Food & Nutrition Child Developement
Fussy Eating Myths and Red Flags
Eating! It's many people’s favourite past time, though for some of us, we may eat to live. Here are some myths that I would like to debunk, to help us better understand our kids' eating habits and the mechanics behind it.
Myth 1 - Eating is instinctive.
FALSE. From birth to 3 to 4 months, sucking and swallowing are instinctive reflexes for babies. However, after 6 months of age, eating is something we learn over time, through models we get from our families.
Myth 2 – Eating is easy.
FALSE. Eating is a very complex task. 26 different muscles and 6 different nerves are required for us to swallow. Eating requires coordination of 8 sensory systems.
Myth 3 – Eating is a two step process. 1 – sit down, 2 – you eat.
FALSE There are actually as many as 25 steps to eating for most children, involving all their senses, from their sense of sight, smell, touch, taste and motor skills.
Myth 4 – If a child is hungry enough, he or she will eat and they will not starve themselves.
FALSE This is true for most children as hunger can be a strong motivating factor. But for children who have underlying feeding problems, they will not eat even if they are hungry because of they do not have the ability to eat that food.
Myth 5 – I can offer the same porridge to my child daily, since he likes it.
FALSE Eating the same texture and taste of food for every meal may cause food jag. Food jag occurs when the food is no longer accepted by the child, and cannot be reintroduced despite it not offered for an extended period of time.
With some of the myths debunked, hopefully it gives parents some basic understanding of eating and feeding so as to have basic knowledge on how to help our children eat better.
When is fussy eating a problem?
Some children might have sensory and/or oromotor difficulties impacting on feeding. Some children have more severe levels of fussy eating that would be otherwise known as “problem feeders” or medically “children with feeding difficulties”. As a Speech Therapist who has worked at Feeding clinics in Singapore, here are some red flags for parents to look out for and seek professional help:
- Children who require food to be blended or are unable to take blended food after 12 months of age.
- Children who require softly cooked food after 18 months of age and are unable to eat adult textured food.
- Children eating less than 20 different types of food.
- Children who food jag, meaning they “lose” familiar foods and despite several weeks of break from the food, are unable to reaccept the food.
- Children who refuse certain textures.
- Children who are unwilling to try almost any new food despite more than 15 exposures.
- Mealtimes are stressful for parents and child.
- Your child needs to be force-fed.
- Mealtimes take longer than 30 min.
- Your child requires distractions in order to eat.
- Poor weight gain and growth, not appropriate for their age
The table below helps to differentiate a Problem Feeder from a Fussy Eater.
|Problem Feeder||Fussy Eater|
|Very limited range and variety of food, usually less than 20 types||Decreased variety of foods, but usually more than 30 types|
|Unable to tolerate new foods||Able to tolerate new foods on plate, and in most cases are willing to touch or taste the food with some encouragement|
|Refuses entire categories of food textures or food groups||Eats more than one food from all textures or food groups.|
Normal developing children may also have feeding difficulties. Feeding difficulties also manifest in children who have medical conditions, for example, children who were born premature, children with cerebral palsy, children on the autism spectrum or children who were previously tube-fed. Children with feeding difficulties may have sensory difficulties making it difficult to process and accept the sensory information from food. For example, they may find it difficulties to tolerate the smell or touch of certain foods. They may also have difficulties moving their jaw, tongue and lips for feeding and hence may only accept softer textured foods. Any negative experiences they have encountered previously including vomiting episodes, gagging or choking during feeding may also contribute to their fussy eating.
Early Intervention is always key! Seek help early! A speech therapist (like myself), occupational therapist, dietitian, gastroenterologist/paediatrican who have experience working with children with feeding difficulties will be able to help. A myriad of approaches may work for your child. This may include oromotor exercises, or systematic desensitization of food in play, depending on your child’s difficulties.
Should you have a problem feeder, you may contact Magic Beans Feeding & Speech Therapy, for assistace.
About the Author:
Desiree is a mother of two princesses, a four year old and a 2 year old. She is also an experienced Speech Therapist who is currently working at Magic Beans Feeding and Speech Therapy Centre. Her specialty and passion lies with working with children with swallowing and feeding difficulties including fussy eaters and premature infants, as well as children who stutter. She also has experience working with children with speech and language difficulties.
Desiree obtained her Bachelors and Masters in Speech Pathology from the University of Sydney, Australia. She was previously the head of Speech Therapy department at KK Women’s and Children’s Hospital. She has more than 10 years of experience working with premature infants and at feeding clinic in both KK Women’s and Children’s Hospital and National University Hospital.
As a mother of two, she understands and empathises with parents, especially those who have a child who require speech therapy. Her experience as a parent herself has helped her gain further insight on how to work and engage children better. It has also helped her to work better with families and their child as she is able to understand the difficulties families face better, being a parent herself. She strives to provide practical suggestions for parents to implement in their homes and daily lives. This additional dimension gives her practice and therapy an edge when working with families and their children.
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