Could fussy eating be a serious problem?

Children are very good at regulating their own food intake, and although it may seem like your child eats next to nothing, by the time you’ve factored in snacks and drinks, he may well be getting enough nutrients to meet his needs. But extreme fussiness becomes a problem when:

• You’re worried that your child’s food intake isn’t meeting his energy requirements
• You have to prepare alternative meals at short notice because his food is left untouched
• You routinely feel the need to supplement your child’s diet with mineral and vitamin pills or drops
• Your child displays extreme anxiety around eating, perhaps to the point of making himself sick
• You suspect your child may have nutritional deficiencies

Symptoms of a nutritional deficiency can include tiredness, fatigue, irritability, moodiness, lack of concentration, hyperactivity, disturbed sleep and constipation. Your child may lose weight, or not gain any for a long time.

If it's just a phase, there are a few things you can try - like these 25 tricks to tempt fussy eaters.

No one’s fault

Some children can’t help being fussy eaters, and there are many reasons why they may go off food.

• Children with autism may display more faddy tendencies and eating problems
• Antibiotics can upset the gut flora leading to a loss of appetite
• A food intolerance which causes pain or trapped wind may make your child reluctant to eat
• Teething or minor illness such as a cold can spoil your child’s appetite, often going on for several weeks
• Constipation causes discomfort and cramps and can turn your child off food
• Just as adults lose their appetite through worry and anxiety, a child who is under emotional stress may lose his appetite

Food is a very emotive issue, and if your child isn’t eating, you may feel like you’re failing him. If you’re concerned about how little he’s eating, try writing down everything he eats and drinks across the course of a week. You might realise that he’s eating more than you thought – and if not, you have some concrete evidence to show your health visitor.

When you need to worry

If your child’s fussy eating seems extreme (for example, if he’s eating a very limited diet), has been going on for a long time, or appears to be affecting his health, behaviour or weight, it’s worth seeing your health visitor. She can help you with strategies for improving his eating, or, if necessary, refer you for further help.

In rare cases, young children can develop eating disorders. The reasons for this are usually complicated, and there may be a number of factors which have an impact on your child’s relationship with food. Every case is unique and requires medical intervention that’s tailored to suit the child.

But in most cases, fussy eating is a developmental phase which will be outgrown – but nevertheless, there is help available. If your health visitor or GP shares your concerns about your child’s diet or relationship with food, she may refer you to a dietician. You can also self-refer to a dietician who practises privately.

In some cases, other interventions may be required. For example, if your child has signs of an autistic spectrum disorder, he might be referred to a paediatrician, or if he appears to be having physical difficulties with eating, a speech and language therapist can assess whether there is a structural issue with his mouth that could be corrected.

Before you approach your health professional, it’s worth keeping a detailed food diary for a couple of weeks, where you chart what was offered and eaten or rejected. This can help the professional to work out what action would be most appropriate.

Visit The British Dietetic Association for more about dieticians and how they could help your child, or go to The National Autistic Society if you want more information about autistic spectrum disorders and how they can impact on your child’s eating habits.