Your job is the plate, theirs is the bite

Registered nutritionist Catherine Jeans answers your questions on fussy eating, from pudding bribes to the beige food phase.

With Registered Nutritionist and Nutritional Therapy Practitioner, Catherine Jeans DipION mBANT CNHC mIFM, from www.thefamilynutritionexpert.com

Catherine and her clinical team specialise in supporting children and adults with eating difficulties, taking a non-judgemental, family-centred approach to supporting balanced relationships with food.

Is fussy eating a normal part of growing up? At what age does it usually start, when does it tend to peak, and why do so many toddlers who ate everything as babies suddenly start refusing food?

It’s completely normal for children to go through phases of more picky eating, and for all of us to have likes and dislikes when it comes to food. This phase can typically peak around 2 years of age, as children naturally go through the neophobic (fear of new things) and disgust responses. These instinctual responses kept our ancestors safe, preventing toddlers from picking up potentially poisonous items and eating them. Bitter, slimy foods in these times were naturally more likely to be unsafe, which is why babies and young children need to learn to accept different tastes and textures, and recognise them as safe. As these responses tend to heighten around 2 years, this is one of the reasons why toddlers can suddenly start refusing foods they were eating before.

The biggest piece of advice I can give families at this age is to stay calm around food. Here are my top tips for how to put this into practice with your child:

• Keep offering foods of all different types, but try to take the emotion out of any responses you give as an adult.
• Try to make healthy eating a perfectly normal part of life. Model healthy eating behaviour, as children learn that something is safe by seeing their grown ups or their peers eating those foods.
• Don’t overly praise children for eating something you don’t expect
• Avoid any negative comments around food.

These should help them to gradually move out of this phase and develop a more balanced approach to food.

Myth: “If they’re hungry enough, they’ll eat what’s in front of them.” Is waiting it out a good strategy, or can it make mealtimes more stressful and the fussiness worse?

This is a difficult question to answer, because it really depends on the child and other behaviours they are displaying. For most children, it’s important to be cautious around offering lots of alternatives to the main meal. Children will pick up very quickly that if they make a fuss, then you will give them an alternative. Again, the key here is to keep the emotion out of mealtimes. Let them know it’s okay if they don’t want to eat it, and it’s available if they want to eat it later. You might say something like, “I can see you’re not hungry now, let’s try again at dinner or lunch…” You might offer them the refused food in an hour or so, or perhaps after a nap, if it’s safe to reheat it.

Or you can prepare them something different at the next meal, and if you’re worried they haven’t eaten much that day, offer them some foods that are usually well accepted at the next meal.

If your child is showing signs of more restrictive and sensory eating, and potentially moving towards a diagnosis of ARFID (Avoidant Restrictive Food Intake Disorder), then they are very unlikely to eat when they are hungry. This requires much more careful and strategic support, with access to accepted foods at every meal.

How many times does a child need to try a food before they accept it? And what counts as “trying”? Does touching, smelling or licking a food count as progress?

This is a great question, because it’s important to remember that we use every sense when eating. Of course, swallowing and digesting the food is the ultimate goal, but to get there, we may need to work on exploring all senses around food. It might be that you start supporting your child to feel safe around new foods by getting them to help you prepare, cook, shop, talk about, smell or lick a little of a new food that you are eating. This is all progress and very healthy sensory exploration.

For some children, it can take many exposures to a food to help the nervous system feel safe around that new food experience. Taking things gradually and slowly in your child’s own time is key. If they do try it, remember to keep your response very balanced and calm. You might ask them how it tastes or what it felt like in their mouth, or talk about how you like that food and why, rather than overly praising. Too much praise can put too much pressure on a child to try or like it again.

It could be that a minimum of 15 tries is needed for a new food to be accepted. You might begin with a small amount of the food you’d like them to try on a different plate, or on a plate with different sections. You might put the food alongside some of their current favourite foods, or offer it as part of a buffet-style meal. It can take weeks or months for some foods to be accepted.

So, it does require a lot of patience and gentle perseverance, avoiding any form of coercion or any form of bribery.

Myth: “Hiding vegetables in sauces is the best way to get them in.” Does sneaking vegetables into meals help, or do children also need to see and learn about those foods in their recognisable form?

I often encourage families to take a dual approach to getting in more vegetables. First of all, we need to make the meals we’re preparing are as nutritious as possible. So, this might involve grating or blending vegetables into sauces, soups or stews, adding ground nuts or seeds into porridge or baking or blending fruit into yoghurt. All of this extra helpful nutrition is really worth doing (exception – if you have a child who appears to be developing very restrictive eating or has a diagnosis of ARFID, then you may need to avoid hiding anything in their food).

In addition to this, we do need children to feel safe and comfortable around a wide variety of different foods. This is why it is also important to put a wide variety of foods onto their plate, in a form they can see. It may be that for some children you put foods that they struggle with on a separate plate, or separated from their main meal so they are not touching. If we do not allow children the opportunity to explore new tastes and food sensations, then we are potentially disempowering their food exploration, and not giving them the chance to broaden their food choices.

Should we use pudding as a reward, or ask for “just two more bites”? What does the evidence say about bribes, praise and clean-plate rules, and what can families say instead?

This is a tricky one for us grown ups! So many of us were brought up with these messages and strategies. It’s very easy to fall into the habit of using pudding as a reward, or encouraging a few more bites. And certainly, grandparents might struggle to stop doing this.

However, research clearly suggests that a more responsive feeding technique may be better for our children’s long-term relationship with food, avoiding any form of coercion or bribery.

Responsive feeding is where grown-ups decide what food goes on the plate, when and where. Children decide whether to eat it and how much. This empowers them to listen to their own hunger and fullness cues and feel more in control and able to explore foods without pressure.

Using pudding as a reward can make it seem more desirable, and vegetables seem like something that needs to be endured or are unpleasant. It can reinforce the idea that sweet foods are special.

It’s fine to serve pudding as a normal part of the meal, but try not to make it something you need to earn. For example, you might say – “we’re having pasta, broccoli, salmon, and yoghurt with berries tonight. You can choose what you’d like to eat.”

The “two more bites” approach encourages children to eat beyond their fullness, and overrides their natural ability to regulate how much they eat. Rather than insisting on two more bites, try saying things like:

• "You don't have to finish everything. Listen to your tummy."
• "Is your tummy still hungry, or have you had enough?"
• "Would you like some more, or are you happy with what you've eaten?"

It’s absolutely fine to praise exploration of food, but praise the process rather than the quantity. For example, rather than saying “well done, you finished your dinner” you could say “you listened to your tummy.” Or instead of, “good girl, you ate all your broccoli” you might say… “you gave the broccoli a try. What did it taste like?”

How can families tell whether their child is getting enough? If a child seems to live on pasta and crackers for weeks, should families be worried, or does nutrition balance out over a longer period than one meal or one day?

Nutrition absolutely balances out over a period of time. It’s much more important to look at what your child is eating across a week, rather than on one day or a specific meal.

A child’s appetite can flux and wane, depending on growth spurts, how well they slept, whether they are going through transitions at nursery/childminder, activity levels, teething, or after a period of being unwell. Some days they seem to eat everything in sight, and on other days they barely touch a meal.

When young children are tired, they just sometimes want to reach for something familiar or easy to eat, which is perfectly normal.

Here are some things to look out for to help you decide if your child is getting enough:

• Are they growing and gaining weight appropriately?
• Are they meeting developmental milestones?
• Do they have enough energy and seem generally well? Or are they continually picking up coughs, colds, other infections and just seem continually under the weather?
• Are they having regular wet and solid nappies, or going to the toilet every day?
• Are they getting in a reasonable variety of foods over time?

Eating only beige foods, such as crackers and pasta, over a longer period of time may mean your child could become deficient in key nutrients, including protein, Vitamin C and key minerals such as copper and zinc. However, this won’t happen overnight or in a few days, which is why it’s important to look at variety over a longer period of time.

Myth: “Fussy eating is caused by parenting, or by giving in too often. ” How much is down to temperament, genetics, sensory sensitivity or developmental stage, and how can families let go of the guilt?

What I want to say to parents and carers is – this is not your fault.

We don’t know for sure what causes some children to develop more avoidant or restrictive eating patterns compared to others. But, what we do know is that every child is unique, every family is unique and that it’s nothing you as a grown up have done wrong. Eating difficulties can appear and wane at different developmental stages, and for most children, it is a phase.

If you’re in the early stages of weaning, you can help to develop a more balanced relationship with food by trying to move through the different stages of weaning and include different tastes, textures and lots of variety. However, many children go through an extremely varied and balanced weaning journey and still develop eating difficulties.

There is often a complex interplay of factors going on for more avoidant eaters. For some children, genetics may play a role, also sensory challenges, which may be especially relevant if there is neurodivergence developing. But not every child who has challenges with food is neurodivergent either.

Why do children eat well at nursery but refuse the same food at home? What is it about eating with other children and a predictable routine that helps, and can families recreate any of it at home?

This is very common, for a variety of reasons.

Children learn what is safe to eat by watching others, so the group environment of a nursery can be really helpful here. If they see their friends happily tucking into carrots or broccoli, they are more likely to eat them too. This is why when you’re at home, trying to have some family mealtimes all together can be really helpful. Let your children see you eating and enjoying the foods you’d like them to try, and talk positively about the food you’re presenting without putting any pressure on them to try it.

Creating mealtime routines can also be very helpful, because predictability helps our children to feel safe. This is very common in a nursery environment, where mealtime is often signalled by group hand-washing, setting the table and sitting together with friends and grown-ups. Try to create this predictability at home, by having consistent mealtimes, giving children time to prepare for meals (for example, “in ten minutes we’re going to sit down for lunch”), create recognisable routines such as handwashing together, sitting down together, setting the table together. Also, have a familiar place to eat, keeping mealtimes relaxed and fairly consistent in length.

Children are also likely to experience repeated exposure to foods at nursery – with rolling menus, common snacks and healthy foods given on a regular basis. You can also model this at home, by trying different cooking methods for one food (for example, grated carrot, mashed carrot, or carrot batons). You can also offer family favourites, with the addition of new foods on a repeated basis.

Where children are showing more restricted eating patterns, it is very common to have place-specific foods. It’s not something you are doing wrong, but when they come home, they may feel able to just be themselves, they may feel tired and overstimulated after a busy day at nursery, and just be looking for comfort and familiarity. It’s also a time when children may be keen to exercise some independence and control. Often refusing a food is less about the food itself and more about how they are feeling.

What does a calm, positive mealtime look like in practice?

A calm, positive mealtime is one where children feel safe, relaxed and accepted, regardless of how much they eat. The aim is to create a pleasant environment where children can explore food, develop confidence and gradually learn to enjoy a wider range of foods, but without pressure.

How much food should go on the plate, should a “safe” food always be included, how important is eating together, and how should families respond to refusal?

• Start with small, manageable portions rather than filling the plate.
• Offer a little of each food and allow children to ask for more if they want it.
• Remember that children's appetites vary from day to day depending on growth, activity, tiredness and how much they have eaten previously.
• Avoid expecting children to finish everything on their plate.

A smaller portion can feel less overwhelming, particularly for children who are selective or anxious around food.

For many children, it may also be helpful to include a preferred or familiar food at most meals. This can help feelings of safety and reduce anxiety at mealtimes. This might be a familiar vegetable or their favourite type of pasta.

If a child refuses a food, the key thing is to remain calm and avoid turning that refusal into a battle. Avoid coercing or bribing them to eat that food, or any negative comments such as, “you’re being very fussy today.” They may just not want to accept that particular food that day.

A helpful response might be: "It's okay if you don't want to eat that today. It's here if you change your mind." This reassures the child that they are in control of whether they eat, while the adult remains responsible for providing appropriate food.

Encourage exploration through touching, smelling, licking or tasting without an expectation to swallow it.

It’s also best to avoid preparing lots of alternative foods immediately after refusal, but instead ensure there is a familiar food available as part of the meal.

Over time, if you keep offering unfamiliar or less accepted foods alongside familiar foods, they are more likely to accept that food. This can take weeks or even months.

A successful mealtime isn't measured by an empty plate. It is measured by whether the child feels safe, included and relaxed around food. Consistency, patience, positive role modelling and repeated opportunities to explore different foods are far more effective than pressure or conflict.

When is it more than fussy eating? What signs would suggest a family should speak to their GP or health visitor, for example a very limited range of foods, weight concerns, gagging or distress at mealtimes?

As we have discussed, it’s common for children to go through periods of more fussy eating. However, it’s also important to understand when they may be going beyond this. Trust your instincts as a parent or carer, because sometimes these concerns might be dismissed by professionals who do not have the right training, with comments such as, “they’ll grow out of it.” Or “they’ll eat when they are hungry.”

Signs to look out for:

• Very limited range of foods, e.g. under 20 different foods
• Struggling to eat new foods
• Going for long periods without eating
• High levels of distress around new foods/other foods: eg gagging, retching, extreme anxiety
• Being unable to eat in other places
• Inflexibility around food – eg not being able to eat preferred foods in different forms (eg different plate or a different shape)
• Not following height and weight charts
• Other signs of sensory hypersensitivity or neurodivergence

If a family only changes one thing this week, what should it be?

Allow your child to decide what to eat and how much, without pressure, bribing, coercing or commenting on how much they have eaten.

Allow your child to explore at their own pace.

And remember, your job is to provide the food; your child's job is to decide what and how much to eat. This can make a big difference to a child's confidence, enjoyment and long-term relationship with food.