picky eating summary
There is a collection of picky eating resources within the membership, but I thought I would provide a little summary of everything.
Low Pressure Meals
We are constantly told to ensure meals are low pressure, but have you ever wondered why? When your child has feelings of uneasiness around new foods, coupled with feeling as though they HAVE to engage with/eat those they develop a stress response. This stress response then leads to an increase in adrenaline, which in turn, suppresses appetite - when you are stressed (in fight or flight) the last thing your body wants you to do is eat!!
Highchair
One of the biggest myths of feeding your little one is that eating is the body’s biggest priority (we’d die if we didn’t eat, right?). However, eating isn’t our body’s first priority – rather we have two far more important priorities, that if aren’t met, eating will become incredibly difficult. Our body’s top three priorities are:
1. Breathing
2. Posture**
3. Eating
Postural stability, at the most basic level, help protect our brains – the purpose of being upright, is to ensure we don’t fall over and hit our head. Postural stability also supports our breathing muscles – our number one priority! Being stable, allows our body to focus on the task of eating, something that takes a lot of effort for our little people as it is so new and unfamiliar. Finally, being stable, allows for better hand to mouth coordination and range of motion of the jaw, required for chewing.
We are trying to achieve a 90 – 90 – 90 position
Back is up lovely and straight, we want to achieve a 90-degree angle at the hips, knees and ankle.
Upright Positioning
We want our little ones to be sitting with a lovely upright, straight back – many highchairs are sloped and aren’t conducive to this upright positioning. If this is your highchair, you can instead, roll/fold a towel up and place it behind your little ones back to have them sit upright. If this something that you need to do, you may need to place a non-slip mat under their bottom to help keep them in this position.
90 degrees at knees
In order to achieve this 90-degree angle at your little one’s knees, they will need to be sitting forward enough that their knees are at the edge of their seat. This is where shallower seats are good, however, this can also be achieved using the above method for achieving an upright position.
90 degrees at ankles
In order to achieve this 90-degree angle at your little one’s ankles, they need a foot rest. A foot rest that can be adjusted based on leg length as they grow. This foot rest ideally, needs to be wide enough that their whole foot fits on the rest, to ensure they get that full support and proprioceptive feedback (feedback through touch, feel and pressure). If you don’t have a highchair with a foot rest, you can easily create one with a nappy box, or books. The caveat here is that you want the foot rest to be stable and heavy, so that your little one can’t use it to play/kick.
Trunk stability
We also want our little ones to be stable through their trunk and to feel supported through their sides, particularly if they have lower muscle tone. This isn’t as essential for all children, but can be helpful if you notice that your little one is a bit wriggly, or a prone to leaning over the sides of the chair. Also helpful if you have a particularly wide seat on your highchair.
Table/Tray
Ideally, our little ones are up at the dining table so we can eat together – this also helps to minimise food dropping and throwing as they have the wide surface of the dining table to reduce the likelihood and make it less easy to drop or throw food off the side of a narrow tray. Either way, we want the tray or table to fall between your little one’s belly button and breast level.
REMEMBER – your little one’s seating arrangement will need to be adjusted every three months or so, to keep up with the rapid way in which they grow. This doesn’t mean every component will need adjusting, as our little one’s body parts grow at different times, but keep an eye on each of the components to the 90 – 90 – 90 positioning.
Below are some suitable options along the spectrum of affordability and include any modifications that may be needed.
Kmart Prandium Highchair/Ikea ANTILOP | $29 each
These are a great low cost option, however, modification is required to ensure adequate posture.
You will likely need to roll/fold a towel and place behind your little ones back to ensure they are upright and forward enough that their knees can be at 90 degrees
You may also need to use yoga blocks or towels either side of your little one to keep them from slumping/sliding to the sides
Use a non slip mat under their bottom to keep in place
Use a footrest - this can be some weighted boxes, or you can purchase a foot rest from places like Nibble and Rest that can slide up and down according to leg length
Mocka Soho/Original Highchair | $129-$159
This is a cheaper version of the Stokke Tripp Trapp highchair, is almost fully adjustable and will suit your little one right into toddlerhood.
The footrest must be placed at least three rungs below the metal rod, so may not be suited to little ones with shorter legs. If this is the case, you may need to place some books on top of foot rest until bubs legs are long enough
You may also need to pack out the sides with towels or yoga blocks to avoid slumping
Stokke Tripp Trapp | $586 (chair, seat + tray)
This is arguably the best highchair on the market, however, it is really expensive. The only modification you may need to make is to the sides, but it often isn’t required unless your little one has low muscle tone, or is super wriggly and needs a reminder to stay still!!
You may need to pack out the sides with towels or yoga blocks to avoid slumping/wriggling
Phil & Ted Lobster Hook Chair | $129
This is a great option if you have a tall table, or no table at all, and need to sit at the bench. The only negative to this is you will need to make some modifications
If you purchase a similar hook on chair, ensure it has a flat, solid base, rather than a sling base AND ensure you place an adult chair below, in case it becomes unclipped
You will also need to create a foot rest - stack some boxes, use shorter chair or stool as a base and place some books on top etc.
My Happy Helpers Adjustable Toddler Dining Chair
This is a great option for those toddlers no longer fitting in/tolerating their highchair.
You may need to pack out the sides/back to ensure your little one is sitting upright
https://myhappyhelpers.com.au/collections/kids-dining-chairs/products/grochair
Routine
It is really important to create structure to meals and snacks. We want to ensure we are offering food every 2-3 hours (on average), and not offering food outside of these times. If we do offer outside of these times, we can create a pattern of grazing that then tends to impact appetite at meals - if our little ones aren't hungry, they have no motivation to engage with a meal. Offering food every 2-3 hours helps to ensure they are never excessively hungry.
It can take up to 2 weeks for a routine change/implementation of a new structure to impact appetite conditioning, so you won't necessarily notice the impact immediately.
Mealtime Routine
Where possible, I encourage you (or your partner/other caregivers) to eat with your little one to reinforce and make use of social modelling - your little one will not only feel more confident eating new/less preferred food with you, but this provides you the opportunity to model how to eat food.
Step 1: Verbal warning that mealtime is going to begin ("we are going to eat in 5 minutes")
This helps to prepare your little one to shift from playing etc to eating, and prepares them for an alteration in sensory input
Step 2: Transition activity
Washing hands, setting table, putting on smock/bib etc
Step 3: Begin meal allowing your child to do what they want for 10 minutes
Have your child sit at the same spot for every meal, utilise plain plates and cutlery to avoid distraction
Everybody eats during this period, no discussion around food, eating, not eating etc
Direct conversation to other topics - what you have been doing, plans for tomorrow/after nap etc
If not eating, then direct conversation toward food
Discuss sensory property of food - squishy, crunchy, hard, soft etc
Talk about what the food can do - give you muscle, energy to play, help your eyes
Play with the food
Step 4: Wrap up meal after no longer than 30 minutes
Continue interaction/discussion as above
If you have been using distraction techniques (tv, books, toys etc) you can introduce this at 20 minutes and continue providing opportunity to eat/interact
If child becomes distressed, wrap up the meal earlier
If child has eaten the entire time, wrap up the meal earlier
Step 5: Clean up
Ask child if they are all done
Ask child (age depending) to pack up once piece of food onto a separate plate (this encourages them to touch the food)
Get child to take plate over to bin (or assist you in taking over to the bin)
Ask your child to place each piece of food into the bin - they can throw in, place in, blow in, spit in
Determining Preferred Foods
Please find a template for you to utilise here when determining your little ones preferred foods. I recommend you print this out, attach to your fridge and add to it as you will likely recall other foods and the goal over the next few months is to be slowly adding to this list.
Preferred foods are those you feel your little one will eat 80-90% of the time with relative ease (2-4 bites). These can also be foods they routinely eat at daycare. Preferred foods can be differentiated by sensory property -
Texture - puree vs sliced vs grated vs dried, cooked, raw
Shape - grated cheese vs sliced cheese vs cubed cheese
Brand of packaged product - sakata vs ritz cracker vs peckish cracker
Determining Family Foods
These are the foods you, as a family, eat. They are the goal foods we want to encourage your little one to be tolerating at some stage. Variety is great, but the reality is, as busy parents, we are all creatures of habit and will naturally eat a finite number of foods/meals regularly. The template of preferred foods, includes a template for family foods too.
The ultimate goal when feeding your little one is to only need to prepare one meal for the entire family. I have created a template here, for you to complete and add your family foods to.
Language Around Food
Research has shown that praise is the most effective means of reinforcement, BUT! We want to ensure it is the right kind of praise. Be really animated, happy and over exaggerated when your little one eats (particularly those foods they are struggling with), but avoid referring to food in terms of consumption (or lack there of). Instead, I encourage you to talk about food from an experience or function perspective.
"Wow"
"Yay"
"You ate your X"
"How yummy is X"
"Mummy loves X too"
"You don't have to eat that today" - this removes pressure, but avoids being finite
"I like XX, this is how I eat it" - this shows them that food can be enjoyed, and models how to eat
Structuring a Plate
When offering food to your little one, we want to avoid overwhelming them with large portion sizes and we want to ensure they feel comfortable with the presence of a preferred food.
The method by which we serve food, both preferred and non-preferred foods, can make the world of difference. Many families tend to offer back up meals, which can be really stressful as a parent to constantly have to prepare multiple meals and think on the fly, but it can also inadvertently cause some behaviours to result. The two main things it often results in, is:
Little ones tend to lose motivation to try new foods or what is served initially, as they know that a yummy preferred food will follow if they don't – it’s not manipulation, rather their simplistic view of the world and the association that has developed
By offering a back-up food, we naturally put those foods on a pedestal, and our little ones can end up developing a preference for those foods
So, instead, I suggest looking at meals as a means to fill up your little ones tummy AND expose them to less preferred foods in a low pressure way. The best way to do this is to ensure you are offering:
A portion of a preferred food(s) -> fills their belly up
Small portions of the less preferred/familiar food -> exposes them to these foods, giving them the opportunity to explore and learn, but no pressure to eat
Number of Foods
When plating food for your little one, we want to avoid offering too many options. Therefore, we want to ensure we are only ever offering three different foods - a protein, starch and either a fruit or vegetable. This will not only provide opportunity to meet the nutritional requirements of your child, but ensures the meals are balanced and exposure to different foods occurs.
You will utilise the list of preferred and family foods we have come up with above to structure a plate for your little one.
One food from list of preferred foods
Two foods from list of family foods
Portion Size
It is really common to inadvertently serve large portion sizes to our little ones. However, research has shown that as little as 1 tbs per year of age, from each food group (protein, starch, fruit/veg) is required to meet the majority of nutrient requirements for children aged 2-5 years of age.
Meat, dairy, fruit, vegetables, legumes, nuts etc
Many children will eat more than this, particularly of certain foods and this is great, but the 1 tbs per year of age rule of thumb is a great starting point, to avoid/limit overwhelm. It is absolutely ok to offer seconds or more of a preferred food.
For those foods that are less nutritionally dense, or more calorie dense, use 1 tsp per year of age.
Nut butters, nutella, cookies, cakes, cookies etc
Preventing Burn Out
A small repertoire of preferred foods and/or a heavy reliance on preferred foods can inadvertently cause burn out of these foods. That is, excess exposure/consumption results in your child becoming sick of these foods - this happens readily with all toddlers, but particularly those that are picky.
As such, it is important to ensure we are rotating through these preferred foods regularly enough. Not only does this prevent burnout, but provides ample opportunity for exposure to less preferred foods. We always want to be serving a preferred food to ensure we are providing a source of calories.
5 from each category (protein, starch, fruit/veg) will enable regular rotation to avoid excess repetition, but may require serving on consecutive days - if this is the case, we want to avoid offering the same preferred food at lunch (each meal differs from the day before, but preferred foods may be repeated across the day).
When offering new/less preferred foods we also want to increase exposure, so ensuring we are offering three new foods per day. To make this easier, I encourage you to make a menu for the week for your little one - this will enable meals to be less stressful at the time – you can find a template here. Remember one preferred food, two family/less preferred foods.
Steps to Eating
Eating is a really complex skill that requires lots of practice and exposure before it becomes really effortless. Think of eating like any other skill your child learns - not only does it require lots of practice, but periods of not practicing (think sickness or teething) can result in a regression of that skill.
The steps to eating provide a visual representation of the steps involved with eating, which is often reassuring for families to see that their child is closer to eating a food than first thought. The steps to eating, also provide us a way to measure progress and encourage interaction. You can find a copy here.
Interacting with Food
As above, the steps to eating also provide us with a means of knowing how to encourage interaction with a food - it is really important to note that there is never any pressure for your child to eat these foods (this will come with time). A phrase I recommend using when/if your child speaks negatively about a food is:
"It's okay, we can just learn about that food if we are not ready to eat it yet/today"
The best way to gauge a starting place for interaction is to (as above) record where your child sits on the steps to eating then aim for interaction utilising the steps above.
Learning plate
The concept of the learning plate is effective for all picky eaters, but particularly those who become distressed/upset by the presence of a less preferred/new food.
The learning plate is a plate that sits on the table that you can refer to it as a place where foods go that your little one doesn't want to eat today, but that they can still learn about those foods. This is also a great way to encourage interaction with these foods at the end of a meal.
Once a meal is over, I recommend you get your little one to carry the learning plate over to the bin, and ask him to do one of the following:
Simply place food into the bin
Show them how to place a piece of food between their lips and blow into the bin
Spit food into the bin
Often what can happen is little ones feel such little pressure around these foods, that they actually end up eating a few pieces of the food. Be sure to include what happens at this point of the meal as progress on the steps to eating.
Encouraging Interaction Outside of Meals
One key, but often overlooked, aspect of providing our little one’s opportunity to become comfortable with food, is doing so away from the table. One of the best ways to do this is to encourage interaction outside of mealtimes. This doesn’t have to be complicated though:
Taking your little one grocery shopping
Washing fruit and vegetables
Cooking with you
Preparing food with you
Observing you cooking/preparing food
Family style meals – instead of serving on a plate to your little one, serve on platters in the middle of the table and allow your little one pick what they want to eat