Imagine looking down at your plate and seeing it filled with spiders and your mother telling you, ‘come on, eat up, it’s yummy’.
This is the sort of horror about new food items felt by many children with food fears. They are not being ‘fussy’ because they want attention, or to ensure they get their favourite food, or because they are stubborn and wilful. They are genuinely distressed about putting certain foods in their mouth.
Many of these are foods that they’d love to eat, in theory, such as pizza, because not eating pizza is socially abnormal and isolating, and even embarrassing. But, when you look down and see the ‘spiders’, no amount of coercing or bribing or penalties is going to work.
This is not a subject that is often discussed, but it’s great for us all to become more acquainted with the challenges faced by other parents, so we are better placed to support them.
So, why are some children so selective and fearful when it comes to food?
From talking to many parents who have children with extreme eating issues, these traits seem to have been there from birth. It’s not uncommon for parents to report that their child could detect a change in formula or be very uncomfortable around food from the start. These are also the same intelligent, caring and intuitive parents who have raised other children who eat perfectly normally.
If you are scared, frustrated and guilty about your child only eating crackers, pasta or toast and they seem to have been super selective from babyhood then take heart, as they may be predisposed to find eating very challenging. This doesn’t mean that their eating journey is now predetermined, but may explain why.
Avoidant Restrictive Food Intake Disorder (ARFID) has become one of the new categories of eating disorders introduced to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders). It identifies feeding issues most commonly found in children or infants. Those suffering from the disorder have a disturbed eating or feeding experience that results in them being unable to take in enough nutrients. This simple self-diagnosis (published by the Eating Recovery Centre) can help determine whether this is something to be concerned about in your family:
- Does your child struggle with lack of interest or avoidance of food or eating?
- Does your child avoid certain or most foods because they can’t tolerate the taste or texture?
- Has your child had significant weight loss and/or failure to gain any weight not related to body image?
There are also children who would not necessarily fit into the definition of the disorder, but have food fears and selective eating habits that prevent them from eating a wide range of foods. These are often found in tandem with other issues, such as sensory challenges or autism spectrum disorder.
Common strategies that work to expand the dietary range of children are often not as effective with super-selective eaters. Their fear of new food overrides hunger and forces them to reject unfamiliar foods, sometimes to the point of starvation. Peer pressure can make them feel uncomfortable and can result in anxiety, rather than positively influencing an outcome. Reward systems are frustrating as it’s yet another target they feel unable to achieve.
Despite these substantial hurdles, there are ways to get children to gradually overcome the fear of new food and slowly add more foods to the menu. Generally, the younger the child, the easier it is to make progress. Habits are not as entrenched and the walls built around ‘safe’ foods are not as high. However, as children age, they know that their eating is restrictive. Often, they are desperate to participate in social occasions, but know that the thought of the food is too scary to contemplate. This gives them the desire to work towards a solution, however difficult the execution.
If your child has very selective eating habits and this has continued for a while, it’s probably not a ‘phase’ or something they will ‘just grow out of’, and it’s worth seeking help.
Generally, very selective would be consuming fewer than 20 foods. Defined as follows:
- Each component of a meal counts as 1. So, a cheese pizza would be four: the base, the tomato sauce, the oregano and the cheese.
- Variations of a specific food also count so, if your child eats mozzarella and Edam cheese, this would count as 2.
A good place to turn is your GP or look for experts in your area well-versed in overcoming food fears in children.
When you do come across a parent stuck between the pasta or the plain white toast, reserve your judgement. They may be a parent who has tried every common strategy to get their child to expand their menu choices. They also may be holding the champagne on ice for their child to be able to even contemplate pizza.