Extreme food selectivity, feeding aversion/disorder

"My child eats only chicken nuggets and fries!"

"We can not go out to any restaurant because my child refuses to eat anything on the menu."

"My child spits out new foods."

"My child has never eaten vegetables or fruits well."

The problem affects many children

These are some of the many frustrations commonly heard from parents of children with extreme food selectivity or feeding aversion. Across the entire population, about 25 to 35% of children are affected. Fortunately, in most cases, despite these feeding challenges, the children's nutritional status is not jeopardized. In fact, most children with feeding disorders are well nourished and perhaps overweight. Because these children are perceived as thriving despite their feeding issues, most health care professionals are reluctant to address the problem.

Their responses may include "Your child will outgrow the problem" or "Your child will eat undesirable food items if you wait long enough." Neither of these recommendations is accurate or reassuring to concerned parents. And without proper intervention, their guilt and frustration mounts up quickly. In a world where food choices are plentiful, these children are consuming and benefiting from only a handful of them.

Fewer home-cooked meals may contribute to the problem

These days families have many dining options. These include home-cooked meals, prepared meals, eat-in restaurants, carry-out restaurants and fast-food establishments. Due to technologic advances and altered social structures, fewer families have home-cooked meals, provided at specific mealtimes. As a result, they are consuming readily prepared meals at various times and places. Though this helps to accommodate busy schedules, menu planning is not feasible. Therefore, in many instances, families tend to eat foods for convenience rather than nutritional value or variety. As a result, children are likely to find comfort in foods they recognize as inviting and familiar. Under these conditions, children start to develop feeding preferences based on limited food exposure. Fast-food restaurants, with aggressive marketing strategies, contribute adversely by exposing small children to their desired food items repetitively through radio and television advertisements.

A food transitioning technique that may help

In order to combat these negative influences, you may want to use a technique that may help to expand a child's diet. In this technique, a food that the child currently accepts is modified slightly with respect to taste, texture, smell, or temperature in such a way that the child is eventually transitioned to accept a less familiar food item. For example, a child who eats only macaroni and cheese can be introduced to another form of pasta similarly prepared, such as fusilli, eventually expanding to vegetables in a cheese sauce and later perhaps to meat. This process continues and branches until food goals are met.

Think of it like this: we all eat what we like. Children eat certain foods because they can tolerate the taste and texture, and the item is appealing enough to eat it at a meal. Though the behavior is very limiting, a child who, for example, eats only chicken nuggets and French fries is at least at a starting point. With this food transitioning technique, parents choose additional new foods that are likely to entice the child by making them more palatable by blending them with the familiar.