As a parent, you want your child to eat well. When a child gets an adequate variety of food and gets enough nutrients, you can be sure of a healthy foundation to grow. But what if your child won’t eat? If that happens sporadically, it is annoying but not a huge problem. 

However, if it is structural, it will become problematic and will cause great concerns for parents. Not to mention the extent to which this can frustrate parents.

Eating problems in children

Food fussiness is a common feeding problem: the child is very selective about which foods he/she is willing to eat. As a child, I used to fish out the onions my mother put into the meal. No way was I going to eat that. I did not like the taste and texture. Same goes for mushrooms, yuck.

All kinds of factors can play a role when a child does not want to eat. For example:

• Physical problems such as swallowing difficulties, allergies, intestinal complications, or an abnormality of the esophagus.
• After the first year, children grow less quickly and therefore have less need for food.
• Developmental disorders such as Autism Spectrum Disorder can cause mealtime difficulties.
• Going through psychological development can cause stubbornness or rebelliousness.
• A combination of child and parent factors, such as emotional child temperament and parents’ controlling feeding practices, namely verbal pressure, physical prompts, and food rewards.

These latter factors were the subject of the study of Stella Rendall, Helen Dodd, and Kate Harvey.

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Food fussiness, emotionality, and controlling feeding practices

The importance of the research of Rendall and her team was to provide further insight into the characteristics and experiences of children who are fussy eaters as well as to yield information to support interventions for children at risk of fussy eating.

For that, they wanted to explore associations between controlling feeding practices and food fussiness further. They also wanted to investigate whether the relationship between children’s emotional temperament and food fussiness is moderated by maternal use of controlling practices. They chose an observational approach, using structured coding schemes, to objectively capture the parent and child behavior.

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Coding mealtime behaviors

Sixty-seven mother-child dyads, with children aged 2-4 years, were video-recorded during a typical meal in their home. The meal consisted of four food items, two of which were familiar (appealing and unappealing) and two of which were unfamiliar (appealing and unappealing).

Mothers’ use of controlling feeding practices during this meal were coded afterwards, using the Family Mealtime Coding System (FMCS). Three subscales of the FMCS were used to study the parent-child interaction:

1. Use of verbal pressure (encouragements to eat, such as ‘try some more of the soup’).
2. Use of physical prompts (such as pushing a plate of food towards the child).
3. Use of verbal incentives/rewards (food rewards and non-food rewards, for example ‘if you eat your peas, you can have your favorite pudding’).

One researcher and a second coder used The Observer XT for offline coding. An interrater reliability of 90% was reached. The second coder subsequently coded 25% of the videos with the percentage agreement between coders ranging from 82 to 96%, an indication that coding achieved a high reliability.

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Furthermore, mothers completed two questionnaires:

1. Children’s Eating Behavior Questionnaire – food fussiness subscale (CEBQ FF) containing 6 statements to assess mother’s perception of their child’s food fussiness and evaluate whether the child eats a variety of foods, the child’s interest in new foods and how difficult the child is to please with meals.
2. Emotionality Activity Sociability Scale (EAS) containing 20 statements to assess children’s temperament, emotionality, activity, sociability, and shyness.

Is the emotional tone of mealtimes a crucial factor?

The research team describes that the key finding of their study is that the relationship between emotional temperament and food fussiness was significant when mothers used more verbal pressure and physical prompts but was not significant when mothers used fewer verbal pressure and physical prompts.

The findings suggests that while emotional temperament may potentially be a risk factor for the development of children’s food fussiness, the feeding practices that mothers use during mealtimes may ultimately determine if such children become fussy eaters.

Reference

Rendall, S.; Dodd, H. & Harvey, K. (2022). Controlling feeding practices moderate the relationship between emotionality and food fussiness in young children. Appetite, 178. https://doi.org/10.1016/j.appet.2022.106259