Should I be more concerned that my five-year-old is a fussy eater?

Dinner battles: struggle to get fussy kids to eat.
Dinner battles: struggle to get fussy kids to eat. Photo: Getty

It's dinnertime and I brace myself for the inevitable tears. I've made a simple pasta dish, packed with veggies (finely chopped to disguise the "green stuff"). I sprinkle grated cheese on top (an act of desperation maybe) and call my girls to the table.

One of them tucks in, declaring "Yum-o" as she shovels delicious pasta into her mouth. The other one bursts into tears.

"It's not fair! I hate pasta!" she begins.

The frustrating thing is, I know that she will enjoy the pasta once she tries it. But persuading her to take the first mouthful is painful for both of us. I take deep breaths and contemplate leaving the room to scream into a pillow. 

Although it can feel like hard work (i.e., sometimes it makes me want to tear my hair out) I've never been overly concerned by my daughter's fussiness. I assumed that it is just a phase and looked forward to the day I put a meal in front of her that isn't met with a tantrum.

But a worrying new study from the US suggests that even moderate "picky" eating can have negative effects on children's health.

According to the study, published in the journal Pediatrics, more than 20 percent of children aged two to six are selective eaters. Of them, nearly 18 percent were classified as moderately picky. The remaining children were classified as severely selective, which means they are so restrictive in their food intake that it limits their ability to eat with others.

The study found that both moderate and severe selective eating were associated with significantly elevated symptoms of depression, social anxiety and generalised anxiety.

Dr Nancy Zucker who led the study, said that some children who refuse to eat might have heightened senses. This can make the smell, texture and tastes of certain foods overwhelming, causing aversion and disgust.

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In addition to this, some children may have had a bad experience with a certain food, and develop anxiety when trying another new food or being forced to try the offensive food again.

Dr Zucker recommends that parents of severe fussy eaters seek help from their GP. But what about kids like G? Should I be worried?

I spoke to family therapist Karen Phillip to find out a bit more about the link between anxiety and fussy eating. She says that in her opinion, the food has little to do with it. "It is a parenting issue, not a child psychology issue," she says.

Philip says that in order to reduce conflict over food, parents should stick to a simple 'eat it or go to bed hungry' strategy.

"Provide the food, advise the child it is up to them if they choose to eat it and clearly advise nothing else will be provided. The child then has the choice of going to bed hungry or eating dinner," she explains.

The theory is that over time there will be less conflict over food because children know there is no point in arguing – they can take it or leave it.

This sort of rule has worked in our house to an extent – more often than not my five-year-old will eat her dinner. But there is still a fair amount of drama (and tears) at the dinner table. It is tempting then, to take the easy option and stick to the meals that I know she loves; Spag Bol, sushi and "dippy" eggs.

I asked Kate Di Prima, Accredited Practising Dietitian and Spokesperson for the Dietitians Association of Australia, if there is any harm in sticking to a handful of basics that guarantee dinnertime success. She tells me that it is "really important" to introduce kids to new foods.

"The more variety they get the more chance that they'll get their full quota of nutrients. If you stick to the same things then eventually they will get taste fatigue and start to knock back the staples," she says.

Di Prima's advice is to increase variety as much as possible. "If you stick to the same thing you might miss an opportunity to expose them to foods that they might like," she explains.

So back to that veggie pasta. After five minutes of crying and protesting about how unfair life is, my five-year-old finally took a bite…. And then polished off the lot proclaiming it was the best pasta she'd ever had. Fussy kids are hard work!