Many parents will have had experience of their child being selective over what foods they will eat and when. Sometimes this can be part of a normal stage of development as they get to grips with new textures and flavours, or as a teen when they have more control over where they eat. When our child has restricted eating, we can become anxious about the impact this might be having upon them or whether it will get worse. Eating together is also a social activity, so it can have wider impacts at family mealtimes, celebrations and engaging with peers. It’s important to explore the reasons behind your child’s restricted eating, understanding this can enable us to remain calm and offer an empathetic approach. Getting cross, anxious or upset about it is likely to just make the situation worse as mealtimes become tense for everyone. It is also important to understand that restricted eating in itself isn’t necessarily harmful, but we do need to be aware of when we need to get professional help.
Why does my child have restricted eating?
If your child is neurodivergent this could well be linked to their sensory processing differences. Our sense are all over the body feeding instructions into our brain. Sometimes this will mean your child does not get signals that they are hungry or thirsty, or that they are full. Your child may be hyper or hypo sensitive, they may find certain textures unbearable or seek out highly flavoured or crunchy foods. Generally, they will prefer “safe foods” that are predictable in terms of texture and taste, this is why they may only eat a certain brand of fast food. Natural foods like fruit can be very unpredictable and meat and vegetable change their texture depending on how they are cooked. Smell can have a big impact, and the sound of other people’s eating can be very uncomfortable. Anxiety can also be a factor, sometimes children become anxious about eating if they have vomited after eating before or if they are pressurised into eating. If your child has generalised anxiety, eating will be very difficult as they will probably feel nauseous. If your child is demand avoidant then they may try to take control of food. Children with ADHD may just be too busy to sit still long enough to eat. If you identify the root cause as being something you can change or get support with then, over time, you may be able resolve restricted eating.
How do I know if this a problem?
Let’s remind ourselves that restricted eating in itself is not always harmful. The body seems to be good at extracting the nutrients it needs from the limited food it does get. Children are often driven to what they need to eat, they might eat one specific food for a while and then move onto another type of food. Overall, they are still getting what their body needs, they just don’t appear to be eating a balanced meal although overall they are getting a balanced diet across the day or week.
It can be helpful to ask yourself the following questions to identify if restricted eating is harmful to your child:
Is your child about the right weight for their height?
Are they still growing?
Are they generally “well”- we could define well as not getting frequent infections, but when they do get an infection they recover within an average time scale?
If you answer yes to those questions it is unlikely that restricted eating is currently causing your child harm, however if things change you should seek further help.
What can I do to help?
- Stay calm. Don’t make mealtimes a battle ground.
- Offer small portions.
- Provide a mixture of relaxed mealtimes; maybe picnic or buffet style with more traditional seated meals occasionally.
- Respect how they want the food presented e.g. food not touching, a specific plate.
- Allow them to choose the seat and they find most comfortable when seating at a table. Some will prefer to be in a corner; others may not want to look at anyone else.
- Facilitate use of headphones or ear defenders if sounds are distracting.
- Try to not to allow them to fill up on treat type snacks or drinks, unless it is water.
- Give a multivitamin supplement suitable for their age.
- Get them involved with food in a fun way; sensory play, cooking, meal prep, looking at new recipes, being experimental with combinations.
- Never force your child to eat, encourage them to sit with everyone else but if they don’t want to eat then that is ok. Take the food away and when they indicate they are hungry try to offer it again. If they indicate they are full respect that.
- Try offering raw or cold food rather than a hot meal, if your child prefers this. You don’t have to eat a hot meal in order to be eating a balanced diet. My daughter only ever ate raw carrots with her roast dinner.
- Keep offering a small number of different foods for them to try, as they get older you may find that they develop a desire for new flavours.
- Do a food diary, this will help you to see clearly over a few weeks if their diet is extremely limit. It may also help you to stop triggers that reduce appetite e.g. anxiety about P.E. on a Wednesday resulting in your child not eating on Tuesday.
- Don’t allow your child to add salt to their food, excess salt can be harmful and even life threatening in children. Be cautious about allowing excess sugar, for example putting ketchup on everything to hide other tastes. Sugar can be harmful to teeth as well as increasing the risk of diabetes over the long term.
- Don’t use food as a reward or punishment. We want to encourage the idea that food is fuel, and we need it to keep our body healthy and growing.
Sources of help:
If you have concerns about your child’s restricted eating, you should always get professional help. Book an appointment with your GP who should be able to do a health check on your child and decide if a referral to a dietician or specialist is required. You can also reach out to your health visiting or school nursing team. See below for additional resources.
ARFID Resources – Suffolk Parent Carer Forum
Supporting Children/Adolescents with Eating Difficulties
Parent Workshop – When Children Won’t Eat – Free 2 hour webinar
What are you looking for – Be Body Positive
RESOURCES | ARFID Awareness UK
Get information and support – Beat
Autism and Restricted Eating – Suffolk Family Carers
ARFID – Avoidant Restrictive Food Intake Disorder – Suffolk Family Carers
