Our daughter, who is eight, had the “best start”: exclusively breastfed, weaned on to vegetables and fruit and healthy home-cooked meals. At some point, she started favouring junk food: pizza, fish fingers and chips. She’d have pasta bolognese for months and then go off it.
She’s decided to go vegetarian so it makes it harder to give her healthy meat alternatives. We’ve tried meal kits but she doesn’t like some of the ingredients. I’ve tried giving her new things, alongside things she will eat, ie cucumbers, peppers and tomatoes and a wide selection of fruit.
She had some potential medical issues and as part of that her weight and height were monitored. She’s been discharged but she is at the top of the percentile for both height and weight. Although she’s active, I’m concerned about her becoming overweight if she continues to eat like she does. I have struggled with my weight all my life and the judgment attached to it. Of course I am conscious of modelling good nutrition and exercise.
I am trying not to ban foods and be draconian about what she eats, however I have told her that I’m going to start making things and she’ll have a choice of eating or going hungry (she’ll get a good lunch at school). I’m at the end of my tether.
I want to reassure you is that it’s not your fault. If you had 10 children, they’d have 10 different approaches to food, even with “best starts”. Children will insist on doing their own thing. However, there are a few different things you might want to try.
I went to one of the country’s leading experts in this field, clinical psychologist Dr Gillian Harris, registered with the British Psychological Association, who has 30 years’ experience in child-feeding behaviour. Although we can’t diagnose your child via a letter, Dr Harris told me about children who have Arfid, which it’s possible your daughter has.
For children with Arfid, certain foods are unbearable, so they are not just being ‘fussy’
Arfid stands for avoidant/restrictive food intake disorder. Dr Harris told me it generally starts to manifest around the age of two, when children become more aware of the sensory properties of their food. “If food doesn’t look or smell right,” explains Dr Harris, “or isn’t easily identifiable or consistent then children can drop those foods.” Harris says Arfid is related to sensory reactivity and anxiety and is largely genetically determined. Those with Arfid are also not overly interested in food.
For children with Arfid, certain foods are unbearable, so they are not just being “fussy”. It’s no surprise your daughter is going for foods that look and taste consistent. Dr Harris says she always sees chips from a certain fast food manufacturer on the “accepted” list, precisely because “they are always the same”. Arfid children don’t like surprises, and anxiety will cause their sensory reactivity to increase.
What to do? First make a list of what your daughter does eat. It’ll probably be more than you think. Second, as Dr Harris says, “pushing your daughter is not going to help; the more anxiety [there is around food] the worse it’s going to get. Her height and weight are fine and she’s active.” Dr Harris didn’t think your daughter’s diet was that bad, but strongly recommends you don’t “make her go hungry, because she will go hungry; this won’t tempt her to eat”.
With help your daughter may develop beyond Arfid (many children do) and that help starts with not making any of your issues her issues. In time she may be motivated to try more foods (Dr Harris said it takes about 10 tries to get to like a food).
“She will in time probably go off pizza because we have a brain mechanism called sensory specific satiety, which tells us not to eat too much of the same food. The pizza may go, the bolognese may come back.”
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Dr Harris also said “talking about her weight is an absolute no-no. Forget talking about healthy and unhealthy food, just go with it.”
Don’t try to trick your daughter either. It’s important you remain calm and don’t force; if she learns she can’t trust you around food that will work against you. Otherwise, just go with what she’ll eat.
Dr Harris did wonder about your daughter’s protein and iron sources. So you could say something like “you could have a bit more protein. Let’s look at where you can get that from.”
If you’re still worried you could try to see a dietitian, who understands Arfid. Try through your GP or if you want to go privately via the British Dietetic Associatio –if they are worried about her, they might prescribe a supplement.
Every week, Annalisa Barbieri addresses a personal problem sent in by a reader. If you would like advice from Annalisa, please send your problem to ask.annalisa@theguardian.com. Annalisa regrets she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.
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