A Psychological Guide for Families:

Feeding & Eating

Child & Family Psychology

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Introduction

This booklet is part of a series that has been written by Clinical Child
Psychologists from the Child and Family Psychology Service. Many
parents and carers experience some concerns about their children and
at times look outside of their family for extra advice or suggestions.

This booklet has been written to help you understand your child’s
eating/feeding difficulties. You can use this booklet as a guide to help
understand and change your child’s eating habits. Choose the ideas
that fit for your family. We hope that it will add some ideas to the
things that you are already doing and help make your mealtimes better.

Problems with food are fairly common – try not to panic.

Many parents experience problems around meal times with their

children. Many children go through phases of refusing to eat, being
‘fussy’ eaters, or having other eating problems. This is often a normal
part of growing up. It can be your child’s way of showing independence.
However, it can leave parents feeling worried and frustrated.

After the first year, children are actually programmed to refuse or spit
out foods. This is because children generally become more mobile at this
time and so are able to find and pick up foods without an adult’s help.
The instinct to spit out food protects your child from eating harmful or
poisonous foods that they might have picked up on their travels!

These behaviours rarely last long. A lot of these problems go away in

time without your child needing to see a health professional.

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Usually children will eat the amount of food their body needs. If your
child has a small appetite then they may just be efficient in the way
their body uses calories.

Mealtimes are different for every family – your child’s eating habits are
only a problem if:-

It is causing you or your child upset or worry.

They are not eating enough or the right foods to keep them
healthy.

This booklet has some simple ideas to help you understand your child’s
eating problems and make some changes.

Identifying the Problem

The first step is to identify the problem. Keep a diary for at least a
week. Record what happens over the 24 hours of each day.

It may be useful to observe and record the following;

How much is my child eating and drinking in 24 hours?

What kind of snacks does my child have in between meal times?
What food is my child eating and drinking? (and what are they not
eating and drinking?)
Does my child get more attention by refusing to eat than by eating
what is on offer?
Do we have a mealtime routine (e.g. all sitting around the table
together)?
Are there any distractions I could stop? (e.g. is the TV on?
Are brothers and sisters arguing? )
How is my child feeling? (e.g. does your child look worried, angry,
upset?)
How do I respond when my child does not eat?
Are there any physical difficulties (e.g. choking)?
What is my child doing in the build up to mealtimes and
afterwards?

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Some reasons why children might refuse to eat

Selective Eating (also known as picky or fussy eating)

Your child might be fussy about the range of foods that they will eat and
may not want to try new foods. Children can sometimes dislike certain
textures, tastes or smells. Keep a note of foods accepted or rejected to
see if there is a pattern. It may simply be a ‘food fad’ which can affect
all children.

Fussy eating doesn’t always mean that your child is underweight or that
your child is unhealthy. Your child could be a very fussy eater and still
take in enough calories and nutrition to be healthy and grow.

Sometimes fussy eating can begin after a period of normal eating.

However, many children who develop fussy eating have a history of
early feeding difficulties, or anxiety. Children who do not manage to try
a wide variety of tastes and textures at an early age are more likely to
be fussy eaters.

Food phobias

Phobias are fears that lead a person to avoid the thing they fear.
Phobias involving food are common, especially in school aged children.
A food phobia can occur on its own or as part of a more general anxiety
problem.

There are different sorts of food phobias. Some children have a fear of
being sick when they eat. Some children worry that food is bad or
harmful in some way. Another common phobia is a fear about choking
or not being able to swallow.

Physical problems that affect eating/feeding in infants

Some children have a physical problem that makes it difficult for them
to eat. If this is the case, you may notice your child has difficulty
sucking, chewing, or biting. You may notice your child is sick or chokes
during meals, or suffers from pain or constipation. Your GP can help if
you think your child has a physical problem that makes it difficult for
them to eat.

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Parents’ Expectations

There can be a mismatch between what you would like your child to eat,
and what your child actually needs to eat.

Your child may have a small appetite. This means that your child only
eats very small amounts of food at mealtimes. All children have
different appetites. Your child may eat less than other children of their
age group and still take in enough calories and vitamins to be healthy
and grow. Your GP, health visitor, or school health nurse will be able to
tell you how much food your child needs as well as what range of foods
they need for a balanced diet.

Other possible reasons why children might have difficulty at

mealtimes

Not liking the feeling of cutlery in their mouth. For example, metal
knives and forks are more likely to be disliked.

Some children like to see the food presented on the plates in a certain
order and don’t like their food being mashed together.

Seeing too much food on a plate can be overwhelming. It can be

better to only offer a little food at first and add more if wanted.

Lots of noise or distractions (e.g. other family members or the

television).

Particular smells (or strong smells) of food.

What could you do differently?

Think about the following questions to give yourself some clues about
what you could do differently at mealtimes.

Are there any distractions around to prevent your child from

concentrating on his/her food?

Is your child getting lots of attention for not eating?

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 What could you and others do or say to let your child know that you
are pleased when they show an interest and eat their food?

What could you and others do instead of giving attention to your child
when he or she doesn’t eat?

Is your child under a lot of pressure to eat – this can increase anxiety
and therefore reduce appetite.

What can you do to help?

Be good to yourself and stay calm!

Parent(s) can feel guilty and blame themselves for their child’s eating
Be difficulties.
good to yourself and stay calm!
Try to concentrate on what you can do now and in the
future. Do not blame yourself for things you think you should have
Parent(s) can feelinguilty
done differently and blame themselves for their child’s eating
the past.
difficulties. Try to concentrate on what you can do now and in the
future. Do not
Make sure blame
that yourself
all the adults for things
in your you think
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life support your have
done differently
approach in the past.
to mealtimes. If you disagree with your partner’s
approach, discuss it at a time when your child is not there.
Make sure that all the adults in your child’s life support your approach
to mealtimes.
How If you
do you feel at disagree
mealtimes? with your
If youpartner’s approach,
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stressed or it
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worried when
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this. Look after yourself so that you
are then able to help your child feel relaxed and confident around
food.

Encouragement and Praise

Encourage your child to try new foods from your plate. Children learn
to eat new foods by tasting them first. They like to ‘copy’ adults and
other children. Offer your child new foods but don’t force them.
Allow them to spit food out again if they don’t like it. You can always
try again another time. Introduce new foods slowly and in small
quantities. Even if they don’t try the food, seeing food can help it
become more familiar.

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 Make sure you give your child lots of praise for positive behaviours
(e.g. sitting still). It is important that they get much more of your
attention for eating and trying foods than for not eating!

Double the impact of the praise by getting as many family members

to praise as possible. You can also praise your child in front of other
adults. Young children often like to please adults. When they see
you are pleased with something they have done, they are more likely
to want to do it again.

Praise immediately and be clear about what has pleased you.

When praising, show enthusiasm by adding eye contact, a smile

and/or a hug.

Avoid combining praise with put downs. Try not to remind your child
of past failures.

Never try to force your child to eat. This may make your child more
worried about mealtimes.

When offering your child a new food, they may need to try it as many
as 17 times before they like it. Remember that there are some tastes
that adults have to get used to – Many adults don’t like coffee, olives,
or alcohol the first time they taste it! It is only after tasting it several
times that we learn to like it.

Don’t try to coax or bribe your child to eat. When the meal is over you
can reward your child for the things they have done well. Don’t punish
your child for not eating – this only makes mealtimes stressful for
everyone.

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 Environment and Routine

Make sure there is nothing more interesting going on around you

at mealtimes that is likely to distract your child.

Present food in fun ways – e.g. on colourful plates, or cut in to fun

shapes.

Try to set up a routine by having meals at a regular time and

deciding on a place for the child to sit.

Make mealtimes an enjoyable social occasion. Sit at a table

together as a family and use brightly coloured plates and cups that
your child will enjoy. Family members are important in setting a
good example of healthy eating behaviour.

Your child may be a slow eater so do not rush a meal. However,

try to limit mealtimes to 30 minutes.

Make sure mealtimes are as relaxed as possible. Like adults,

children find it difficult to eat when the atmosphere is tense.
A good example is a buffet at a party. The variety of food
available coupled with the relaxing atmosphere tends to
encourage us to eat more than we normally would.

Get your child involved in preparing, cooking and tasting the food
before it is served at the table.

Only give your child an amount of food that they are likely to be
able to eat – you can always give more if they want some.

Cut out sugary foods and drinks – these tend to fill children up
but don’t contain much goodness.

Limit snacks during the day so your child does not feel full up
before mealtimes.

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Mealtimes can be fun! – If you are playful in the way you introduce a
new food to your child, it will help reduce their worry. Play with your
child and enjoy pretend cooking and pretend mealtimes to help them
feel more relaxed around food and eating.

Who will support you whilst you are making these changes?

When making a plan to help change your child’s eating habits include
anyone who helps care for your child. This may be your partner,
grandparents or even your health visitor for example. When you are
making a plan to help change your child’s eating habits, it is important
that everyone who cares for your child during mealtimes is taking the
same approach. Try not to make lots of changes all at once as this
could be very confusing for your child.

How to maintain your efforts when things are going well

- Support from family and friends.

- If you have a health visitor he/she should be able to support you
with some of these ideas.
- Keep a diary so you can notice progress; steps can be small.
- Change can sometimes take time.
- If this doesn’t work then please contact your General Practitioner.

When to seek the advice of a Health Professional

If the problem shows no sign of improving, or if you are worried about

your child’s weight, growth, or health you should contact your General
Practitioner for further advice.

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We hope that you have found some ideas in this booklet that you would like to try out. In our experience, change
can be a difficult process for everyone in the family, and things can get worse before they get better. It can be hard
to keep going, but many families tell us that it is worth persevering.

Please let us know what you think about this booklet

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4. Please tick the box and give us your address if you would like to receive another booklet from our range.

Helping Children Cope with Anger

Brothers & Sisters: Helping your children to live with and learn from each other
Sleep Problems
Sleep Walking, Nightmares and Night Terrors
Separation & Divorce
Soiling
Bereavement
Managing Behavioural Difficulties
Understanding Reactions to Trauma
Children and Adversity
Feeding & Eating

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Please return to Child and Family Psychological Health Service

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Grounds of St Cadoc's Hospital
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