Food Refusal in Young Children (Part 1)

Why do they refuse certain foods?

I have been busy doing some work with young children who are “fussy eaters”. I work closely with a nursery nurse, who has worked in the field for many years. She uses positive parenting techniques with parents and has leaned to apply these directly to young children’s eating behaviour. I thought I would share some of the things that I have learned so far.

Firstly, we don’t like to use the term “fussy eater” and “fussy eating”. Instead, we prefer to refer to the behaviour as “food refusal”. “Fussy eating” implies something about the child, rather than a behaviour. Parents often resign themselves to having a “fussy eater” in the house, and feel helpless to change this. Instead, the term “food refusal” implies a behaviour which parents can take action to manage.

While on the topic of having a “fussy eater” in the house, this often implies that the child is being compared to another child or other children. All children are different, and if Child 2 eats less than Child 1 did at the same age, parents should usually have no cause to worry. Well children eat as much as they need to run around and have lots of energy, and to continue growing. Some eat more, some eat less, some days they eat more, other days they eat less.

I would go so far as to say that children are better at listening to their bodies and eating as much as they need than adults. We often eat set amounts out of habit. For example, we will usually eat exactly one sandwich, one packet of crisps and our apple for lunch, because that is what we have brought and we have learned to eat everything on our plates. In contrast, children will often eat half the sandwich, a few bites of the apple and some of the crisps, leaving the rest. This is absolutely fine. This is as much as they need.

In terms of eating behaviour, allowing children to eat as much as they need and not teaching them to clear their plates is a valuable gift we can give our children, setting them up for more mindful eating as adults. Know anyone who feels compelled to clear their plate? Is this you? It is such a hard habit to break as an adult, so let children eat as much as they need and learn to listen to their “I’m full” hormones.

Food refusal is thought to be a normal evolutionary behaviour that happens when children are around 18 months-2 years old. This would have been the time when, in traditional hunter-gatherer communities, children started walking and stopped being breastfed. Food refusal (technically called neophobia, or fear of new things) is nature’s very clever way of making sure that young children who have just started exploring the world do not eat poisonous or harmful substances.

Children most often refuse vegetables and healthier options, and there are several reasons for this. The first is that we like junk food! Humans have a natural liking of sweet foods, and many junk-type foods are sweet. I would argue that even processed snack foods that are not sweet have often been manipulated by food manufacturers to appeal to our food likes (I will post more on this at a later date).

We are all a bit lazy in the sense that we don’t like chewing too much. It takes time and effort. So we often like sloppier textures that are quicker to eat. Children are no exception. I have encountered numerous children who will eat nothing but children’s yoghurts, commercial baby and toddler food and crisps. The difference between children and adults is that we are able to weigh up and assess the healthfulness of the food that we are eating and make a decision. We can decide to eat something healthier, knowing that this is better for us. Or we can choose the pleasure of eating something less healthy. Children do not have this ability, they have yet to learn this. They will invariably opt for the food that appeals to their taste buds and their nucleus accumbens (the pleasure centre of the brain)!

From an evolutionary perspective, it makes sense for children to refuse many of the foods that they do. Bitter tastes are often associated with poisonous plants, and it is thought that this is why they will often refuse vegetables until they learn to like them.
Young children will often refuse foods that are combined, covered in sauce or where they cannot make out the individual components. They often like foods to not touch. This is perfectly normal, and a behaviour to ignore. It is thought that young children will often be averse to foods that could be noxious substances. If you think about it, adults will recognise the smell and sight of a bowl of chilli con carne as a tasty meal (if you like chili con carne, of course). We have learnt this from several experiences. Young children have not yet learnt this, and a plate of chili con carne might look exactly like a pile of poo or vomit!

Children observe the behaviour of those around them at mealtimes, and this is how they learn how and what to eat. They watch you eat a food on offer and your positive responses to the food (smile, yum, carry on chatting, seem to enjoy it) and learn that this is a safe food. This explains why children will often take food from your plate, even when they have exactly the same on their own plates! You’re eating it, so it must be safe. They may try it and their first response is yuk, this is an unusual taste. They may make a face or spit it out. Ignore this behaviour and carry on enjoying yours. This signals to the child that this food is good and your response is the expected response. Next time, they’ll try it again and, often after a few attempts, will usually learn to like the new food. It can often take as many as 10-15 attempts for a child to learn to like a new food. Just carry on offering it and enjoying it yourself.

The story above demonstrates why a positive atmosphere at mealtimes and role modelling is so important to developing the tastes of young children. I am often asked to advise parents where the children eat on their own, or with the parent or care giver who does not eat the meal on offer themselves at the same time. Children need to see adults eating. They also need a positive atmosphere at mealtimes, so that they can learn to associate eating with a positive experience. Any stress and negativity, and they will learn to associate this with the eating experience. And this is exactly how parents feel, when their child is refusing food – stressed and cross! It often takes an Oscar-winning performance to keep your cool in these situations.

When a child refuses food, it releases stress hormones in the parent. A great way of nature making sure you focus on getting the child to eat something, at least. But maybe not so helpful in 2017, when we have easy access to many different foods in our fridges and cupboards, all just a few paces away.

Which brings me in to the next point: Do not offer replacements. It is not better that your child eats anything, something, than healthier options. As already discussed, this will invariably be a junk-type food, whether sweet or not. These foods are usually low in fibre, low in iron and low in other micronutrients (like vitamins, minerals and essential fatty acids). By replacing refused food with junk-type food, children learn that this is the consequences of food refusal. Poor intake of fibre can exacerbate or precipitate constipation. This is fairly common in children and can affect their appetite. Poor iron intake is associated with anaemia, which also effects appetite. It is possible that suboptimal intakes of other micronutrients may also affect appetite, particularly zinc.

Instead, make rules around treat and less healthy foods. Many parents opt for a one-per-day rule. Others might think this is excessive, opting instead for a one-per-week rule. Still others may prefer to offer these types of food only occasionally, for example at a party. Whatever your rule, you could offer the child the choice of what, remembering to keep his or her choices simple. Generally, a choice between two options is enough – any more than this, and young children often get confused, unable to process the options, and frustrated. “It is Friday evening, so we are all going to enjoy a treat. Would you like crisps or chocolate?”

Let me know your thoughts – what has worked for you?

Join me next time, when I will be looking some more at role modelling, portion sizes and behaviours to ignore.

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