How To Feed A Fussy Eater

Dr. Sajeev KumarC.S.C, D.C.H, M.B.B.SCardiologist

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Even children who have medical, temperamental, and/or neurological barriers want to learn to eat the food their parents and other trusted adults eat, and push themselves along to do it to the extent of their abilities. Based on trust in the child’s drive to learn, grow, and master, the intervention is simple: parents learn to feed based on Satter’s Division of Responsibility (sDOR), which allows the child to master eating. While parents and helpers must be attentive to the child’s medical, developmental, and oral-motor issues, most feeding issues are the same as those of any other child. Stages in feeding look the same; they just come along more slowly. Challenges at each stage are the same; the child just works harder and longer to master them. Eating quirks are the same; it is just hard to sort out the “child” in these quirks from the “special needs.”Understanding causes will restore your trust in your child to do her part with feeding. To fully understand those causes, you and your child need to have had a full assessment, including longitudinal and developmental history and growth and, most particularly, feeding dynamics past and present. Most medical and even nutritional assessments don't address feeding dynamics and history, and it leaves a gap in understanding. Medical assessments and labs are helpful with respect to indicating whether your child has recovered from early medical maladies and/or has some other malady. Swallow tests and oral-motor evaluation are helpful for the rare child who has a significant mouth, throat or esophageal problem. Most feeding “problems” tend to be variants of normal and those that the child can work through on her own in the context of positive feeding. Some children are exquisitely sensitive to tastes and textures, have a strong gag reflex, and throw up easily. Children who are diagnosed as having sensory processing disorders (SPD), simply react negatively to certain tastes and textures and must be protected from pressured feeding so they can gradually learn to accept those tastes and textures. Some children get a late start with eating because they have medical issues and/or are fed by tube during their early lives. However, even if your child has any or all of these issues, once medical issues have stabilized, s/he can learn to eat the food you eat, provided you provide regular and unpressured opportunities to learn. That means you follow Satter’s Division of Responsibility in Feeding. You provide the food matter-of-factly again and again and eat and enjoy it yourselves, and your child joins in with family meals. Here are some typical causes of children’s food refusal: •Misinterpretation of normal growth and attempts to compensate: Children come in all sizes. A child’s height and weight are normal as long as growth is consistent, even if it plots at the extreme lower end of the growth charts or even off the charts so they have to be plotted using z scores. Trying to get a child to eat more or grow faster backfires by increasing the child’s resistance to eating and, in the long run, slowing growth. •Pressured feeding. Any sort of pressure—even subtle, indirect, manipulative pressure—makes feeding unpleasant for a child. Making feeding unpleasant for a child creates negative associations—fear, anxiety, revulsion—that interfere with the child’s ability to eat what and as much as s/he needs. Children who are pressured to eat lose their desire to learn and grow with eating, and give the impression that they will go hungry rather than eat unfamiliar foods. Extreme pressure from parents or therapists canmake a child give in and eat, but enjoyment in feeing is sacrificed for both parent and child. •Errors in feeding/misinterpretation of normal eating. At all stages, attempting to compensate for children’s normal extremes in eating behaviors can precipitate food refusal. From birth, some children don’t eat much, show little apparent interest in eating, or have atypical hunger cues. Even for the child who nurses well, the transition from semi-solid foods through the almost-toddler to the toddler period is full of pitfalls, any of which can concern parents, make them put pressure on feeding, and cause food refusal. •Stress. Chaotic or under-supportive family dynamics, often manifesting as lack of structured and supportive feeding, stresses children, and they eat less well. Children who have had negative early eating experiences associate any feeding pressure with those early experiences and eat less well under stress. Division of responsibility-based intervention. Have the right goal: your child’s developing positive eating attitudes and behaviors. S/he will relax at mealtime, enjoy being there, pick from the available food, eat or not-eat, ignore or matter-of-factly turn down food s/he doesn’t want, and ask to be excused. He should be given all homemade foods and not a diet chart based diet. 

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Dr. Rakesh SharmaMD PediatricsPediatrician

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It is a normal behaviour of young kids to be fussy eaters. You keep on trying different type of food. Your child weight is fine. 

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Dr. Amit ChitaliyaFELLOWSHIP IN PCCM, FELLOW-PEDIATRIC FLEXIBLE BRONCHOSCOPY, FELLOWSHIP IN PEDIATRIC CARDIAC CRITICAL CARE, D.C.H., M.B.B.SPediatrician

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A fussy eater! a real problem for parents, well in this case --> you shall concentrate small elliquates frequent feeds which are calorie dense like kheer, raab, sheera, khichdi, egg white (boiled egg), brown bread with cheese slice and vegetables, ragi, soya milk and or soya chunks recipes etc etc. 

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Dr. Abhijit MisraMD - PaediatricsPediatrician

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He is suffering from constipation.  he should be on a good fibre rich diet. Give plenty of water.  regular laxative if needed along with a good diet plan. As constipation is a chronic problem in most cases and most common cause is habitual constipation.  You must ensure a regular bowel time after a drink irrespective of passage of stool. He should be sitting for sometime say 10_ 15 minutes in a fixed time daily in a Indian style toilet. She appears  to be a fussy eater. Most importantly you need to be patient with her. Don't shout or scream while feeding her. Try to make her feeding time fun or playtime. After not giving any food for 3 hrs at least make him sit with the food he likes (solid foods not pastes or liquids) with spoon and katori or fork. Let him at least play with the food for some time. If he likes milk a lot then try to give solid like plain rice, oats. Chatu. With the pediasure You can have a deal with him. He will take 1 sip milk and 1 bite of something  This way he will learn to chew Threptin  biscuits are good to taste and are rich in protein (casein) Avoid giving him chips fast food Makes small pieces of food  and ask  her to try just 1 bite. If he likes the taste she will have another. If he likes chicken. Give him chicken in different  ways. Introduce him to egg. Boiled or omelette whatever he likes. Play with him till he feels tired. Playing running will improve digestion. Don't loose temper You can give him  one egg a day Cucumbers made into small pieces will help  with problem of flatulence. Children have to deal with new  food, new habits. So they act out. Do not get flustered if he criesmakes a scene. Sit quietly, go to another room, ignore him. He will learn that bad behaviour  will not allow him to get her own way. I know it's very difficult but keep trying as that's the best you can give him. Pain  abdomen  may be due indigestion earmarked, gastritis. Good hand hygiene: Regular nail trimming Washing hand after each toilet visit. And before taking any food in any form Also take care of drinking water quality. Test Adviced: CBC with AEC Stool and urine R/E, M/E USG abdomen Share the reports if any Kindly do the follo You can check out the Health blog I manage with my wife. It has many helpful tips. The VIP Resource library gives you lifetime (free access) to many  childcare, parenting tips. 

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Dr. Abhijit MisraMD - PaediatricsPediatrician

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He appears to be a fussy eater. Most importantly you need to be patient with. Don't shout or scream while feeding him. Try to make her feeding time fun or playtime. After not giving any food for 3 hrs at least make him sit with the food he likes (solid foods not pastes or liquids) with spoon and katori or fork. Let him at least play with the food for some time. If he likes milk a lot then try to give solid like plain rice, oats. Chatu. With the pediasure you can have a deal with him. He will take 1 sip milk and 1 bite of something this way he will learn to chew threptin biscuits are good to taste and are rich in protein (casein) avoid giving him chips fast food makes small pieces of food and ask her to try just 1 bite. If he likes the taste she will have another. If he likes chicken. Give him chicken in different ways. Introduce him to egg. Boiled or omelette whatever he likes. Play with him till he feels tired. Playing running will improve digestion. Don't loose temper you can give him one egg a day cucumbers made into small pieces will help with problem of flatulence. Children have to deal with new food, new habits. So they act out. Do not get flustered if he criesmakes a scene. Sit quietly, go to another room, ignore him. He will learn that bad behaviour will not allow him to get her own way. I know it's very difficult but keep trying as that's the best you can give him. Pain abdomen may be due indigestion earmarked, gastritis. Good hand hygiene: regular nail trimming washing hand after each toilet visit. And before taking any food in any form also take care of drinking water quality. Test adviced: cbc with aec stool and urine r/e, m/e usg abdomen share the reports if any. 

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Dr. Prashant Kumar SinghMD Paediatrics, MBBSPediatrician

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This is a common complaint from parents of children of this age group. Generally children in this age group are very fussy eaters, need not worry if they are active and playful. Do not force feed the child. 

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Dr. Sajeev KumarC.S.C, D.C.H, M.B.B.SCardiologist

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First of all you stop bottle and feed from glass. The vitamins you give are good enough .Most children are fussy eaters and you just monitor weight 

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Dr. Richa Arora AgarwalVisiting Consultant - Rajiv Gandhi Cancer Hospital, Saroj Super Speciality Hospital, D.N.B. PEDIATRICS, MD - Paediatrics, MBBS, Bhagwati Hospital, Rainbow Hospital- PanipatPediatrician

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Hji some kids are fussy eaters. Try to inculcate good eating habits. Don't introduce wrong foods. If she is active and then skinny you don't need to worry much. Whatever is being made at home should be served. Take care. 

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Dr. NatrajP.G.C.C. Pediatric, MBBSPediatrician

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Try offering one spoonful or two spoonfuls of the following: pureed or mashed cooked vegetables, such as carrot or potato. Mashed or pureed fruits, such as banana, cooked apple, pear, or mango. Gluten-free cereal, such as rice, sago, maize, mixed with your baby's usual milk. You can also give cauliflower. You could try starchy vegetables, too, such as sweet potato. Once your baby is eating these fruits and vegetables happily, you can move on to other foods from the main groups: bread, rice, potatoes, and pasta dairy foods meat, fish, eggs, and beans introducing a range of foods and tastes at this stage may reduce the chances of your baby becoming a fussy eater later on. It's important to offer your baby savoury foods as well as sweet at this stage, so she learns to like a range of flavours. 

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Dr. Sajeev KumarC.S.C, D.C.H, M.B.B.SGeneral Physician

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Some children are very fussy in eating do not force feed and make eating enjoyable. If you tell me her weight and test her tft and cbc in a good lab and send reports to, me privately, I can help better. 

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