children to explore food gradually through their senses, such as by seeing, smelling, and touching it first before actually tasting it. Then, parents could slowly introduce this during mealtimes by encouraging children to have a nibble of the food first and see how they respond to it. It is important to set up clear rules in relation to the amount of food the child is expected to it or to follow the child’s guidance when allowing them to choose the amount they are willing to try.
- Creating a positive mealtime environment. Putting pressure on the children to eat a certain type of food could lead to negative experiences. Parents sometimes cater for children’s preference for food pickiness which could reinforce fussy eating and reduce the opportunities of trying new food. OTs could work with the families to develop the strategies, encouraging positive mealtime opportunities. For example, visual cues, games, reward charts, and using positive words.
- Involve the children in meal preparation. Involving children in meal planning can be a great strategy to work on their tolerance to food exposure. Activities like grocery shopping, cooking, serving, and cleaning up after meals are great opportunities. For instance, we could plan a balanced meal together or even allow the children to choose the bowl and cutlery that they want. It will give them a sense of control regarding their own food environment; therefore, it helps the children to feel less overwhelmed when the food is presented to the plate.