Food challenges if your child has additional needs

It is perfectly normal for toddlers to refuse to eat or even taste new foods. Do not worry about what your child eats in a day, or if they do not eat everything at some mealtimes. It’s more helpful to think about what they eat over a week.

The best way for your child to eat well and try new foods is to copy you, so it is important that you eat alongside your child when you can. Children learn from seeing their parents and other family members eating and enjoying a wide range of foods.

Any child can be a fussy eater. And all children will refuse food at some point. If your child is active and gaining appropriate weight, and they seem well, then they’re getting enough to eat.

However, refusing foods can be common if your child has additional needs.

Neurodivergent children particularly often experience senses such as the taste, smell, sight and feel of food in a different way to other children.

You might not be sure at first what it is that is making your child refuse foods or react negatively to them, or whether it is anything to be concerned about.  But if you are worried in any way, please do talk to your health visitor or GP.

Top tips and ideas

Issues with refusing food can include:

• Being upset or overwhelmed by smells
• Being upset by the sound of people eating
• Being upset by loud noises such at the TV, washing machine or shouting
• Disliking having different foods on the plate at once
• Having foods on a plate touching each other
• Disliking combined foods (like putting gravy on top of meat)
• Preferring pale-coloured or beige foods
• Getting upset at changes in routine or how food is served (on a blue plate instead of a white one; sausages with peas instead of with sweetcorn; fork instead of a spoon)
• Wanting to use a particular fork, cup, plate
• Finding it hard to sit still to eat
  
  

In order to find out what triggers or overwhelms your child, try keeping a diary of behaviour around mealtimes and foods, so you start to recognise patterns – this might include:

• whether there is background noise or not
• where they are sitting
• what plate they are using
• how food is organised on the plate
• whether other people are eating noisily around them
• whether foods are presented differently or in new combinations
• you give them something they were not expecting, or something that is new
• whether they are calm enough before mealtimes begin
  
  

Once you understand the pattern, you can start to plan around it to minimise some of the barriers.

What can I do to help my child feel comfortable to eat?

You can follow some ‘rules’ depending on what exactly it is that is an issue for your own child:

• Make sure food isn’t touching other food on a plate or use a separate plate for new foods
• Use the same plate, cup and cutlery each time
• Turn the TV/radio off or on – depending on what your child needs
• Allow them to sit in a different space if necessary
• Give small amounts then add more if wanted rather than overload the plate
  
  

Always try and avoid making meals a battleground. Try not to put pressure on them, and avoid getting stressed yourself, as they may pick up on your anxiety and be even less inclined to eat. Try to be patient and recognise it is likely to take time to change their behaviour.

Consider whether your child has sensory overload: Sensory overload occurs when the brain receives more input from the senses—such as light, sound, touch, taste, or smell—than it can effectively process. When overwhelmed, the brain may react as if facing a threat, triggering a fight, flight, or freeze response. In children, this can lead to meltdowns or distress that may be misinterpreted as ‘bad behaviour’, rather than a sign of sensory overwhelm.

Portion control

• Remembering the size of your child’s stomach is quite small will help you keep the portions of food you give them at the right amount. Also remember that your child’s appetite will vary from day to day.
• Give small amounts first then add more if wanted rather than overload the plate too much at the start.
• When your child shows you or tells you they have had enough, let them stop eating even if there is still some food left on the plate, as this will stop them over-eating even when they have had enough.

My child eats things that are not food – should I be concerned? 

Pica is the medical term for when children eat non-edible items. Common items that children with pica eat can include sand, chalk, playdough, clothing, faeces, hair and paper.

Children below the age of 18 months often explore objects in their mouths. Due to this, pica is not diagnosed below the age of 2 years. Pica occurs more frequently in children with learning difficulties and is often associated with autism.

Seek help if you are concerned:

For general advice on eating well, fussy eating and eating difficulties – see the range of useful weblinks below. If you are still concerned, keep a record of what your child eats – when, where and how often – and share this with your GP or Health Visitor.

Video resources

The following information and video created by the NHS, has some useful information and advice for children from 18-30 months

https://www.nhs.uk/baby/weaning-and-feeding/fussy-eaters/

Useful sources of information and support

General advice on eating well in toddlers:

NHS: https://www.nhs.uk/what-to-feed-young-children/

https://www.nhs.uk/baby-and-toddler-meal-ideas/

British Nutrition Foundation: https://www.nutrition.org.uk/nutrition-for/toddlers-and-pre-school/

HENRY – www.henry.org.uk

First Steps Nutrition – https://www.firststepsnutrition.org/eating-well-resources

Fussy eating:

BBC Tiny Happy People-Fussy Eating and how to avoid mealtime battles: https://www.bbc.co.uk/bitesize/articles/zy8dp9q

These are helpful in relation to children with autism:

https://family-action.org.uk/self-help/support-your-autistic-child-with-food-eating/

https://www.autism.org.uk/advice-and-guidance/topics/behaviour/eating/all-audiences

Tips on sensory processing difficulties with food: https://sends.org.uk/blog/f/my-child-is-not-a-picky-eater-tips-for-sensory-difficulties

PICA:

https://www.autism.org.uk/advice-and-guidance/professional-practice/managing-pica

nhs cambridgeshire/pica-eating-non-edible-items/

Pica (eating non-edible items)

The National Autistic Society is a charity that supports families – their advice and guidance section has a lot of useful information – https://www.autism.org.uk/