Advice about Food and Eating

It's natural to worry whether your child is getting enough food if they refuse to eat sometimes. But it's normal for young children to refuse to eat or even taste new foods.

Do not worry about what your child eats in a day or if they do not eat everything at mealtimes. It's more helpful to think about what they eat over a week.

There are lots of reasons why a young child might have difficulty with eating in general or eating particular foods:

Sensory – do they recognise when they are hungry or full? do they seek or avoid strong flavours or certain textures?

Physical – do they have difficulty with swallowing? Are they partly or completely fed via NG tube or PEG? Do they have allergies or intolerances, reflux or oral aversion? Are they teething?

Psychological – are they seeking control over what or when they eat? Are they scared because they have choked on or been sick after eating certain food types?

Situation – are there sounds, smells, or sights distracting the child? Are their feet supported when sitting in their (high)chair?

 Ideas to try...

Identify safe foods that your child will consistently eat.

Don’t react negatively or apply pressure if your child doesn’t eat.

Offer opportunities to play with food in a non-eating setting. Start with dry food play (e.g., dry pasta, lentils, rice), before moving on to wet food play (cooked spaghetti, baked beans, whipped cream, custard, fresh fruit). Be aware of any allergies.

Keep a food diary – note down what they eat, how much and when. Record anything that you think might be a barrier to them eating and think about how you can change this.

Adapt food to accommodate your child’s needs - do they need food to be a certain colour or brand or is it important that the food doesn’t touch?

Smell/ lick/ bite/eat strategy – when introducing new foods, encourage the child to smell the food first with no pressure to do more than this. On the next occasion, encourage the child to smell the food again and if they feel comfortable, try to lick it or touch it briefly with their tongue. As they become more comfortable licking the food over several meals, suggest a bite (but not eating or swallowing) and finally try a small piece to eat.

Use a ‘tasting plate’ next to but separate from their normal plate of food and introduce new foods on this. Place food in the middle of the table so that the child can select what they want to put on their tasting plate.

Use a plate which has divided sections for children who like food to be separated.

Introduce foods that are similar to foods that they already eat. Think about what the child likes about their safe food, is it the texture or flavour or both? For example, if a child eats chips, you could try roast potatoes as these have a similar taste and texture, if they like crunchy foods like crisps, you could try crackers, breadsticks or crispy bacon. This is called food chaining.

If the child is becoming increasingly upset by new foods being introduced and is finding mealtimes stressful, take a break and go back to safe foods for a week.

Mealtimes can be part of social occasions, such as birthdays or religious holidays. These special occasions often involve new or different foods and smells and more people around the table, leading to increased noise levels. Think about what is important to you as a family or community and what you can do to support a child who finds this challenging, e.g., does everyone need to sit around the same table or could there be a quieter table nearby? Could the child eat their safe foods on their regular plate, and could these safe foods be available for everyone so that the child feels included?

Involve the child in food preparation and shopping.

For children who are fed via PEG or NG tube, you can use dolls with an NG tube or PEG to role play eating and mealtimes.

Useful Websites:

www.arfidawarenessuk.org

www.beateatingdisorders.org.uk/get-information-and-support/about-eating-disorders/types/arfid/