Food Refusal

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As children grow and develop, so do their eating habits. The number of foods in a child’s diet is expected to increase with developmental age. Food refusal is a severe feeding problem in which children refuse to eat all or most foods presented and exhibit problems with growth. Toddlers In their second year become very wary of foods that are unusual or look different in some way to them. This is a normal developmental phase. A subgroup of these children demonstrate such severe food refusal that their nutritional status is compromised. 

 

Eating Types

  1. Many children are described as “Good Eaters” who experience a variety of foods which vary in taste, texture, and presentation. The Good Eaters are interested in and enjoy many different foods. In addition ,they can tolerate the presence of new foods and try new foods

  2. Not all children are Good Eaters; some are Picky Eaters. The “Picky Eater” prefers fewer foods and has certain aversions to foods. However, the Picky Eater has enough foods in their diet that they maintain health and balance while receiving a variety of nutrients.  A picky eater can:

  • Eat foods from each texture group and food group

  • Tolerate the presence of new food

  • Be willing to touch or try new foods

  1. “Problem Feeders” are on the far end of the continuum; the children in this category have severe aversions that impact their health and well being, and prevent them from eating a balanced diet. Generally, the Problem Feeder demonstrates one or more of the following 

  • A limited food selection of 10-15 foods, or less

  • Refusing one or more food groups(often preferring carbohydrates)

  • Prefer certain foods to always be the same brand or the same color.

  • Aversion when presented with novel foods

  • requires the same food to be presented at each meal

  • Gag when trying new foods or smell of these foods

 

Although food refusal is common, and can pose a significant health risk for some children, few researchers and clinicians have described the different forms food refusal may take. This review proposes that food refusal can be expressed in qualitatively different ways, including (a) unpredictable food refusal; (b) selective food refusal; and (c) fear-based food refusal.

Furthermore, it is proposed that each form of food refusal gives rise to a qualitatively different feeding disorder: Unpredictable food refusal is associated with infantile anorexia; selective food refusal is related to sensory food aversions; and fear-based food refusal is central to a posttraumatic feeding disorder.

Why do children often refuse foods?

  • Fear of new foods (also called food neophobia) is believed to be an evolutionary response that either the refusal of new foods or the refusal of foods that were once eaten without any fuss reflects a basic fear response. This fear response is actually a normal part of a child's development and the majority of children go through this phase, which tends to peak around 2 years of age. Children show this fear by refusing to taste new foods that look 'different'. This might be a food that has a color, shape, or texture that they are not familiar with. As children become more aware of the sensory properties of foods. Unfortunately, since many vegetables have a naturally bitter taste, this is one food group where the process of neophobia can hinder the development of a healthy diet.

 

  • The most likely reason for extreme food refusal in toddlers is lack of experience. Infants with limited experience of foods and textures during their first year, reach the neo-phobic phase (from 1 year – 18 months) whilst they are still only used to a few tastes and textures. 


 

  • It's also worth noting that food allergies may be a possible cause of food aversion. In some cases, a child may refuse to eat a certain food (eggs, for example), due to an underlying allergy that has yet to be diagnosed.

 

  • He is tired:  life does not always go to plan. After a very busy time or a day full of new experiences, he may be just too exhausted to eat well.

 

  • There are too many other distractions competing for his attention: If you are out he may be more curious about his new environment or the people there, than the meal.

 

  • Painful gums during teething will reduce his appetite. He is not hungry because he is not feeling well.in addition , Stress decreases appetite and children will avoid mealtime if the perceive it as a stressful time.

 

  • Children may have “food jags” where they will request and eat the same food at every meal. The problem with this is that often children will suddenly refuse this food. 

 

Signs toddlers might need help with food and eating

  • Toddlers not eating or not eating enough as many parents worry about whether their toddlers are eating enough healthy food. It’s common for toddlers to eat only very small amounts, to be fussy about what they eat, and to refuse to eat at all.

  • Liking a food one day and refusing it the next is common toddler behavior. 

  • You’re concerned about your child’s growth or overall nutrition.

  • your child won’t eat entire food groups for a time

 

While some feeding problems resolve with time, for many children, they can become a long term problem and may affect growth and development.  If you would like to talk to a professional about your child's food refusal you can schedule a consultation here.