When should you worry about a fussy eater?

We all want our children to thrive. And one way to help is by making sure they're eating a healthy diet. But what happens when a child starts to refuse certain foods? What can we do to help, and when should we seek professional support?

Many parents notice children becoming fussier about their food at around 18 months to three years old. A child who may have loved broccoli may suddenly refuse it, or an infant who loved to try new things may suddenly seem reluctant and suspicious.

This may be to do with a condition called 'neophobia' - the fear of new things - that many children develop at this age. For the vast majority of children, this is a phase they will grow out of, but it can be a very stressful time for parents.

How fussy is your child?

As parents, we can get very stressed when our lovingly prepared food is refused. But sometimes this stress can mean we don't have a clear sense of the problem. Often we remember the failures more than the successes and it may seem as if our child is eating virtually nothing.

One way to establish your child's eating behaviours is by keeping a food diary on their behalf. "Food diaries can be a useful way to see on paper what your child is managing to cope with, and what they've actually eaten at mealtimes," agrees Chloe Elliot, specialist paediatric dietitian at City Dietitians. "Sometimes children aren't eating well at home, but are eating everything at nursery when surrounded by their peers, or in other environments."

A food diary will enable you to build a clear picture, establish your child's likes and dislikes and - if necessary - will be something you can show a medical professional if you feel concerned.

How to handle a fussy eater

No matter how great your parenting skills are, if a child doesn't want to eat something, it's impossible to make them. Sometimes we can persuade children to take a little bite with a bit of coaxing and persuasion. But when we're met with blank refusal, there's very little we can do.

Thankfully, if your child refuses to eat some foods, this isn't necessarily a cause for concern. "If they're refusing all vegetables, but have a balanced diet overall, are eating fruit and not suffering from constipation, it's not a cause for concern," says Elliot. "I often advise parents to give children a general multivitamin if they are worried - it's not going to do them any harm."

Don't give up

It can be frustrating to continually provide your child with vegetables or other nutritionally dense food only for them to refuse to eat them. But according to Elliot, it's important that we continue to provide these foods, even after refusal. "Offer them vegetables, even if they say no every time," she advises. "There will be a day when they surprise you. Children need a lot of exposure to a new food to finally accept it. If they won't have it on their plate, try putting a little side plate of vegetables nearby."

Remember, too, that the situation can get very challenging for your child too. "When children are about two years old, it can be a very frustrating time," explains Elliot. "They're learning to talk, but can't quite communicate what they want."

Strategies to try

Alongside keeping a food diary, it can be useful to encourage your child to interact with vegetables and fruit in different ways. Try whipping up smoothies - which may make fruit and veg more palatable, whilst not dispensing with essential fibre - and find other fun ways to introduce vegetables into their lives.

"For example, try playing with mashed potato as if it's playdough," suggests Elliot. "Cut some vegetable shapes and do painting with them. This will help them get used to the feeling of the vegetable on their hands."

It's also OK to serve your child similar meals every day. For example, if they enjoy pasta with some vegetable sauce, there's no reason to provide continual new things for them to eat. "Children often go through phases where they like a particular food more than others," agrees Elliot. "It's fine to give them the same meal several times within a week if that's what they're happy to eat."

When should I worry?

Many parents start worrying almost immediately when their child begins to refuse certain foods. But, while it's important to monitor their intake, this behaviour isn't usually a cause for concern.

However, if your child is refusing an entire food group - dairy for example - it might be time for a chat with your GP. "If their diet becomes particularly restrictive or if they stop eating a certain food group for a long period, then consult your GP," advises Elliot.

It's also crucial to seek medical advice if your child appears not to be growing, or is losing weight. "Growth is absolutely essential," agrees Elliott. "If their diet is so limited that they are losing weight, take them to the GP to investigate whether there is any additional cause."

Avoid stress

While your child's diet is important, it's also crucial you don't become too stressed if your child develops fussy eating habits. "The child can feel parental stress and it makes them more anxious," says Elliot. "If they don't eat something, remain calm and move on."

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