Skip to main content

Food and Eating

Restricted eating can be common in children who present with various backgrounds.  This often goes way beyond “fussy eating”. 

The Essential Basics:

These suggestions are really important.  Getting the basics right will enable your child to move forward with their eating.  Children are NOT likely to improve their eating without these basics in place. 

  • Never force your child to eat – this always makes the problem worse
  • Keep calm.  Pretend you do not mind them not eating even if you do
  • Try to eat in a relaxed environment
  • If your child never sits with you to eat, show them that you have a pleasant and relaxed time eating.  Gentle encouragement to get them to join you, even for a short time is progress. There should be no expectation of your child eating if they don’t normally eat with you
  • If your child is a slow eater let the first course last less than 20 minutes
  • Offer pudding even if the first course is not touched.  All food is good food
  • Do not comment on any uneaten food
  • Experiment with having the radio or music on or off at meal times. Some children do better with them switched off, other children eat better when there is some background noise. Brahms classical has been linked to good digestion
  • Offer food regularly, about every 2 hours. Three meals each day and snacks between meals –food should be presented at the same place wherever possible i.e. the table

Nutrition

We recommend that your child has a multivitamin and mineral preparation.  There are a variety of different ones from liquids to chewy types.  Choose an age appropriate one that you think your child may like. Multivitamins aimed at younger children (i.e. chewy / liquid preparations) can be used if a tablet / capsule won’t be taken. 

Constipation and Reflux

It is hard for your child to want to eat if they are constipated or experiencing reflux.

Treating them will often help.  If you think that your child may have these problems ask your GP, Consultant or Dietitian for advice.

Recognising what textures and types of food your child is eating.

List the foods that your child will eat, then describe each of the textures, flavours and colours

o   Crunchy, soft, dry, wet, sloppy

o   White, beige or any orange colours etc

o   Sweet, savoury, strong flavours or bland

o   Do they eat different textures, but separately?  e.g. they will eat crunchy cereal and drink milk, but not together

Once you have this information try to work within your child’s preferences.  Find other similar foods by trying them yourself

Try to make sure that you offer all their preferred foods frequently (every week to fortnight) so they don’t ‘forget’ they like it.

Try to resist any attempts by your child to reduce this list further ie keep offering a food even if they say they don’t like it anymore.

When the basics are in place, decide on one of the following options to work on to increase the range and types of foods.  It is very important that you only try these ideas when you feel confident that you and your child are ready to do so.

Increasing the Range of Foods that your child will eat.

  • Children with restrictive eating are often most comfortable eating a specific food.  If you always provide this exactly, they will have a natural tendency to reduce the number of foods they eat. Therefore it is really important that you continue to give your child foods that are slightly different and not always an exact match to their preferred food.  This prevents further restriction of foods that they will eat and will help improve the range of foods that are acceptable to them. Presenting the food in a serving bowl rather than the child seeing the packaging can also help
  • Increasing variety within a single type of food

Example 1

Jack likes a particular large white sliced bread, medium cut.  The following slight variations were suggested.  Jack tried the item most acceptable to him first.  After the initial item Jack went on to try the others from this list.

  • Small loaf, same bread                               
  • Pizza bases
  • Same brand but thick or thin sliced Rolls        
  • Unsliced bread                                            
  • ½ and ½ white and wholemeal
  • Pitta bread                                                   
  • French sticks
  • Ciabatta

Example 2

Amy will only eat first stage stewed apple and custard baby jar.  (She is 5 years old.) The slight variations below were tried

The same flavour, but a different make was tried.

Then a powder version was tasted.

Next a tiny amount of apple sauce (the tip of a teaspoon) was added into the pudding.

Finally a tiny amount of custard or yoghurt was added to the pudding.

 

Suggestions to encourage your child to eat a new food :

1.   If your child loves a particular food let your child know that you will expect them to taste a tiny amount of a new food first (The amount can be miniscule).  Do this at every meal, with the same new food and the same amount.  Once your child is doing this regularly increase the amount of new food given.  This can be increased again once your child accepts the new amount at each meal.

  • The starting point may be looking at and smelling the food regularly
  • Move to touching the food with their finger and smelling
  • Putting their finger to their lips
  • Putting a spoon to their mouth with the same food on it
  • Putting the spoon into their mouth
  • Continue with small stages

 

2.  If your child loves a particular food of a suitable texture tell your child that you are mixing in a tiny amount of a new food. This can be done to the whole meal or a small amount of meal taken out to have the new food added which needs to be eaten first.   Slowly increase the amount of new food added.  This can even be a savoury added to a sweet food.  Eventually your child will be eating the new food.

What if my child needs to increase their weight?

  • Having sufficient energy for growth is more important than healthy eating where children are underweight
  • Where restricted eating can be extreme, it is important to give your child the food that they will eat regularly.  This sometimes means children only eating one food e.g. chocolate or yoghurt for days at a time.  This will mean that they will need to eat the food at break times at school

Poor food intake and poor weight gain is often the cause of parental anxiety.  This can be picked up by your child and can make the problem worse.  Try to stay calm and work through the suggestions in this sheet

 If you are able to add extra foods such as butter or sugar to your child’s diet this will help increase their calorie intake.

If you need further information and advice please contact your Dietitian Public Health Dietetics Team - Betsi Cadwaladr University Health Board (nhs.wales)

 

Additional Resources for those with extreme picky eating/restrictive eating

See and Eat Website – A website with e-books about different vegetables journeys from farm to fork and other activities and resources to educate and engage children about food and where it comes from. Good for exploring new foods in non-threatening environment.

https://www.seeandeat.org/

 Child Feeding Guide Website - Website with award winning free tools and support to help tackle fussy eating based on evidenced based practice for parents and health care professionals. Includes interactive wellbeing tools to monitor and see changes/improvements in parent’s and child’s emotions around meal times and a log to keep track of foods offered and the child’s response to it. 

https://www.childfeedingguide.co.uk/

 Food Refusal and Avoidant Eating in Children, including those with Autism Spectrum Conditions: A practical guide for parents and professionals By Gillian Harris and Elizabeth Shea (2018)

Book for more detailed information regarding food refusal and how to gradually increase variety in diet.

 The Fussy Eater’s Guide to Exploring Food, A book for children by Alison Butterworth, Samantha Sargent and Kay Toomey (2023)

Workbook for Children with interactive ideas and activities to encourage increased exposure to new foods.

Stories of Extreme Picky Eating: Children with Severe Food Aversions and Solutions that helped Them by Jennifer Friedman (2020)

A book with more information on extreme picky eating with real life examples and activities/strategies that were used to increase food variety in the child’s diet.

The Autistic Teens Avoidant Eating Workbook by Elizabeth Shea (2023)

 A workbook for Autistic teenagers to help them recognise the signs of avoidant eating, cope with food related anxieties and manage sensory overload. It also covers stresses that can come with communal and social eating.