“Are you worried about your child’s picky eating?”
You are not alone – fussy or picky eating is very common in children. Parents often worry excessively about their child’s appetite, specifically the lack of it, as they are concerned that it would lead to malnourishment. However, even though your child’s appetite can fluctuate a lot, their overall caloric intake day-to-day is actually constant. This means that your child’s growth is usually not affected by picky eating behaviours unless there are certain red flag symptoms or signs.
Take heart that most children eventually learn to accept new foods upon repeated exposure. Therefore, parents should try their best and be patient to teach their children good eating habits to help them eat more effectively.
While there is no standard definition of fussy eating clinically, some children may demonstrate behaviours that indicate a certain degree of pickiness about food.
As a general rule, most infants triple their birth weight and increase their birth length by 50% in their first year. From 2 years old till puberty, the average growth rate continues at about 6–8 cm per year for height, and 2 kg per year for weight.
A common misconception that parents have about children’s growth is that the 50th percentile on growth charts is the expected normal weight for every child. However, this is not true as the growth of the child is also dependent on genetics apart from nutrition. A picky eater who is growing along the 10th percentile line, but whose parents are small in size, may not be suffering from reduced growth from picky eating, but it could be related to his/her genetic potential.
“Do not be overly pre-occupied to get your child to gain weight even if they are not at the 50th percentile.”
In fact, only children with growth parameters ≤ 3rd percentile and ≥ 97th percentile will require more detailed assessments. It is also important to not focus on an isolated measurement but look at the growth of the child over time.
A small number of cases of fussy/picky eaters are due to medical conditions, which would require a proper evaluation before diagnosis. For the majority of such cases, the cause(s) of fussy/picky eating is not always clear and is often related to biological and psycho-social factors.
a) Biological factors related to fussy eating
b) Psycho-social factors related to fussy eating
1. Optimise the appetite of your child
(a) Serve small, frequent meals and snacks instead of 3 main meals. Try going for healthier options such as cereals, fruits, yoghurt, cheese or a hard-boiled egg between meals.
(b) Only give beverages/soups at the end of the meal, to prevent their stomach from becoming too full from the liquids. Avoid giving your child sweet beverages as that can increase satiety as well.
(c) Have scheduled meal times.
2. Minimise distractions during meals
(a) Seat your child at a table/feeding chair for all meals/snacks so that they are clear on the objective of the meal.
(b) Avoid toys and screen time at all mealtimes.
3. Families should eat together for bonding purposes; it would be good to use the opportunity to teach your child about food and good eating habits at the same time.
4. Allow your child to feed and handle his or her own food. Accept the mess and avoid scolding them for it. Be patient.
5. Systematically introduce new food
New food should be introduced in small amounts. If your child refuses, offer just 1 bite without forcing. Stop after 3 attempts. Re-introduction can be done after a few days or weeks. Do note that it can take up to 10 exposures before your child fully accepts a new food.
6. Set time limits for meals
(a) Start eating within 15 mins from the start of a meal.
(b) Each meal should not last longer than 30 mins.
7. Serve age-appropriate food in proper portions e.g. palm size for each item (can increase if the child requests for more)
8. Keep your attitude neutral when feeding your child
(a) Do not appear too excited
(b) Never appear angry
(c) Do not involve rewards or punishments
Always remember that every child is unique. While parents may try their very best to get their children to eat, patience will go a long way. Be reassured also that nutritional supplements and appetite stimulants can be considered if your child’s diet is deemed insufficient for his growth, depending on advice from your paediatrician.
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Incorporated in 2005, Singapore Medical Group (SMG) is a private specialist and primary healthcare provider with a network of more than 20 medical specialties. The Group is committed to its promise of providing patient centred medical care and experience to every individual. SMG has 35 clinics and a growing network of SMG Associates all across the island.