Thursday, 7 January 2016

Why my child is NOT a 'fussy eater' - food aversion and food allergy

'Fussy eating.' Have you ever heard that phrase? 


Well I have and I hate it! 

It's the hidden condemnation, the stigmatization that accompanies the phrase that I really hate the most. The assumption is that as a child you're trying to get attention, or 'get away with' something, or that as a parent you haven't been strict enough. As far as I'm concerned, although this could be the case, in some circumstances, this kind of stigmatization really ought to be stopped!!

There's a reason why (in our house) most dinners come with cooked carrots!!

For us, it all began at a really early age. 'Baby' was just beginning to wean. It was difficult to put her down and get on with things. I didn't like to cook with her in a sling, in case she got hurt, so cooking food was altogether a tricky matter. 

To begin with, I relied a fair bit on bottled baby food, until one day I decided to take on the task off cooking her food from scratch. I dutifully boiled up and mashed some carrots (not without resistance from 'Baby' I might add). She, being hungry, by the time I'd finished, happily accepted the first mouthful, then she took the next a little more slowly... and then she stopped. 

It's amazing how much a six month old face can tell you! She looked incredibly dismayed. Big tears rolled down her cheeks. This was not what she was after! And she steadfastly refused to take any more! Me, inexperienced, panicky, immediately felt the pressure and tried to perform the 'firm but fair mummy' trick. No, no, no, she wouldn't take it. Her mouth was firmly sealed shut. That was that. Angry, confused and... humiliated even, I eventually gave in and found her something else to eat - after all I couldn't let her get hungry, could I??

Some people might think that's where I went wrong and that I caved too quickly. But I honestly couldn't see how a six moth old could be 'trying it on'. And as we continued to wean she appeared happy to try all kinds of food, but then things went into reverse - her tastes started narrowing down and bit by bit 'Baby' became a lot more selective. 

If only (and not for the first time) I knew THEN what I know NOW... I think quite a few things could have been a lot easier for both of us!

1. A lot of food advice seems to be hung up on everyone getting their five - now SEVEN - a day. Good advice for healthy adults. Not quite as necessary for babies, whose diet should be higher in fat than fibre. If you're fed this message when your kiddo is struggling to eat one a day, where do you go from there??

2. Some people are super sensitive to taste. I watched a programme about this once. I so wish I'd recorded it and tracked down the expert they interviewed. She explained how some people can detect taste in a way that others can't. She called them 'super tasters'. I believe she found they have more taste buds than the rest of us. 

I can't remember the detail, but do remember that this struck a real chord with me at the time, in connection to 'Baby'.  If I try to 'hide' something in her food, she's on to it! She can also detect different brands of food. She's a lot better now, but at one time, she narrowed herself down to ONE type of sausage - no other sausage would do. So every time we had sausages it had to be that brand or she wouldn't eat it!

3. 'Fussiness' over food can work as an early warning system for allergic children. The Hub's nephew, somewhat older than 'Baby' is allergic to nuts. He also is very sensitive to tastes. Once he even detected that some food we were eating in a restaurant was a bit off. It turns out that food allergy often goes hand in hand with food aversion - there's some kind of detection system that operates with saliva in the mouth. It's a kind of protective response. I learned this from a Paediatric Allergy Consultant on Twitter (George du Toit @goallergy) who tweeted: 

Amazes me that infants can correctly ID many of the foods they r allergic to, typically precedes verbal skills.


Oral mucosa is packed with allergen & toxin recognition cells, designed to protect us, generate early warning signals 

Du Toit included a link to this article. I find this both fascinating and also incredibly helpful - recognition that there is link between food allergies and food aversion. I know this is a common topic among children without allergies as well, but many food allergic children definitely have that problem. And who can blame them? After all, food actually CAN and sometimes DOES hurt them!

4. Getting heated about food refusal can make things worse! Negative emotions can actually embed the problem deeper. The best thing you can do is remain calm and take the pressure off - insisting that the child eat something they really can't stomach adds to the anxiety in the child and can lead to shut-down.

At the end of the day you want a child to enjoy eating their fruit and veg. The danger of making them eat it under duress, is that they will eat it when forced, but will not learn to enjoy it. Then, instead of developing a healthy habit for life, they will not eat fruit/veg. when there is no longer anyone around to make them.

5. Avoid introducing sugar (including natural sugars) too soon. It turns out a lot of baby food manufacturers add fruit juice to their veggie mixes - which obviously sweetens them and makes babies more likely to eat them. Although it may seem like a trendy fad (to be avoiding sugar) it makes complete sense to me, with the food journey we've been on. It's much harder to reverse a bad habit, once it's begun.  I am convinced that allowing 'Baby' to eat biscuits contributed to her food refusal - just you try explaining to a nine month old why she can't have another biscuit!! The same thing goes with chocolate! No one had to teach MY kid how to like it!!

Some 'Do's':

1. Keep offering food, you'd like them to eat, even if they have previously refused it.

2. If something is refused, don't give up on it, but just leave it for a while (like several weeks, I find, 'cos 'Baby' has a very good memory) before reintroducing it... again and again and again, if you have to. I've heard it said that it takes 20 tastes to move from liking to disliking a food. In 'Baby's' case I think it's more like 200, but we are beginning to see results!

3. Model good eating behaviour: 
  • Everyone in the family sit down and eat together, round a table.
  • Try not to appear 'fussy' yourselves. (Yes, most adults I know have things they are 'fussy' about eating (i.e. sprouts), so why do we condemn young children??) Don't go the other way though, with too much, 'Oh this salad is soooo yummy!' Kids just won't believe you!
  • Provide and eat with your little one the things you'd like them to eat. This has been tricky for me, as not being able to eat such a wide variety of raw fruit and veg. (due to OAS) has meant that I haven't been able to model this too well for 'Baby'.

4. Eat in company where you can - particularly with peers. Children like to copy their friends, and also show-off what they will eat, when their friends won't, so this can be a handy little trick, to have up your sleeve. Obviously this also means that the others around the table need to be eating things that your little one CAN eat. With multiple allergies I appreciate this could be slightly more tricky.

5. Offer variety, if something is refused don't argue, threaten, or create a fuss, just allow the child not to eat it. Try to provide some of what you know they will eat, alongside things you suspect they won't.

6. Avoid talking negatively about your child's eating habits in front of them - this could also reinforce negative responses to food. For example, if they continually hear you say, 'She won't eat this,' or 'He's just fussy,' then it's not going to help matters at all and could be self-fulfilling.

7. By all means present food attractively, nice plates, cutlery etc. but don't expect this to result in a miracle cure overnight! 'Baby' was so suspicious of food that even if I made a face on the plate, she's spot a bit of fruit/veg. a mile off and refuse to even try it - all that careful food prep. for nothing!!

Presentation can help - I dressed up her pancakes to get her to eat them, but she wasn't completely averse to these, just slow!

8. Resist pressures from well-meaning friends/family. Avoid eating with those who put the pressure on!

9. Ask for help. Explain your approach to family/friends so that they can 'fall-in' with your approach. If it gets really bad, see if your GP will refer you to a dietitian for back-up. 

Some 'Don'ts'

1. Don't blame the child.

2. Don't 'take on' the guilt trip - either from yourself or others. I knew I'd tried to introduce things the right way. I've tried threats/bribes all sorts, but NONE of these worked. 

3. Don't give up. It may take a while - a lot longer than some other peoples' kids, but it can be done. And by the way, most kids go through this to some extent or another.

Our breakthrough

Surprisingly for me, the biggest break-through came when, finally, last year, I went to see the GP. It had got to the stage where Kiddo was not wanting to go to school, because she was feeling pressure to eat things that were making her gag and to finish everything on her plate. 

I has also realised that the Kiddo had all kinds of other sensory sensitivities, involving light, sound, touch, being underwater etc. some of which we had conquered, some of which we were working through and some of which remain on our 'to do' list. These are often associated with autism, but there is no way Kiddo is autistic, but I wondered if they were linked to her so-called 'fussy eating' somehow. Feeling a bit out of my depth, I decided to see a local GP.

The GP listened carefully to everything I said and agreed to refer us on, but crucially, she told me and my child that she thought I had been doing all the right things. She told me she had three kids. All of them had been raised the same way but that one of them, for no obvious reason, was exactly as I had described Kiddo, with all her sensitivities and food aversion. 

Then the GP told the Kiddo, that it'd be good if she could keep trying things - she didn't have to keep eating them if she didn't like them, but just give them a try. That really clicked with the Kiddo and from that point on she has often been heard to say, 'Can I just give it a try, Mummy?' even with foods that she knows she has refused before! Some things she has cautiously continued to eat, others she hasn't...yet! But I know now for sure that we have now 'got the ball rolling', so to speak.

Suddenly, she wanted to try strawberries, again, and... finally liked them!

I think this approach worked for us for three good reasons:

1. It gave me confidence because it reinforced the conclusion to which I had already come - it wasn't the Kiddo's fault, or my fault and that piling on the pressure just wasn't working.

2. It gave Kiddo the confidence that Mummy was doing the 'right thing'. That might sound strange to you, but at the time, school was giving very different messages about food and a few other things. This was 'mixing up the messages' for her and making her doubt my wisdom!

3. It gave the Kiddo the confidence to try again and know that it was okay not to complete something - that nothing bad would happen - which actually freed her up to experiment.


Onwards and Upwards!!

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