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Fussy eating: should you be worried?

Concerned that your baby's fussiness is affecting his health? Here's how to get help


Posted: 3 February 2011
by Lucy Dimbylow

Baby crying in high chair
If every mealtime ends in tears, it could be time to seek help

Almost all babies and toddlers go through periods of pickiness, and while it can drive you to distraction, it’s rarely a cause for concern. Children are very good at regulating their own food intake, and the vast majority manage to take on all the nutrients and calories they need, even if their diet seems very limited.

But more extreme or prolonged fussy eating can begin to take a toll on your baby’s health and wellbeing. So when does normal toddler pickiness become something more serious?

Why is your baby a fussy eater?

There are many reasons why your baby or toddler may go through a fussy phase.

  • Moving on to the next stage of weaning (e.g. from smooth purees to lumps) can be off-putting
  • Refusing to eat can be a way for a toddler to exert his independence
  • Filling up on milk, snacks or drinks can put him off solid food
  • Teething or minor illnesses like colds may affect his appetite for several weeks
  • A course of antibiotics can upset the balance of bacteria in the gut and spoil his appetite
  • Eating often takes a backwards step while your child masters a major milestone like learning to crawl or walk

There are also other, more serious, reasons why a child may become a fussy eater, such as:

  • A food allergy or intolerance causing pain or trapped wind
  • An underlying behavioural condition such as autism
  • Constipation, leading to tummy cramps and discomfort
  • A condition such as reflux that causes pain on eating, or a physical problem such as tongue tie that makes swallowing difficult
  • Worry, anxiety or emotional stress

When to worry

It’s important to remember that we all have likes and dislikes, and it’s unreasonable to expect your child to enjoy everything you dish up. It’s also extremely common to go through a fussy phase, and many mums who have older children who are now excellent eaters can recall a period when mealtimes had them tearing their hair out. But there may be cause for concern if:

  • You have to prepare alternative meals at short notice because your baby won’t eat what you’ve cooked
  • Your child doesn’t seem bothered by missing meals completely
  • You’re worried that his food intake isn’t meeting his energy requirements
  • Your child shows signs of extreme anxiety around meals, perhaps even making himself sick
  • He seems to have physical problems with eating, such as gagging or choking
  • You feel the need to supplement his diet with vitamin drops or tablets
  • You’re concerned that he’s showing signs of nutritional deficiency, such as tiredness, pallor, weight loss or slow weight gain, lack of concentration and disturbed sleep

Getting help

If your child’s fussy phase has become extreme or has been going on for a long time, and simple strategies like offering praise and rewards haven’t worked, try keeping a food diary, writing down everything he eats and drinks across the course of a week. You might realise that he’s eating more than you thought – and if not, you have some concrete evidence to show your health visitor. She can help you with strategies for improving his eating, or, if necessary, refer you for further help.

In most cases, fussy eating is a phase which will be outgrown, but sometimes other interventions may be required. For example, if your child has signs of autism, he might be referred to a paediatrician, or if he appears to be having physical difficulties with eating, a speech and language therapist can assess whether there is a structural issue with his mouth that could be corrected.

A very small number of young children can develop eating disorders. These are rare, and the underlying factors are usually complicated. If your health visitor or GP shares your concerns about your child’s diet or relationship with food, she may refer you to a dietician. You can also self-refer to a private dietician: visit www.bda.uk.com for more information.

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