In my clinic, I typically see toddlers, nursery-aged and early-school age (KS1) children with behavioural, learned or sensory issues resulting in food refusal. Children who are growing well are usually meeting their nutritional needs for energy, but may be lacking in other key nutrients eg. calcium, iron, essential fats or vitamins. In general, aversive experiences in infancy related to the mouth, throat or feeding can be linked to food refusal later on. Examples include repeated reflux, respiratory difficulties, food allergies, tummy pain or force-feeding of any kind. Children with sensory processing differences may experience food very differently and have difficulty accepting a range of foods. Limited early feeding experience, as described in feeding difficulties in infancy, will likely contribute to feeding difficulties in childhood, particularly food refusal. An early feeding history can be a helpful way to understand what has happened in the past, and find ways to work with and improve the present.
Behaviour and Learning about food and eating
For children, it’s not just about what they eat, but how they eat, and in what ways they can learn positively about food and eating. Parents are learning too! Not least about how best to support their child to enjoy a wide range of foods to meet their nutritional needs. The question becomes: how do young children enjoy eating and learn to regulate their eating behaviours? Eating should be social, enjoyable and stimulating for children but as many parents know, it can be a challenging task! Being present at mealtimes means children experience various social interactions, copy or try new ways of eating, and acquire familiarity of how food looks, smells, feels and tastes. Over time, this all helps to expand the repertoire of foods tried, accepted and enjoyed. Giving praise in whatever small way, is a great way to build good habits at the table and enjoy the experience of eating with others.