For two years, Perth mother Pam King battled daily to get her son Ollie to eat.
“There was a lot of screaming and crying both from him and from me, literally trying to force food down his throat and screaming at him, ‘how can you say it’s yucky when you won’t even taste it?'” Ms King said.
“We resorted to all sorts of screens and bribes and threats and it was awful.”
Her son mainly ate bananas and was losing weight, and Ms King recalled regular judgement from those around her, who told her she just was not being strict enough.
When eating is agony
But when she took her son for a dental check-up when he was three years old, the dentist immediately spotted the problem.
“She saw his tonsils and said: ‘Oh my God, have you seen this child’s tonsils – does he eat?'”
Ollie’s tonsils were classified as Grade Four in volume, the highest level, meaning that they touched in the middle and made swallowing food, particularly meat, painful.
Paediatric dietitian Kyla Smith said the Kings’ story is one she sees regularly in her practice.
“Every second client, I’d say, would have some experience like that or at least some kind of pain or difficulty around eating that’s taught them as a young kid that this is something to fear,” Dr Smith said.
It’s very rarely kids who are just being tricky for the sake of it.”
The ‘white food’ kids
If it is not physical agony, fussy eating can commonly take the form of only eating a very limited number of foods they feel safe with.
“The white-food diet is probably the most common kid that I would work with,” said Lauren Pike, an occupational therapist who works with children and parents on eating issues.
Yoghurt, chicken nuggets, bread, cheese and sometime bananas make up the white food diet and appeal to children because they are always consistent in their taste and consistency, and are less likely to lead to unpleasant surprises.
“If you take a bite of that nugget it is going to be exactly the same as that last time you took a bite of a chicken nugget,” Ms Pike said.
For many children, a refusal to eat certain food can be due to sensory issues, and a strong dislike of the shape or texture of the food in question.
“Some kids really like smooth puree and as soon as we start adding a bit of finger food or a little bit of lumps they get really bothered by it,” Ms Pike said.
“They might gag quite a lot and or they might just refuse to open their mouth.”
Then there are the toddlers who just enjoy saying no
“It is very normal and developmentally appropriate for kids at around 18 months to two years to become quite fussy,” Ms Pike said.
Mealtimes are a rare opportunity for young children to assert independence and control over their lives.
“They learn to say no and they learn that meal times give them some power over mum and dad,” Ms Pike said.
At the same time, their appetite naturally declines.
“Until age one, they are growing so much and then all of a sudden that growth really stops,” Ms Pike said.
“They just don’t need as much food and so they stop eating their three Weetbix that they were eating a month ago.”
Going to bed without dinner can be ok
Dr Smith’s approach is to teach parents to take the battle out of mealtimes and teach them that it is not their responsibility to force feed their children.
“We have this fear if they haven’t eaten their dinner then, ‘I’m sending them to bed hungry’, as a punishment almost,” she said.
“If you’ve served up dinner and you know that you’ve made sure one component of that is a safe food, it’s something that your child can eat, and they’ve decided that they are just not hungry enough at that time, then that’s OK.
“One of the things that I always say to parents is it’s never your job to get the food into their tummy, ever. Your job is to provide it.”
Learning to trust food again
Pam King’s son, Ollie, had his tonsils and adenoids removed 18 months ago and is now sleeping and eating better, but it has been a gradual process.
“He had two and a half years of trauma around food,” Ms King said.
“We just take all the pressure off – I put the food on the table and the first thing that changed was he started coming to the table willingly, he wasn’t being dragged kicking and screaming.
“He just decides if he is going to eat or not and it’s a slow process of building trust.
“We don’t call Ollie a fussy eater anymore, he is just learning to like a whole lot of foods and he will get there eventually.”