When Should I Worry About My Child’s Fussy Eating?

Every day I’m asked for help with fussy eating and I know it’s something that almost ALL parents struggle with at some stage. 

I know first hand, from professional and personal experience, just how much of an impact fussy eating can have on a family and how much stress, worry and frustration it can cause.  

However, I’m often asked questions around where the line is when “Fussy Eating” becomes more serious, or of more concern, and when parents therefore might

need more clinical or specialised support. Therefore I wanted to address in this blog what “typical” toddler eating behaviour is and offer some suggestions of when one might need to ask for more help.  

Please note that the content of this blog should absolutely not be used to replace medical advice and if you have concerns about your child’s eating or their growth/general health, it’s really important to seek specialist support. At the end of this blog I’ve signposted some extra resources that you may find helpful if you are looking for additional support.  

What is typical toddler eating behaviour?  

I spend A LOT of my time talking to and reassuring parents about their child’s eating behaviours, and it’s clear that there ARE plenty of behaviours that are very typical for young children, especially those tricky eating toddlers. It’s quite literally why I wrote my book How to Feed Your Toddler and also why I created my Fussy Eating Crash Course to help parents who are struggling with feeding little ones. 

Behaviours that can be common for babies and young children are*:  

• Food refusal 
• Inconsistent appetites – eating well at some meals and less at others 
• Food throwing 
• Refusing meals and requesting snacks 
• Refusing to try certain foods on the plate
• Finding it difficult to stay in the highchair and wanting to get down frequently  
• Becoming upset if they don’t like the food on offer or if it’s not a favourite food/meal  
• Eating well in childcare settings but becoming more fussy at home 
• Wanting to graze all day  
• Preferences for “plain” or “beige” foods – (children like familiarity and these foods are consistent in look/flavour/texture, easy to eat and a quick source of energy for children) 
• Preferring certain textures – this is really child-dependent as ALL children develop skills for eating at different paces 
• Wanting help to eat, even if they have the skills – sometimes children are simply tired or something is affecting them that they just want that little bit of extra support and comfort  

It’s really important to look at these factors in the context of your child’s OVERALL health and wellbeing. If some (or many) of these behaviours are occurring very regularly during mealtimes, causing significant disruption AND there are any additional concerns around your child’s growth or development, it may be that these aren’t simply “typical” toddler behaviours for them. Context always matters.  

For more detail on why fussy eating happens, check my blog.  

What support can I get for fussy eating? 

Navigating phases or ongoing fussy eating can leave parents feeling worried, frustrated, stressed, isolated or like they’ve failed – all of which can impact mealtimes even more. It can also be really hard to know where to turn and who to talk to when you’re wanting support to improve mealtimes. 

Here are some ways you can get support for your child’s typical fussy eating behaviours: 

• Online – there is a lot of support online and on forums where parents share tips and hacks on how they have coped with fussy eating episodes. Remember that not all of these will work for you and also not all of these will be “evidence-based” practices, either.  
• NHS – The NHS has advice on food refusal as well as more general pages on feeding a balance of foods to toddlers. 
• Specialist blogs – I have LOTS of free resources on my website and blog that go into real detail about fussy eating, what to look out for, why it happens and what you can do to help reduce food refusal at home. These may be a good place to start if you’re struggling: 
• FREE fussy eating factsheet 
• Mealtime language to help with fussy eating – from a child psychologist 
• How to manage behaviour to help your child enjoy mealtimes  
• What to do about food throwing  
• What should I do when my child refuses a meal?  

• My Instagram page has plenty of posts covering general advice, support and reassurance for fussy eating and I do a regular Q&A on there every Monday where I answer lots of typical questions on fussy eating and food refusal.  
• Webinars. My Fussy Eating Crash Course is an in-depth look at WHY fussy eating happens and WHAT you can do about it – it covers a lot more detail than what’s on my blog and can help if you’re looking for that extra bit of guidance and reassurance 
• Peer support groups: I have a free Facebook group for Fussy Eating support – this can be a supportive space to reach out to other parents going through similar phases and get tips and tricks that have worked for others  
• My book How To Feed Your Toddler has lots of support for the tricky toddler years – I spent a lot of time researching and learning whilst writing this book, and it’s really designed to help you know what to expect and how to help your child, and yourself throughout this period 
• GP/Health Visitor – this is the best first port of call to go to if you’re looking for support that’s specific to your child. I know specialised support is often hard to come by, but it’s important to check first and ask your GP or Health Visitor whether there are facilities that are local to you and what resources are available in your area.  
• One to one consultations: if you’re able to, private support can be really beneficial to get tailored, individualised support for YOUR child. You can email info@srnutrition.co.uk if you would like details of professionals who can support you and your family on a one to one basis.  

When should I start to worry about my child’s fussy eating? 

Something parents are naturally concerned about, is at what point they should start to worry that there may be more to their child’s eating behaviours than just being typically “fussy”:

Some things to think about that may indicate you need further support are:  

• Significant fussy eating behaviours persist with little to no improvement over a long period of time (several months) 
• If your child eats a VERY limited number of foods (e.g. less than 15-20 different foods) and/or is brand-particular about the foods, they will eat – e.g. will only eat Heinz baked beans and will refuse other brands  
• If you child refuses whole food or texture groups 
• Your child will not eat anything if their accepted foods are not available at mealtimes 
• Your child has significant aversions to foods mixing or touching  
• If your child’s eating is significantly impacting your/your family’s day to day life and you frequently feel anxious about eating out in restaurants or at friend’s/family’s houses 
• Your child appears to be in considerable distress/discomfort at most mealtimes – e.g. frequent gagging/inability to chew appropriately or manage a variety of textures  
• Your child has any other medical and/or developmental conditions that may have an impact on their ability or willingness to eat – for example; food allergies, sensory processing disorder, gastrointestinal conditions (e.g. reflux), neurodivergence  
• You have concerns about your child’s growth e.g. they are losing weight, not gaining height (note: your child can be a healthy weight and still have problem feeding that needs support) 
• You child shows signs of sensory differences or sensitivities that significantly impact their eating and/or other activities of life e.g. washing, dressing.  With food this may be demonstrated by acceptance or rejection of food based on specific sensory characteristics e.g. colour, shape, smell, sound (e.g. crunchy) 
• Your child may be visibly anxious at mealtimes or experience challenges that result in frequent excuses to leave the table, becoming tearful, gagging at the sight of food, making themselves sick or verbalising feelings of anxiety 

Please note that this isn’t an exhaustive list, and there may be other things that you have concerns about that you would like to speak to someone about. Please do seek further support if there is anything you feel that isn’t right.  

What support is right for my child?  

When thinking about what support might be relevant for your child, it’s useful to look at how many foods your child will usually eat, as well as other behaviours or symptoms that may be present.  

The table below shows what symptoms to look out for and what appropriate support may be for your child. Note that this table should not be used as a diagnostic tool and should not replace specialist medical advice.  

Symptoms	What could it mean?	Where to Seek Support
Nutritional intake is generally appropriate to meet growth and developmental requirements  Typically eats more than 30 foods	This is likely to be considered a typical eater, although many children will still go through phases of refusing foods or preferring familiar foods.	If you’re experiencing stressful mealtimes or would like support with general fussy eating advice, you may find my blog, book or crash course helpful.
Typically eats around 20–30 foods. Nutritional intakeis generally appropriate tosupport growth anddevelopment. May avoidnew foods or havepreferences aroundtextures or how foods areprepared. Thesebehaviours have beenpresent for less than twoyears.*	This would generally be considered typical fussy, picky or selective eating.	My crash course may be helpful, or you may wish to seek 1:1 support from a paediatric dietitian or other feeding professional if you’re finding mealtimes particularly challenging.
Typically eats fewer than20 foods. May have ahistory of feedingdifficulties (e.g. problemswith bottle feeding,significant distress atmealtimes, gagging,sensory sensitivities or oneor more of the concernslisted above).*	This suggests your child may have a feeding difficulty that would benefit from further assessment. Some children with these features may ultimately meet the criteria for Paediatric Feeding Disorder (PFD) or another feeding disorder, but this requires a comprehensive specialist assessment.	Seek advice from your GP or Health Visitor, who can advise on local services. You may also wish to seek assessment from a specialist paediatric dietitian or multidisciplinary feeding team (which may include speech and language therapy, occupational therapy or psychology depending on your child’s needs).
Typically eats fewer than10 foods. Feedingdifficulties have been ongoing for a prolongedperiod and your child mayhave significant anxietyaround eating, nutritionalconcerns, difficultiesdeveloping eating skills orseveral of the concernslisted above.*	This suggests more significant feeding difficulties that warrant specialist assessment. Some children with these features may be diagnosed with Paediatric Feeding Disorder (PFD), ARFID or another feeding disorder following a comprehensive multidisciplinary assessment, but not all children with severe selective eating will meet these diagnostic criteria.	Your child is likely to benefit from specialist 1:1 assessment. Speak to your GP or Health Visitor about referral options, or seek support from an experienced paediatric dietitian or multidisciplinary feeding team. Depending on your child’s presentation, speech and language therapy, occupational therapy, psychology or paediatric services may also be involved.
My child previously ate awide range of foods buthas suddenly developedan intense fear of choking,vomiting, contaminationor another distressingevent, resulting in severefood restriction.	This pattern may indicate feeding or eating disorder and should be assessed by an appropriately trained healthcare professional.	Seek medical advice from your GP as soon as possible. Depending on your child’s needs, support may involve CAMHS, paediatric services, a specialist paediatric dietitian or a multidisciplinary feeding team.

References: SOS Approach to Feeding, Feeding Matters, ARFID: An Introduction to diagnosis and management online short course, The Feeding Trust, 

Please remember: The number of foods your child eats is only one part of the picture. Growth, nutritional intake, oral motor skills, medical history, anxiety around food and the impact on everyday life are all important factors when deciding whether further assessment or support is needed. Many children with feeding difficulties do not have ARFID or PFD, but they can still benefit greatly from specialist feeding support.  

*When thinking about the number of foods your child will eat, consider whether they will eat different forms of the food – e.g. if they eat chicken – will they eat grilled/roast/stir fried chicken or will they only eat chicken nuggets? Do they eat broccoli when it’s blended into a muffin/pancake but wouldn’t eat it whole? This doesn’t have to mean your child will eat these foods ALL the time, without fail, but will they generally accept those foods when offered.  

What can I do if I’m worried about my child’s fussy eating? 

One of the biggest questions parents have when they’re worried about their child’s eating is WHO can I speak to? I often hear that parents are told that they’re “just being toddlers” or it’s “just fussy eating” or there’s nothing to worry about because they’re meeting their milestones and they’re growing well.  

Of course, all of these things ARE true – we know that children can become more selective around 18 months as they develop more autonomy and their growth slows down. And it IS reassuring and relevant that they are growing well and meeting developmental milestones. HOWEVER, it isn’t helpful if you are seeking further support and you feel that you aren’t being taken seriously. It is really important to seek support from someone who is specialised in paediatric feeding and can appropriately support you if you need more support.  

The first step is to speak to your child’s GP or Health Visitor. They are most familiar with your child’s medical history and can give you information about appropriate services that are available within your area (Including local dietetic, psychology, SLT or Occupational Therapy services).  

If you are struggling to get support, or feel that your concerns are not being taken seriously, you may wish to seek further support privately.   

Depending on your child’s needs, support may come from: 

• GP or Health Visitor
• Specialist Paediatric Dietitian or Feeding Therapist
• Speech and Language Therapist (when oral motor or swallowing difficulties are suspected
• Paediatrician
• Feeding multidisciplinary team (where available)
• The Feeding Trust has a database of trained professionals who can offer support for paediatric feeding difficulties
• BEAT is a charity that supports people and families living with eating disorders. 
• ARFID Awareness is a helpful resource if your child has had a diagnosis of ARFID.   
• Your local CAMHS service may be able to offer further support if your child’s eating is related to any mental health concerns

Thank you to Paediatric Specialist Dietitian Emma Shafqat for her support with this blog.