When picky eating becomes a problem

Children with sensory issues often struggle with eating, risking their health and leaving their parents frustrated and at a loss. Here are some suggestions to try, says Jessica Giljam-Brown.

Children, like adults, have food likes and dislikes, but what happens when a child dislikes more than Brussel sprouts and broccoli? For some parents and children, meals times are a stressful battle ending in tantrums and tears. At what stage should you be concerned that this fussy “phase” might be affecting your child's health?

Normal, picky, or problem?

There are three groups of children when it comes to eating: The “normal eaters” who are happy to try new foods and have few foods which they refuse to eat, “picky eaters” who will eat more than 30 different foods, and “problem eaters” who will eat less than 20 different foods, and sometimes as little as five. Problem eaters will ignore all hunger and thirst cues to avoid eating a particular food, and won't give in. Both picky and problem eaters are at risk of malnutrition, as a limited diet means that they are getting a limited range of nutrients. It is important to understand that there are different causes behind picky and problem eaters. Picky eating is usually a behavioural problem; encouragement and consistent meal structure can normally solve this. Problem eating can be caused by a physical gut issue, food allergies, previous tube feeding, or children with a sensory disorder. Parents of children with physical issues, allergies, or past illnesses often understand and know why their child is a problem eater, but for the parents of children with sensory disorders, it can be a struggle to understand why their child won’t eat and they often feel lost as to how to how to fix the problem.

Sensory issues and food

Sensory Processing Disorder (SPD) is the name given when there is a problem in the way in which the nervous system responds to the signals coming from the senses. Often children with SPD will favour one taste, colour, or texture.

Other things you may notice in a child with SPD:

  • Will exclude foods they once ate, and will not go back to eating these foods, even after a few weeks.
  • Will only eat hot or cold food.
  • Panic, cry, gag, and scream if given foods they don't like.
  • Irritated when getting dressed – doesn't like socks or shoes, gets upset if they can feel the seam in the clothing.
  • Oversensitive to touch, noise, smell, and new people.
  • Easily distracted and overwhelmed.
  • Doesn't like messy play or food.

Getting the right nutrients

It is important to try to maintain or improve the nutritional status of your child, regardless of whether they fall into the picky or problem eating category. Low zinc, iron, magnesium, and omega-3 levels can worsen neurological disorders and effect taste and appetite.

  • Zinc is responsible for the way we taste and respond to the texture of food. Zinc-rich foods are lamb, beef, and oysters; otherwise, a liquid zinc supplement can be added to drinks.
  • Iron plays an important role in regulation and signalling of your appetite, and children who struggle to eat meat or vegetables will often be low in iron. Include iron-rich meats and dark green vegetables in your child's diet if possible; otherwise, look to supplement, or use iron fortified cereals, bread, and milk.
  • Magnesium helps both the mind and body relax, and children with SPD are often overly stimulated or stressed and will use more magnesium than normal. Nuts, cacao, and dark green leafy vegetables are good sources of magnesium, but in a problem eater, the easiest way to give them a consistent dose of magnesium is in their bath water. Magnesium salts can be dissolved in the bath and absorbed through the skin.
  • Omega-3 fatty acids are important for the growth and normal brain function of all children, but especially in those who have neurological disorders such as SPD or autism. Usually, a supplement is the best way to ensure a child is getting enough omega-3. Liquid omega-3 oil can be added into meals, soups, and smoothies.

Managing picky and problem eating

The first step in helping a picky or problem eater is to make sure you have the right support. Talk to your healthcare provider and decide if you need the help of a food disorder therapist  or a qualified nutritionist or dietitian, and sometimes both are needed. The key to making progress with picky and problem eaters, as hard as this may be, is to keep the environment surrounding food, eating, and mealtimes calm. Often the problem with SPD children is the fear of the food, so try to give your child as many unpressured chances as possible to experience the food. It is important that your child has a structured meal time. Have the family sit together, eating the same foods in a calm and enjoyable way. This shows the child that other people can and do enjoy the food, and there is nothing to be afraid of. Use tiny steps when introducing a new food. Use a reward system for each tiny bite, or even just touching the food to their lips. Use lots of praise when the child takes a bite, but give no attention when the child doesn't. Expect that this will be a long process, and try not to rush it. Let your child pick a condiment to eat with the food they dislike. While eating mayonnaise or tomato sauce at every meal is not ideal, it can help. Start by allowing the child one teaspoon of the condiment, then slowly decrease how much he is allowed to put on his plate until he eats without the condiment. If colour is an issue, try sneaking foods into sauces, baking, or smoothies. While this doesn't help increase the number of foods a child is willing to eat, it does help improve the nutritional status of the child.

Jessica Giljam-Brown is a holistic nutritionist. wellnessbyjessica.com
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