Until you have a child who's a picky eater, it's difficult to image the impact that it can have on your entire family life. Jo Cormack is a feeding specialist who helps families with picky eaters return to a calm and peaceful way of life, especially at meal times.
Picky eating covers a huge variety of people and one of the questions that people always ask me is, is it a phase and how do you know it's a phase?
Picky eating covers a really wide range of behaviors from a child who just doesn't like their squid to a child who is only eating three foods.
It is important to distinguish between mentally normal picky eating which is more about the boundary challenging and attention seeking and the other end of the scale, the very problematic eating, which is characterized by anxiety type behaviours.
Research says two thirds of children who are picky eaters from a young age will grow out of it three years later. However, what about the other third?
While for some children it is a phase, I don't know how helpful it is from the parents’ perspective to see it like that.
I like to look at each child on a case by case basis.
If you are a concerned about your child eating then get their weight and growth checked.
If there is a problem with weight and growth then it’s a red flag for something and will need further investigation.
If there isn't an issue with weight and growth then parents can relax rather than having this nagging anxiety that their child is getting enough food.
The second thing is trusting parents’ intuition. If you are a parent, you look at your child and you just have that sense that something's not right, maybe they're not sleeping very well or they’re pale and listless or maybe they don’t have much energy.
Then you might start to think something really could wrong.
However, if you look at your child and they're happy, energetic and they're running around. Maybe they need less food than you think.
Over feeding children is huge problem and according to a research done by Infant Toddler forums, one in three children in the UK is over overweight or overfed.
Moreover, eighty percent of parents offer bigger portions on foods that are easy to eat like spaghetti bolognaise rather than carrot sticks.
The over feeding problem is driven by a kind of cultural fear of hunger. I’m talking about appropriate hunger not the kind of hunger you have with neglect.
A good relationship with food is all about self-regulation and in order to self-regulate, you need to be in touch with those physical cues. But some children maybe never given the opportunity to experience the cues because they're being overprotected from hunger.
Going back to the previous question about how to know when to get help from a specialist. When your child has an immediate and visceral reaction to the food in front of them, this could be an anxiety reaction that could be caused by many different things.
It’s useful to try and empathize with the anxiety. One analogy that I really like is that what would you do if you were out with your friends for dinner and you were presented with a pile of putrid octopus? And your friends will be like there you go, I spent all day cooking it. And your stomach would turn and you’d be horrified.
So we need to emphasize with children who are really genuinely frightened, anxious and think what is this like for them. It's just like being presented with a plate of rotting octopus.
Related: Picky Eating and Temperament
There are three primary he causes a food anxiety in my clinical experience.
The first is temperament. If a child is just cautious and sensitive by nature, just like they might be really wary when they’re at the park and there’s a new play equipment, that massive new slide and it looks really scary, they might be equally wary of new food.
Another huge area is sensory processing difficulties. If a child has that sort of sensory sensitivity or any sort of sensory processing problems which many children do. That can have a massive impact on the relationship with food.
Another thing is maybe a child choked on a piece of banana and has this pain association with the negative experiences with food.
Before you know how to help your child with anxiety you need to try and get to the bottom of what's behind it. Sometimes that can require professional input.
All of us have a lot of sensory data that our brain has to process and integrate. For some people that's really difficult.
Imagine you struggle with processing data from your sense of smell and taste which is your olfactory senses. You might find that a plate of food is really challenging because you've got that that soft strong smell coming off it.
But then you've also got other sensory data coming in from that meal.
You've got the textural stuff, you've got the visual stuff as well and this is where it's hard for a child eating in a school environment, they might be eating at a dining hall and have all the auditory sensory data as well.
I do a lot of work with Australian feeding specialist Simone Emery and she talks about is this concept of a sensory cup.
She describes how children might go through that day, maybe spent the morning at preschool or kindergarten and they had all this sensory stimulation and their sensory cup is full. Then they come back, they sit at the table and it is just overwhelming.
All that sensory data they get from their food is just too much because it's too much for them to process. That could be extremely difficult for an adult to relate to because maybe that adult doesn’t have any sensory processing challenges.
It’s useful to look at the child and think away from the table. Does this child have sensory sensitive to other areas?
It’s useful to have a clear idea of what exactly those sensory processing difficulties are and how extreme they are.
It’s great to get an assessment by an occupational therapist but that can be really hard to come by unfortunately.
But that’s really the goal because they're the professionals that have a really in depth understanding of sensory processing.
You can also do a lot as a parent.
If your child hates having their hands sticky it's about simultaneously exposing her to that but also being empathic. You might put a washcloth on the table during meal time so they can have a bit of control. So whenever they feel uncomfortable with sticky hands you can tell them to wipe their hands.
You can also have a sensory bin. Every day they can have a little sensory explore and experience. You’re not completely protecting them from it. It’s that fine line you’re treading between giving them experiences that will be helpful and also recognizing that something's really tricky for them.
To summarize, it's about taking their concerns and their anxieties and addressing them.
You need to discipline but you don't have to do that in the hard way. You could do it in an understanding way.
I’m a huge fan of Ellyn Satter’s Division of Responsibility where the parents are saying this is the structure we're having, this is where we're going to be eating and this is when we're going to be eating. It’s fine to be firm on that. But that's different from being controlling around how your child eats and whether they eat what's in front of them.
It’s good to have very clear boundaries that you maintain firmly but fairly and calmly while also completely leaving children to make their own eating decisions from within the context you’ve set.
For example my children would happily eat an entire box of breakfast cereal every morning if I let them which I don’t. So I put a limit. We have a little cup that we measure it. They can have two bowls of breakfast cereal which I think is plenty and beyond that you can have fruit if you want to have more.
My children always push and push. This morning my nearly nine year old said “Celeste always get four bowls!” Instead of entering into their argument, I said from now onwards we are all going to have two bowls and stated that firmly and clearly.
A lot of behaviour around food has nothing to do with food at all. It has to do with other behaviours and untangling all of it can be really complicated.
Look carefully at your child's needs to get a clear schedule for what meals and snacks they need in terms of their age and stage.
That’s very surprising to a lot of people especially when children are limited eaters.
If a child says can I have XYZ, the parent maybe has this underlying anxiety about how much they're eating. Which goes back to making sure that they do get their weight and growth checked so you know whether to be anxious about that.
Parents are very keen to give some food but it's so much healthier psychologically to have that clear structure that you have predetermined so you'll never give your child food because they're bored.
Self-regulation is feeling your body's hunger cues and respond to them and stop eating when you feel full.
When parents take on that role of making the decision about how much their child should eat, which in in research literature is called controlling feeding practices, even saying “Eat three more mouthfuls”, you’re actually getting in the way of a child’s ability to listen to those signals and self-regulate.
The key to getting your child to have a good relationship with food is to support self-regulation.
Let your child listen to those internal cues and eat until they’re full and then stop.
A lot of people don't necessarily understand just how complex, picky eating is and it's really easy to look from the outside of a family and see a parent who's giving their children three kinds of foods and say, “Well, in my family, we wouldn't give my child just three kinds of foods. We serve them an array of vegetables, and they just have to eat it.”
It shows a great misunderstanding of what's going on for that child.
There are lots of things parents do that could make picky eating worse, just as there are a lot of things they can do to make it better.
Mothers shouldn’t beat themselves up. Rather than going with that guilt, just congratulate yourself for actually being incredibly brave to face up to some things that need changing and to go and get good information.
Parenting is really difficult and it's really difficult to be the parents that we want to be because our children are constantly screaming.
We want the best for our children and even if we know the theory on how to do that, applying it can be difficult.
I think, particularly in the UK, there should be so much more support for all parents.
If they're doing the wrong things for the kids, it's because they don't know not because of malicious reasons.
It’s also important to look a cultural norms.
This whole agenda where parents feel that it's their job to get food down the child is culturally normal because probably that’s what the parents experienced as a child. It’s about understanding that the way we feed our children comes from the society we live in.
It comes from how we were raised.
Jo Cormack has a course specifically for parents of children who are anxious eaters. It’s a sixty day program and it has six modules. It takes you absolutely thoroughly into what happens in the brain when a child is anxious, processing your own reactions.
When I work with families, the first thing they want to know is how can I get my child to eat more food? Yes, that is a long term goal but the first thing to work on is getting that eating environment right.
If meals are stressful because you're stressed or because your child is stressed, that needs to be addressed first. You can't bring variety in until meals a relaxed, positive and upbeat.
If people are at a bit of a loss how to make that happen, check out Ellyn Satter’s Division of Responsibilities. That's a great starting point.
Thank you to Jo for her fantastic advice to help us combat picky eating and to help our kids learn healthy eating habits.
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