As simple as it seems – eating is a complicated process. There are 32 steps in the process of eating that most of us take for granted. For example, the process includes tolerating, interacting with, smelling, touching and tasting and finally eating the food. If there is a problem along the way, behavioural problems related to eating begin to emerge.

Even just the physical aspect of swallowing and eating requires the interaction of more than 30 different nerves and muscles. If there is a lack of coordination at any stage, eating habits and intake can suffer.

When it goes beyond fussy: The RED FLAGS 

  • Growth (weight and height) is not increasing as expected for their age
  • Ongoing choking, gagging or coughing during meals
  • Recurrent episodes of heartburn
  • History of breathing coordination/breathing issues
  • Inability to move to lumpy foods by 10 months of age
  • Inability to move from breast/bottle to a cup by 16 months of age
  • Refusal of foods of a certain texture
  • An infant who cries and arches at most meals (heartburn/ allergy)
  • Meal times are a constant battle

Extreme Food Refusal 

There are many reasons why a child refuses to eat (beyond the normal fussy eater). Some children have sensory processing issues which mean that eating can be extremely stressful for them or extremely unpleasant. Others have had allergies or tube feeding as a baby which creates negative associations with eating.

If a child is a fussy eater then they may be at risk of a nutrient deficiency such as iron. It is also stressful for parents as they struggle with a child’s diet which is limited to less than 20 foods. It is a slow process to work through these barriers to eating and the treatment approach will largely depend on age e.g. play based for younger kids/learning based for older children. It is important to tease out where the problem lies so that the most appropriate approach can be used.


Tips for the Fussy Eaters 

  • Never hide foods in other foods – these kids usually have an incredible sense of smell!
  • Never force feed – it just won’t work.
  • Aim to get calories in through favourite or accepted foods and begin to link with different and new foods.
  • Aim to find an accepted multivitamin – one that the child will accept.
  • Creating trust between the child and the person providing the food is essential!

Help for fussy eaters 

Our paediatric dietitian has specialist training in helping children and parents to reduce the stress at mealtimes, assess and correct any nutrient deficiencies and improve the variety and quality of the diet. Working toward a healthy and balanced diet will ensure fussy eatereachhes their growth and development potential.

To get more help with a fussy eater, book an appointment with our paediatric dietitian below.

Jacqui Palmer
Paediatric Dietitian

Jacqui has been a Dietitian for 20 years in both Queensland and London. Jacqui has worked in some of London’s largest hospitals and witnessed such courage and determinate in the children she helped that she became committed to improving their quality of life though better nutrition.  In London, Jacqui worked as a clinical paediatric dietitian at the prestigious Royal London, St Barts and Lewisham Hospitals. Jacqui has developed significant experience in complex allergies, faltering growth, gut health and Autistic Spectrum disorder. Please note that Jacqui offers telehealth appointments only. We find that this works well with busy parents and children feel more comfortable. 

Specialist areas:

Fussy eaters

Growth and weight issues

Food allergies and intolerances

Autism and spectrum disorders

Gut issues in children