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10 Fussy eating red flags for babies & toddlers

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10 Fussy eating red flags for babies & toddlers

I frequently speak to parents who have children whose eating challenges started when they were really little. Not the typical toddler fussies, but when they were first starting to eat as babies.

These are often parents not 2 or 3-year-olds, but children already at school or even college. Eating challenges that start very early on are almost always due to an underlying problem. If this is not addressed, it stands to reason that eating may not improve.

Similarly, if eating is difficult right from the start, it does not build comfort or joy around food and mealtimes. Again, and logically, this can make for ongoing feeding challenges.

Knowing what to look for if you do have a little one is important. * WARNING* some of this probably flies in the face of ‘food is just for fun under 12 months’ advice.

If you have an older child who is not eating well, and when they were younger they had some of these issues, it probably explains why they are still struggling, and why many of the usual strategies for helping children to eat don’t work.

Feeding red flags for babies & toddlers

1. Medical or oral motor challenges:
i) Issues coordinating eating and breathing.
ii) Ongoing problems with vomiting. Or frequent spit up.
iii) Nasal reflux – more than one incident of vomiting or spitting through the nose.
iv) Choking – frequent choking or coughing during a meal (this is different to gagging as it involves problems with breathing). It can be a sign that a child is unable to manipulate food properly in their mouth.
v) Consistent drooling/ or food or liquid leaking from the mouth.

2. Baby doesn’t like food – if babies are only interested in the bottle/breast at 8 months * then it’s a sign that something may be preventing them from eating food. Obviously an extreme reaction to food like crying or arching away would be a red flag.

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If no foods at all are accepted by 9 months * it is worth requesting an evaluation.

I know that we’re repeatedly told that food for babies under 12 months is just for fun and so not to worry. However, I have worked with countless families where food wasn’t easy right from the start and the child forever struggles.

If they are not eating at 8-9 months, there may not be a big issue, but they are at a stage where naturally they are learning to chew. Missing this window can make things more difficult later on.
There could be:
– Oral motor issues
– Sensory sensitivities
– Silent reflux
– Allergies
– Problematic lip or tongue ties
– Other challenges

3. Baby won’t eat baby food – some children love purees and happily slurp them down. Others accept them but aren’t very enthusiastic.

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Where it’s a concern, is if they are consistently refusing purees, especially if they are crying or arching away. It can be a sign that there are some sensory sensitivities involved.

Textures are a challenge for some children and mushy/wet may not be appealing. An option is to offer more table foods, as is common with baby-led weaning.

Offering table foods is a good option, however, it’s important for children to also be able to manage purees from a spoon so they can tackle yoghurt and mash, for example later on.

This does not mean pushing them to eat pureed foods, but consistently having them on offer so a comfort level is built around them. Touching them with the hands is a great start towards being able to eat them, but always done in a fun, gentle way.

4. Gagging at the sight of food – if a baby or toddler gags when they see a food, or a certain type of food, or when they touch or taste it, it could indicate a sensory sensitivity.

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Some gagging when touching or especially tasting is normal, and babies do have a sensitive gag reflex to keep them safe. However, if it’s every time and its specific tastes or textures then it indicates a sensitivity.

If there is gagging later, after the food has already been in the mouth for a while, it’s more likely to be an oral motor issue. Baby may be unable to move the food around, chew it or swallow it easily so it’s hitting the gag reflex.

Again, this is not periodic gagging which is normal when learning to eat.

5. Baby won’t eat table food – Generally, babies will be able to eat table foods by 11 months *. If this is not the case, seeking an evaluation is advisable.

One thing to try are baby puffs. These are a great first food as they are crunchy but melt away in the mouth so don’t require advanced chewing skills.

6. Stuck on purees – it is surprisingly common for babies to love purees and not want to move onto anything else.

Unfortunately, this can result in them missing that window when they do learn to chew and do learn to accept a range of foods.

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A good strategy is to initially thicken the puree rather than introducing ones with lumps if you are stuck on this stage.

However, 11 months is still a good benchmark for when foods other than purees should be accepted, if you’re not making progress.

7. Mealtimes are a battle – if mealtimes are consistently challenging, it’s generally a sign that things are not going as they should be.

Also, if a child is really fussing or irritable either during or right after meals it’s indicating that something is making them uncomfortable.

8. Baby has no interest in eating – or your child takes forever to eat. If they take more than 30 – 40 mins for a meal it can be a red flag, especially if combined with other challenges.

Similarly, if a baby will only eat if they have a distraction like an Ipad or parents dancing on tables it can be a sign they don’t have an intrinsic drive to eat.

Eating with distractions commonly develops for many fussy eaters so this would only apply if baby has never been able to eat unless these distractions were in place.

9. Food is pocketed – holding food in the mouth for long periods of time (like tucking into cheeks, for example) can be a sign that baby lacks the sensory awareness that food is there. Or maybe they lack the tongue coordination to chew and swallow properly.

Babies may also overstuff their mouth with food. Doing this may be a sign that they crave the sensation of food pushed up against the tongue or the cheeks, like a strong hug, it could be calming.

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10. Baby/Toddler not feeding themselves – obviously, a 6-month-old is not able to manage a spoon like a pro! However, if they are 8 months * or older and are not using their fingers, or utensils to feed themselves it could be a sign of sensory sensitivities.

Not wanting food to touch the hands, or not wanting spoons or forks in the mouth could be avoidance of textures.

These are just guidelines and it’s important to look at this calmly and in totality.

For example, one of my sons used to love cramming food into his mouth as a baby. However, in all other respects his eating was developmentally normal.

So as with all these signs, if it’s occasionally or if everything else is progressing well it is probably not something to be concerned about.

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On the other hand, my son went on to have other sensory sensitivities so if I knew then, what I know now …

*all ages are noted for children who are otherwise hitting other average developmental milestones so may be different, for example, for premies.

 

 

Judith, MA Cantab, Grad Dip Psychology, is an AOTA accredited picky eating advisor and internationally certified nutritional therapist. She works with 100+ families every year resolving fussy eating and returning pleasure and joy to the meal table.
She is also mum to two boys and the author of Creating Confident Eaters and Winner Winner I Eat Dinner. Her dream is that every child is able to approach food from a place of safety and joy, not fear.
Learn more about Judith here: https://theconfidenteater.com/about/

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