Fussy/picky eaters - anyone ever used a consultant?

[ClaudiasWardrobeplease]

I'm just wondering if anyone has used, and can recommend a consultant to help with coming up with a strategy for my incredibly fussy picky eater (age 3 and a half).

Since age 2 I have followed ALL the advice and read tonnes and have applied everything but to no avail. (In a nutshell I'm calm, unflappable about meals not eaten, there's no bribery, no emotional blackmail, I encourage him to help prepare food, present him with something familiar alongside the new, and know that it takes 15 goes for them to like something etc etc etc. but it's still awful.)

I'm now (privately and away from my child) tearing my hair out with how hard this is. He is beyond fussy and stubborn and it's not sustainable.

Back when he was much younger there was an issue with his sleep and we used a sleep consultant by having a one-off Zoom consultation and she was amazing - came up with specific strategies for him which we tried and within days the sleep issue was resolved.

I was wondering if such consultants exist for fussy eating and if anyone can suggest anyone good?

Sounds like you need a dietician, the one we saw was helpful but a lot of tactics and strategies you will already know, and some of it was fanciful!

How fussy are you talking?

Fussy! To the point that meals are now not being eaten at all.

My DD was a perfectly normal eater till she was about 2, then dropped 95% of her foods overnight. Her response is strongly sensory though, rather than simply picky.

She is 16 now and about to be assessed for autism. We suspect she has ARFID - part of this is around difficulties moving through the usual 'neophobic' stage.

I'm not trying to diagnose your child but there are lots of strategies to help with fear and sensory responses. Dr Gillian Harris is excellent.

https://www.arfidawarenessuk.org/

Sleep issues, eating issues etc - is it worth speaking to the health visitor and discussing whether to do an M-CHAT questionnaire? This looks into possible autism. Sensory difficulties are a part of the condition and this can be a big issue around food. I have 2 with autism, one similar problems to arfid.

is there a similarity in food your 3 year old will eat sensory wise - plain colours (or bright) sweet/sour/salty or cold/hot crunchy/soft

following similar lines may help to introduce more food eg cream crackers might be a bit like dry cheerios. Ice lollies might be like frozen grapes. Etc

i know what you want is to feed your kid rich wholesome dinners and I’m sure a dietician will be helpful just thinking of some more ideas.

in the meantime make sure you keep up with vitamins and fortified foods where possible.

When DD was a tot, the health visitor referred us to what they called the 'Feeding improvement clinic' and they gave us a lot of support.

One thing they did say was that it is a genuine eating disorder, not just 'fussiness' as so many friends and relatives will have you believe, and as with other types of eating disorder, it is extremely difficult for even professionals to treat.

They said that as long as she was eating something at each meal, and she was having at least one thing from all the food groups, even if not all on the same day, don't worry. They also said to take the pressure off completely, and stop trying. Stop making food and meals an issue by making them as casual as possible, and to convey the impression that we couldn't care less about what she was doing at mealtimes. Provide food, and make no comment whatsoever. Pay no attention, and definitely stop trying to persuade.

Good luck.

My DS started before fussy at 18 months old and it’s been a long and stressful road. We are now waiting to see a paediatrician for possible sensory concerns at age 8. It is normal and very common for small children to go through a fussy stage, which for some can last years or right into adulthood.

The importance is determining whether there is a medical reason such as ARFID etc, or if DC is just choosing to be fussy. See your GP to discuss but if it’s just general fussiness then the book Getting The Little Blighters To Eat is good and has simple strategies to use.

DS was under a dietician from age 4 for 18 months and tbh it was a waste of time. If you are well informed about good child nutrition and have thoroughly researched strategies for offering food etc (see book above) then all our dietician did was reiterate what we already knew. She would also quite literally lecture DS (then 4-5 yrs) about listening to your parents and eat the meals you are given. DS just looked at her blankly.

I also did a Fantastic Food Finders course for parents through the SureStart children’s centre which was good, but again it was more for those who weren’t well versed in fussy eating.

I did a self-referral to an NHS Occupational Therapist for DS at age 5 and had a phone appointment for 30 mins. She asked me dozens of questions and concluded that there was no sensory issue and he was choosing to be fussy. You could see if you can do this in your area.

So, see your GP but if all is fine and it’s just general fussiness then follow basic strategies like what is in the aforementioned book / online advice. Unfortunately there is no quick fix to fussy eating, but if someone has found it then I’d love to know!

Thanks for these helpful responses.

I've done online questionnaires for Autism (M-CHAT), ARFID and ADHD (though that's not usually diagnosable at 3.5), and all come back as or very low. I am not worried about Autism at all based on my knowledge (teacher) and the questionnaire - none of the issues really correspond with DS at all.

The ARFID score was on the cusp though.

He does also have a bit of sensitivity manifesting itself as stubbornness over clothing (texture etc) but not to a serious or unworkable extent that I've read about with some children with Autism. I wonder if he is just a boy in the sensitive / spirited zone perhaps.

I've been following the advice in the Getting the Blighters book and will continue your do so.

Similar to the pp above as a baby he ate everything and was adventurous. This all started almost overnight at age 2, implying it could be decision-based behaviour.

Update: I did speak to my DS nursery which was helpful and they gave me a few ideas. They said at nursery there are literally no other options for food if the meal is not eaten, whereas at home if he refuses to eat any dinner I will usually offer toast or cereal before bed as I'm worried he'll be hungry and therefore awake at night. Perhaps he's learning that there will always be toast or cereal so no need to eat a meal.

Has anyone had success in offering up no alternatives to the meal and removing all snacks (bread rolls, toast etc) from view so that the child knows there is nothing else?

I'm thinking this might be worth a try but wondering how I action this. DS does know there is a snack always available when he asks so I think this should change. We only have healthy snacks but still.

Any views on this aspect?

I was an (odd) picky eater until I was in my teens. Luckily I eat healthy food, but only things I'd eat where salad items, cheese, some fruits and dry bread - I'd literally go all day without eating as didn't want breakfast, school dinners were compulsory (ie no packed lunch) and I didn't even want puddings. A Sunday roast was me was a couple of raw carrots! I did find a sweet tooth in my teens, but started trying new foods when I moved away from home age 29. I had the odd cold while growing up, was happy and now eat most things (never really taken to meat, hate things like celery). At primary I struggled to do as well as other children, but don't think that was down to my diet and concentration and I ended up being in top sets in secondary. Luckily enough I still love the above foods, but enjoy many others things, and other things I eat as I know they're good for me.

Just wanted to let you know, that it worked out ok in the end in the hope it'll help you relax a bit more over the situation.

I do this with my DS- no alternatives to the meal and no snacks. I will compromise on this very occasionally if the meal genuinely is a bit challenging for him (eg a bit spicy) but like you I usually always serve a 'safe' food as part of the meal so I feel confident that I'm not being cruel or depriving. I am very determined not to make a separate meal, ever- I was fussy as a child and my parents made separate meals for me, I don't want my son to have the same issues as me. Mealtimes are arduous with him and take forever but he does eventually eat a good amount. I don't pressure him to eat more than he wants but I do tell him that once the food is gone there'll be nothing else. Solidarity- its so tough! You should definitely remove the toast those as that will be maintaining the problem

I'm speaking as a labelled "fussy eater".

Has anyone had success in offering up no alternatives to the meal and removing all snacks (bread rolls, toast etc) from view so that the child knows there is nothing else?
Please don't. I really wouldn't eat anything rather than eat anything. Give me 24 hours and I not just won't be hungry, but actively not fancy food at all. I would have won that every time.

How fussy is he? List what he'll eat. I suspect you'll find it's far more than you think.
Dd1 got down to steak and kidney pie, lasagne, sprouts, broccoli, boiled potatoes and sweetcorn at one point.

My experience was I was labelled fussy as a child. Really, looking back, I wasn't fussy. I didn't have a big appetite, and I didn't like mashed potato nor brown bread. We had mashed potato and/or brown bread with every meal barring breakfast and pancake day. So every meal felt a battle.
Today, I eat most things. But even the sight of mashed potato, or the smell of brown bread can start me retching. So making me eat it did nothing except mean that once I had the choice I have never eaten them again. (equally well, dh had one food he didn't like as a child, sprouts, and he was made to have one every time they were served. Again the result is he's never tried one since, and I suspect if he did, he'd like them)
What I realise is that I just wasn't particularly keen on the basic English food my parents served. I'm actually far less fussy than my siblings, who were labelled great eaters. I was happy to try new things, which they weren't, and liked the more "exotic" (as my parents thought) things like pasta and pizza. 🤣

My advice, having both gone through it, and had a dd who, as above was very fussy:

1. Small potions. Even now, give me a large portion in front of me and my appetite and I struggle to eat. Better to give hardly anything then offer more.
2. Don't insist they eat everything, or even comment on that they have/hadn't.
3. Don't put something known to be hated on the plate. Anything put on the plate there is an expectation to be eaten, which makes it hard to eat anything.
4. Try and have something that they like every meal. For my dd that meant occasionally she had a meal of just broccoli. Don't comment. Let them go ahead.
5. On a similar vein, try and make sure at least once a week does "pander" to their choice. So we had a lot of steak and kidney pies one year.
6. Let them serve themselves. We had the rule that if they served themselves they should eat it all. Obviously there's times you back down from that. But after a bit of experimenting, they'll learn their limitations.
7. Let them help shop/cook. Even now dd (she's in her 20s) likes to do the shopping (which is great, saves a job!) because she makes sure there's stuff she likes.
8. Don't make a song and dance about them eating, or trying something new. Again, really off-putting to eat.
9. Snacking. Yes, fair enough to limit snacking. But actually it may be that their body works better little an often. I feel much better for 4-5 small meals a day or 1 large, 2-3 small than 2 large (I don't do breakfast). Just make sure snacks are healthy most of the time.
10. Don't use pudding as a reward. Yes, it can be tempting, but if I didn't want to eat, then offering pudding if you eat it all just made me feel like I was trying to walk up a cliff. I wasn't going to make it anyway.
11. Sometimes a less healthy item can help eat a "better" item. I still struggle eating any bread. Eating a crisp with bread helps no end. Dd uses ketchup or mayonnaise for things she's less keen on. Again, let them, no commentary.
12. Lastly relax. Let them do it their way. They'll almost certainly get there in the end. For dd it was uni when she discovered that toast (having refused it for 8 years at that point) was cheap, nutritious and tasty. I nearly fell off my bed when she was eating it when she video-called me early in her first term. For me, it was simply the freedom to choose my own meals. I choose to eat what I like. My dc think mashed potato is an amazing treat because I do it so rarely. I eat fine now, just not with the meals I grew up with.

What is your child eating? If they have a balance, even if highly restricted, it's fine. If they will only eat sweets, it's a problem. I have a restricted eater and we can rarely eat outside the house as it is too hard. But protein wise he eats baked beans, peanut butter, cheese on pizza and some fish, so actually a le to get the nutrition in, even if it is the same thing every other day.

You mention nursery - does he eat there? And if so, what?

You have my sympathy, DD eats a pretty restricted diet. At home I let her eat food she enjoys (so that's a lot of broccoli), outside the home we work hard to mitigate.

The reason I ask about nursery is that we chose one that gave all children the same hot meal each day, in the hope this would help. It didn't. DD at nothing at all for the first 6 months, and slowly worked up to eating what she'd have at home (e.g. just the rice).

We've focussed on a (more or less) balanced diet, even if it's repetitive. DH and I eat a broader range of food, some of which DD helps prepare (but still won't eat). I was very stressed when she was younger (this is a child who really didn't want to wean, her eating has never been 'normal') but I'm less stressed now.

Thanks. Not sure if you've seen my update but at nursery things are very different as they only offer one meal and he tends to eat it. They also let them serve themselves from a communal plate so I'm thinking of trying communal serving dishes at home.

Glad he's eating at nursery, and thanks for clarifying - you'd said they offered one meal with no alternative, but I wasn't sure if he actually ate it.

Hi any update please

I know this post is 18 months old now, but this was so helpful to read, thank you!