Questions and Answers on Fussy Eater's – Featuring Roisin Gowan Paediatric Dietitian

Roisin’s Background and Work History

I qualified in 2009 with a 2.1 Honours Degree in Dietetics. Since then, I have worked in NHS Teaching Hospitals in Newcastle and Leeds, and in GP clinics in their community. I moved to Ireland in 2012, and have worked in Cavan General Hospital, Vincent’s Private University Hospital before joining Crumlin in 2014. I have worked in both hospitals at Temple Street and Crumlin since then and accrued specialist experience and skills in paediatrics over the years. I currently am responsible for training UCD dietetic students at our hospital. I am a registered dietitian with CORU (regulatory body for allied health care professionals) and a member of INDI (Irish Nutrition and Dietetic Institute).

I provide a Paediatric Dietetic Service to Dublin and surrounding areas. I continue to work as a Senior Paediatric Dietitian at Our Lady’s Children’s Hospital in Crumlin, Dublin where I specialise in infants and toddlers, general paediatrics, eating disorders and oncology. I also do private consultations and home visits and Corporate wellbeing.

Questions and Answers

My child has suddenly become a very fussy eater, how do I ensure they are getting enough variety?

Many parents report that one of the hardest and most frustrating aspects of caring for their little ones is ‘feeding their child’. Young children are developing their own personalities and temperaments and in some cases food refusal is their way of exerting their independence or commanding attention. Most problems stem from parents worrying and giving their child too much attention for not eating. This is a temporary phase and parents should be reassured that most children will go through a phase like this. Distractions at mealtimes, inappropriate weaning, excessive drinks, limited variety with food, manipulative behaviour and parental anxiety all contribute to fussy eating. The key to dealing with this, is to identify if this is a one off day (in which case not to worry about it) or if the child has been eating poorly for days/weeks. It can be helpful to write down what the child is eating as often they will eat little and often during the day and this is adequate for their nutritional needs. A few strategies to deal with this behaviour and make mealtimes less frustrating is- no distractions at family mealtimes….established regular family mealtimes…..watch that not too much fluid is consumed (avoiding fizzy drinks, and offering milk or water only) suitable chair for child at mealtimes…not to react if child refuses meal,…encourage messy play…vary food served at mealtimes….

What are your suggestions for a healthy lunchbox, so they aren’t getting the same thing every day? The key is to make it healthy and balanced ! A starch (wholegrain bread, crackers, wrap, pasta, couscous) protein (meat, fish, eggs, hummus, cheese like babel, beans or lentils) and fibre (fruit or vegetables) For a sweet you could add a low sugar yogurt. Making it attractive is key! Lots of colours (grapes, kiwi, mandarin, bananas)

My kids won’t eat leafy greens, what should I do?

Offering your child new tastes can be daunting for a little one, especially if they have not eaten it before! Adapting the strategies such as regular mealtimes, not reacting in face of provocation… can be a start. When introducing a new taste such as vegetables, getting your child involved in preparing meals, and allowing messy play offers sensory opportunities that allows the child to become accustomed to this new food. If vegetables are a food item that was previously accepted and now blankly refused, stay calm! Offer vegetable with favourite meals at least 30 times ( can takes this long for a child to accept it) and encourage and praise when child accepts food…putting the vegetable on a favourite plate, making shapes using a biscuit cutter, or incorporating the vegetable into cooking (spiralised noodles, smoothies, healthy muffins or brownies etc) can be ways to get your child to accept vegetables. Involving your child in the cooking proces will help too

I’m worried about my child’s weight, how do I help without making them self-conscious?

I’m not sure if you mean your child is overweight or underweight, both of which can cause alarm. I would suggest that if you have any concerns regarding your child’s weight, to bring them to a registered dietitian. Dietitians are clinically trained to nutritionally assess and manage weight related disorders and can give trusted and evidence based advice that can be tailor made to your child’s condition.

What are your tips for helping children to make healthy food choices?

Out of sight, out of mind! Not having foods with a high sugar content (sweets, fizzy drinks, chocolate, biscuits) in the household. Let me illustrate this with an example. If you walk past a bakery and smell freshly baked pastries and treats, it triggers your motivation to eat pastries. Yet if you don’t walk past the bakery, you wont have to fight yourself to avoid eating a sugary fatty food. By reducing your exposure to food cues (sugary foods in the cupboard or freezer) this can help prevent children from eating too much sugar. Get educated! Reading the back of nutritional labels- cereal for example can have a high sugar content.

Keep foods simple- buy wholesome fresh foods with few ingredients. Drinks should be water or milk. Keep food balanced: include a starch, protein and fruit or vegetable at mealtimes. For treats- The Baby Led Feeding Cookbook has lots of natural and healthy snacks that won’t break the sugar bank. Enlisting help from grandparents too- instead of rewarding grandchildren with sweets, get them to offer a non-food treat like a kids magazine or an activity.

I’m also a big believer in getting kids from a young age involved growing food. It teaches them lessons about sustainability, where food comes from, seasonal produce and a sense of achievement when they see something grow from scratch. Vegetables that can be easily grown from seeds (salad leaves, radishes, spring onions etc) are a good start. I remember this was something we partook in school and it worked! Also growing up on a farm, we had to help out picking strawberries or potatoes for one Irish pound a day (deprived childhood)

For older children, good behaviour food charts, can also be helpful!