Picky eaters? They'll eat when they're hungry... won't they?

They won’t. Children labelled ‘picky eaters’ have something much more complex going on than plain fussiness or using food refusal to exercise power. The problems are not behavioural they are biomedical. The problem is rooted in the child’s biochemistry, and because of this we won’t solve the problem with reward charts and hostile stand-offs. We need to investigate the underlying issues and correct them to allow the child to move forward.

I work a lot with children with autism where limiting foods is a common problem. I would also say that eating disorders too have their basis in biochemical imbalances. In both cases nutritional deficiencies, imbalanced gut flora and food intolerances can combine to cause sensory issues and anxieties that influence food choice. There is also the problem of self-selecting foods containing proteins that might give them an opiate-like effect, such as gluten or casein. Or specifically choosing carbohydrate-rich foods to raise blood sugar levels or feed non-beneficial bacteria and yeasts. The signals our body sends out in these instances lead to very strong cravings.

Other issues with food selection include the exclusion of protein rich foods. Sometimes poor digestion causes a child to refuse protein foods. Proteins require good levels of stomach acid to be broken down and used efficiently by the body. It becomes a vicious circle because brain chemistry is affected further by the inability to break down protein the amino acids needed to build neurotransmitters.

To say a child with autism, with a history of reflux, colic and vomiting, will ‘eat when they are hungry’ and to enforce strong rules around this would be mistreatment. A child with strong sensory disturbances experiences lumpy foods or certain textures as repugnant. To sit at the table until the food is eaten would be traumatic.  

While it’s true that these experiences can make a child feel anxious about trying certain foods it is certainly not the only cause of anxiety. Many of these children have constant anxieties, the root of which is multiple but almost all are biological in origin. Nutrient deficiencies can lead to chronic anxiety and imbalanced gut flora can also contribute. Identifying the physical issues and correcting them with a biomedical approach, over time, helps children to accept more foods without anxiety or disgust.