{GUEST POST} Fussy Eaters and Mealtime Difficulties

Fussy eaters and mealtime difficulties

{Kindly written by Denise Stapleton APD & Gillian Griffiths OT – authors of SENSE-ational Mealtimes}

Eating can seem like a simple behaviour, when in fact one in two infants and toddlers are reported by their parents to have feeding problems. Up to 40% of children may be fussy eaters for a period of two years or more, but fussy or picky eating usually passes as children get older. However, mealtimes for some families are fraught with ongoing grimacing, gagging, distress, anxiety, worry, frustration and anger in their children.

What causes mealtime difficulties?

There is a long list of reasons that can trigger things not going to plan and trigger a tricky eater. If your child experienced a premature or complicated birth, early hospitalisation, has medical or developmental conditions, pain, trauma, excessive stress, reflux, vomiting, ear, throat or chest infections, allergies, intolerances, and/or constipation, these are just some of the conditions that may have contributed to complex mealtimes. Parents who experience post-natal depression, anxiety and stress can also make mealtimes tricky for some families.

One of the key areas to explore to help begin to improve mealtimes for your family, in conjunction with a health professional assessment, is your child’s sensory preferences for mealtimes.

What are sensory preferences?

Sensory preferences are the sights, sounds, types of touch, smells, tastes, temperatures, textures and types of movement we prefer in our day.  Our sensory preferences influence what we detect, tolerate, are distracted or distressed by, avoid, or seek more of.

Think back to a memory of your favourite meal.  Where were you, who were you with, what happened, what did you eat, how did you eat it, how did it make you feel and what do you remember? 

Sensory preferences are unique to each individual as they are based on: sensory thresholds in the brain; genes; the surrounding; environment; feelings; interactions and experiences during each day and across a lifetime (i.e. memories).  On top of this, pain, stress, trauma, fatigue, reflux, vomiting, infections, allergies, intolerances and constipation can make a parent or a child more or less sensitive.  Discovering sensory preferences takes time as we may have a different threshold for each sense and the amount of sensory information we avoid, tolerate or seek more of can change during the day.  Parents can also project their own sensory preferences onto to their children.

How do sensory preferences affect mealtime behaviour?

During mealtimes we use EVERY sense to help us notice, be calm, interact with others, socialise, be seated, use utensils (or not) and finally to eat.  We continually use our senses to gather sensory information from our surroundings and our body in order to ensure our mealtimes are emotionally safe, successful and enjoyable.

Our sensory preferences directly influence our thoughts, feelings, memories, interactions with others and our behaviour. If our brain detects or remembers an experience that feels unsafe, worrisome or dangerous, our body might experience a Danger Centre Response (fight, flight, freeze or fright).  These strong feelings might be associated with the sensory properties of certain foods, the surroundings or interactions and can have a very large impact on mealtime behaviour.

Can you remember eating a food that caused you to feel unwell or vomit?  Can you tolerate the smell, sight, taste or texture of that food now?  How does it make you feel?  What would you do if you were forced to eat even just a little bit? How would you behave?

How can I help my child feel safe at snack and mealtimes?

You can support your child’s ability to stay calm by taking time to SENSE-itively tune in to his or her cues. A child’s cues let us know how he is feeling and when he wants more or less or something different. When you tune in to your child’s sensory preferences, you can create a ‘just right’ experience that will feel emotionally safe for everyone and hopefully bring pleasure.  Ongoing pleasurable mealtimes can positively shape a child’s mealtime behaviour and the types or range of food he will eat.

Top tips for fussy eaters 

1. Reflect on your past mealtime experiences when you were a child and with your child. What were the things that made you happy at mealtimes and what made you feel anxious? How are mealtimes different when your child is calm and happy at mealtimes, compared with when they appear anxious and refuse food?

2. Become aware of your sensory preferences. Do you prefer quiet and calm mealtimes or do you prefer noisy conversation around a busy table? Do you enjoy mild flavours, or go after bold, fragrant and spicy flavours?

3. Tune in, acknowledge and empathise with your child’s sensory preferences, feelings and experiences of mealtimes as well as your own. How are they similar? How are they different? How might this influence your mealtimes?

4. Consider the impact of your and your child’s similarities and differences. How can the family mealtime cater to everyone’s preferences while still enjoying the same meal?

5. Discover the capacity you have to shape your own and your child’s feelings and behaviours around food through sensitive exploration of ‘just right’ challenges. Your child may not suddenly munch away on a broccoli stalk or piece of chicken but slowly and surely he or she might talk about it, touch it, smell it or even lick it with gentle encouragement and the right environment (and of course no pressure) over time. And one day he or she may just surprise you.

Denise and Gillian are the authors of Sense-ational Mealtimes which is a go-to parent guide book supporting clinicians and families with varying mealtime difficulties.

Gillian Griffiths is an Occupational Therapist with 15 years experience as a senior practitioner, program manager, consultant and facilitator of professional development and caregiver programs. Gillian has extensive training from the USA and Australia in Sensory Processing; Picky Eaters vs Problem Feeders: The Sequential Oral Sensory (SOS) Approach to Feeding; Infant Mental Health; Family Partnerships; Circle of Security; Trauma; The Developmental Individual Difference, Relationship Based Approach (DIR)/Floortime, Perceive, Recall, Plan Perform; Therapeutic Listening and Infant Massage. Gillian uses her vast experience and a broad range of evidence to make SENSE of complex mealtime difficulties. Gillian is co-director of Engaging Your Senses. She supports teams and professionals across Australia and internationally to provide effective, holistic services for the whole family.

Dr Denise Stapleton is an Accredited Practising Dietitian and Nutritionist with 28 years experience in nutrition and research. Denise passionately supports families with varying mealtime difficulties and therapeutic dietary needs throughout Australia as a private practitioner, senior community dietitian, researcher, author and mentor. Denise has training in Picky Eaters vs Problem Feeders: The Sequential Oral Sensory (SOS) Approach to Feeding and Making SENSE of the Senses. Denise collaborates nationally and internationally with professionals from a wide range of backgrounds who are supporting families with mealtime difficulties. Denise worked for many years as a paediatric dietitian in a children’s hospital and when she joined with Gillian, they began anticipating new possibilities that their combined expertise would bring to families with mealtime difficulties.

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