Fussy eating describes a number of separate, but related, feeding problems.
Neophobia is when a child refuses to try new foods, finickiness is when a child only eats a limited range of foods and inadequate appetite is when parents have the impression that their child fails to eat sufficient quantities of food for adequate nutrition.
Food neophobia
Infants and young children do not like to eat new foods and many parents are unaware that the initial rejection of new foods is completely normal.
This initial rejection reflects an adaptive process common to all human beings. The early periods of infant feeding can be challenging for parents, because all foods are new at one point or another.
An infant's inborn preference for a sweet taste means that the initial introduction of sweet-tasting fruits rarely causes acceptance problems.
Repeated exposure helps infants and young children overcome their initial rejection of new foods.
Several studies have shown that food neophobia appears to diminish with age.
It is possible that a child who is particularly reluctant to try new foods could develop a preference for a limited range of foods, especially if parents give in.
Finicky eating
Infants who are not given opportunities to overcome their fear of new foods through repeated exposure, may become finicky eaters.
Another possibility is that children may become finicky eaters because they have conditioned taste aversions, which result from the pairing of a particular food with a negative experience.
Conditioned taste aversions are fairly common. A correlation between young children's fussy eating habits and gastrointestinal upset during infancy has been identified.
Social influence has also been identified as being related to finickiness.
Studies done found that when a child is exposed to a peer who prefers a food that is not preferred by the child, the child's preference could be reversed to match that of the peer.
Inadequate intake
Parents often overestimate the amount of food that their young children need to eat.
If children are allowed to listen to their internal hunger and satiety cues, they can and do regulate their energy intake.
Children who are taught to "clean their plate" rather than listen to their appetite, become reliant on these external social cues.
If children are given a variety of nutritious foods, they select a healthy diet for themselves.
Parental feeding practices
There are at least three child-feeding patterns that are practised by parents across cultures.
They are highly controlling, laissez-faire and responsive parenting.
Highly controlling parents will routinely assume total control by force-feeding their children. This practice provides little opportunity for children to take control of meal timing, meal size and food selection.
Laissez-faire reflects the assumption that children know when, what and how much they need to eat. Parents never force food issues, even if the child is at nutritional risk.
In responsive parenting, parents set limits but moderate the degree of parental control in response to their child's changing capacity for self-control.
Each parental feeding style is associated with distinct child eating behaviour outcomes.
For example, by appropriately responding to their children's distress and demands for food, responsive parents generally provide a positive feeding environment, facilitate their children's acceptance of nutritious foods and help their children develop self-control in feeding.
On the other hand, highly controlling parents create a negative feeding environment, impede their children's development of self-regulation and may in fact be the source of their children's picky eating patterns.
A study done by Pelchat and Pliner found a strong correlation between parental feeding behaviour and children's picky eating patterns.
Practical applications
The key is for parents to remain pleasant and calm while providing non-threatening opportunities to try new foods.
Parents can help their children learn to accept new foods by providing healthy, regularly scheduled meals.
Children's normal hesitancy to try new foods often can be overcome with repeated exposures to those foods.
Making a "courtesy bite" of each new food a family rule, give children the repeated exposure they need to learn to accept and enjoy new foods.
Including children in meal planning and preparation can also make children suprisingly receptive to new foods.
For extremely finicky eaters, it might be a good idea for parents to serve at least one or two items they know their child enjoys at each meal, rotating among the major three food groups.
This ensures that the child receives adequate nutrition and has positive mealtime experiences.
All parents need to resist the temptation to use threats, rewards and pleadings to get their children to eat.
These tactics only interfere with children's development of intake regulation.
In the case of offering sweet rewards for eating less-preferred foods, re-inforce the child's dislike for the less-preferred food while enhancing the child's preference for the sweet reward.
When should health workers be concerned?
Fussy eating patterns can be a cause for concern if a child is not eating a balanced diet and is not growing and developing well.
A balanced diet in terms of nutritional adequacy pertains to foods from the three basic food groups (energy-giving foods, body-building foods and protective foods).
With regard to different cultures, the health worker can encourage mothers to suggest solutions that will work best for her family.
During the early years of life, infants and young children undergo tremendous cognitive physical and emotional development.
Fussy eating is a normal expression of these developmental changes.
When parents provide pleasant, routine opportunities to experience a diet rich in variety, "fussy eaters" can and do develop healthy eating habits. - Purity