Need to know

• Understanding your child’s picky eating

Most kids go through a phase of picky eating. Even the most compliant of children may decide one day that they will only eat a handful of foods. Our palate takes years to mature and most kids become more adventurous with food as they grow older.

Some children do not outgrow their restrictive diet and will continue to limit what they eat into adulthood, often impacting how they interact in social situations centred on sharing meals.

A child’s picky eating can become a serious problem. Some foods which were initially accepted drop off the menu because they have been over consumed, further limiting the range nutrition a child consumes. The lack of fibre and vitamins will slowly start to impact a child’s immunity and digestive system; with related discomforts likely to make them more hesitant to expand their diet.

Why it’s important

Eating problems can become very stressful for parents as they attempt everything from sneaking in vegetables in “accepted” foods to bribery and threats. The constant refusal of food can make each meal a chore for both the parents and the child involved.

By the age of 6 most kids start to increase the range of foods they eat, but if you are concerned about your child’s weight, growth or development make an appointment with your doctor to rule out ARFID.

ARFID stands for avoidant/restrictive food intake disorder and it is characterised by avoidance and aversion to food and eating. Unlike other eating disorders it is not due to an individual’s perception of their body image. ARFID is linked to anxiety or phobia of food and/or eating, a heightened sensitivity to the texture, taste or smell, or a lack of interest in food/eating.

There are some risk factors that increase the likelihood of your child developing ARFID, these include:

• A diagnosis of Autism, ADHD and/or an intellectual disability
• Low interest or low appetite food avoidance
• A co-occurring anxiety disorder, putting them at risk for other psychiatric disorders
• Gastroesophageal reflux disease (GERD) or other childhood conditions that lead to pain or discomfort with digestion and passing stools
• Phobia/trauma of choking or vomiting

Treatment of ARFID is specialised and individualised depending on existing underlying conditions. A developmental paediatrician can assess for neurodevelopmental differences and gastrointestinal problems which can inform the best approach and allied health professional required for treatment.

In many cases, children outgrow their picky eating phase. As their parent, there are a number of strategies you can use at home to help your child expand their palate and develop a positive relationship with food.

Tips & strategies

• Keep a food diary – over 3 days keep note of all the foods your child consumes and rejects to get a real understanding of the problem.
• Reduce stress and chaos – having pleasant interactions at mealtimes with few distractions are important in ensuring the whole family is able to relax and enjoy the meal. 
• Involve them in food preparation – depending on your child’s age you can involve them in washing fruit or cutting vegetables. The key is to expose them to the foods repeatedly in a positive way without the expectation that they need to eat them. With time you can encourage your child to smell the food, lick it and eventually offer it as an option to eat.
• Experiment with different textures – changing preparation methods from raw to roasted, fried or mashed can also influence how your child responds to a new food.
• Always include “safe” foods – you can continue to prepare a variety of foods for your child to try but always serve “safe” foods that they eat. Restricting the food available at mealtimes can backfire and make your child eat less and develop a stronger preference for forbidden foods.
• Don’t give up – it can take 10 to 15 exposures to a food before a child can start to eat a new food. Once your child accepts something new don’t stop putting it on rotation!