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wholesome child fussy eating ➋ SENSORY ISSUES Children with sensory issues may get upset by things like the tags in their clothes, loud noises such as the vacuum cleaner and certain smells or bright lights. One of the main sensory issues that leads to fussy eating is called oral defensiveness. A child with oral defensiveness shows unusual sensitivity to taste, smell, and texture. Common signs that a child may be oral defensive is that they will easily gag, may not transition off purees onto finger foods, avoid messy tactile play (finger paints, sandpits, messy food), fuss when it’s time to brush their teeth or wash their face as it creates an uncomfortable sensation, have repetitive diets and be picky about foods, and dislike eating in unfamiliar places such as friend’s homes or restaurants. Sensory issues are very prevalent in children who have autism spectrum disorders and most of these children will need to seek help from experts such as occupational therapists, who specialise in this area. At the same time these children benefit from working with a trained nutritionist or dietitian to ensure the foods they are trying to integrate are beneficial. ➌ ORAL MOTOR DELAYS These can begin with the inability to suck and swallow and include the inability to chew properly due to weak muscles. Many of these children are undiagnosed and for them it is easier to eat white bread, pasta, chocolate and foods that dissolve in the mouth and do not require excessive chewing. Hard vegetables and foods such as meat are avoided as they require skills these children do not possess. These children will need to be treated. Common signs that a baby or child may have oral motor delays is an inability to latch at the breast or suck at the bottle, an inability to bring their bottom lip down to suck food off a spoon, struggling to pick up food and bring it to the mouth, an inability to chew solid food without choking, frequently gagging because their gag reflex has not moved to the back of their tongue and every time they eat they feel like they are going to gag, choke or vomit. Older children may not have the ability to move food around their mouth using their tongues. Other signs your baby or child may have an oral motor issue: • drooling. • gagging frequently on food. • spitting up during and after meals. • coughing and gagging while eating. • difficulty chewing, difficulty keeping food in mouth during meals. • refusal of foods, pocketing food and negative behaviours around mealtime. • changes in voice during and after eating. • recurring respiratory infections/pneumonia. • poor weight gain/growth. ➍ LOW MUSCLE TONE Children can be born with low muscle tone (hypotonic) or have low muscle tone due to a specific diagnosis such as Down syndrome, or they can acquire low muscle tone through ‘nutrient deprivation’ or ‘cellular malnutrition’. Children with low muscle tone: • have reduced stamina. • can have difficulty with maintaining positions like sitting for meals, hence the importance of correct highchairs and seating. • become fatigued by chewing food. • have trouble using their hands to self-feed. • have trouble pushing with constipation due to muscle weakness. nutritional causes of fussy eating Common causes of fussy eating include zinc deficiencies, cravings for sugar or salt, as well as stressful mealtimes. Below are the main causes that I see in my practice: 1. Introducing sugary foods too early on. If children are exposed to sugar too early, they will alter their sweet taste receptors. Research has also shown that sugar is highly addictive, and has a drug-like response in many children – the more a child eats it, the more he or she wants to eat it to feel the euphoric feelings associated with sweet foods. For fussy eaters, it’s really important to balance their blood sugar levels and curb their cravings. (See more about the effects of too much sugar in children and how to manage it in the Reduce Sugar chapter). 2. Introducing too many commercially prepared foods. As a parent, you can’t compete with processed foods that not only contain sugar and salt (two of the most highly addictive tastes that can interfere with children getting used to natural foods) but also contain flavour enhancers, 23 Consider this… Research now shows that the most influential factor in determining children’s taste preferences despite their genetic make-up (up to 85%) is due to the foods they are exposed to early on in life.