"The truth about fussy eating"- Dr Kyla's Review
OK so who tuned into the SBS documentary “The Truth about Fussy Eating?” I did, but I was wasn’t confident it would do our cause any justice. Here’s what I thought…
WHAT I DIDN’T LIKE
We open with the voiceover warning us of “a DEADLY new eating disorder”. Uh oh. Then a boy’s Mum tells us “We probably thought he was going to DIE.” More uh ohs from me. This boy is now “LEGALLY BLIND, basically because he didn’t eat his veggies.” They actually said that…
OK so this is wayyyyyyyy over the top. I hate that TV shows have to sensationalise everything. I understand that this boy had significant medical and nutritional issues, but this is not ‘the truth about fussy eating’. Your child WILL NOT go blind if they don’t eat vegetables.
The doco focuses on ARFID (Avoidant Restrictive Food Intake Disorder). The key to diagnosis of this condition is the extremely limited diet AS WELL AS malnutrition or weight loss. I have mixed feelings about this as a diagnosis. Obviously I am super understanding of the significance of restrictive eating, and I don’t want to underplay it. BUT, I also think that making this a medical diagnosis terrifies parents and makes eating more stressful for the whole family (which creates more eating difficulties!) Anyway, I would never talk about this as a diagnosis with any of our clients, no matter how restrictive they were. But other feeding therapists may approach this differently and that’s totally ok.
The ‘therapy’ provided for Jake was entirely the opposite of what we would do at Mealtime Building Blocks, or what most feeding-specific therapists would do. They basically put him in a room with his most hated foods and he couldn’t leave until he ate it. He was essentially forced. The psychologist described him as rocking and shaking in the corner. Then she told Mum that she would have to hold this boundary at home. This bit makes me really sad. And to be honest, this would NOT work for most of our clients, mainly because they’re already scared enough of new foods. We don’t want to make life more traumatic for them, or their families.
WHAT I DID LIKE
The doctors weren’t worried, but Mum was. No one took her concerns seriously. This happens ALL THE TIME for our clients. I’m glad this was given air time. At the end they say ‘Seek help with someone else if your doctor isn’t listening.’ Hear hear!
Jake the fussy eater ate a beige diet of white bread, potato chips, nuggets and frozen chips. This is a pretty extreme diet in terms of limited foods, but the ‘beige’ or ‘white food’ diet is pretty common. We definitely have clients with very restricted diets, but actually only having four foods is quite rare. If you’re concerned, write down a list of EVERYTHING your child eats. I’m confident that most of you will have more variety than this. We classify a problem feeder as a child who eats less than 30 foods.
Jake had an allergy to peanuts and a cow’s milk intolerance. The doco didn’t go into this enough, but early scary interactions with food can definitely predispose a child to eating difficulties. It creates anxiety around food for both the child and parent and this worry needs to be managed to create a healthy attitude towards eating.
The doco did touch on the Ellyn Satter Division of Responsibility, which underpins all of the work we do. I believe this approach helps to significantly reduce the stress and anxiety associated with fussy eating, and lets us help kids to start to build trust with new foods. The feeding clinic at the University also had a similar approach to the food play therapy we do in our clinic at Baby Steps, with their positive exposure to new foods through play. It was made out to be their own method, but to be honest it looked very similar to the Sequential Oral Sensory approach which is used worldwide.
There were bits I loved in this doc, and bits that really made me cringe. They were over the top about fussy eating causing death and blindness. Yes, the fussy eater featured was legally blind, but he was one person and we don’t know enough about him and his medical history to make any generalisations. The other featured kids didn’t have any medical issues.
I really liked that the doco emphasised how hard it was for parents to watch their kids go through this, and how difficult it was for them to feed their kids when they refused everything. One mum made it clear how impossible it was to reason with her daughter about food. These parents really felt that they had no options but to feed their kids potato chips at every meal.
The key piece is how stress with feeding makes all of these issues worse (and I’m not sure there was enough emphasis on this for my liking). The first Mum described begging her son to eat and then chasing him around the table to force a multivitamin into his mouth. This was NEVER going to work. I really think that we have to start by taking away the worry and pressure around feeding before we can help kids to eat new foods and eventually a varied diet. Parents do not cause fussy eating, but our response to feeding difficulties is critical in shaping how our kids respond to food. This is one of the big things we help families with in our work with fussy eaters. If this is something that you’re struggling with then I hope this doco has shown you that your are definitely NOT alone, and that help is out there. Get in touch with us for an appointment if you’d like some help.
About Mealtime Building Blocks
Dr Kyla Smith is a paediatric dietitian specialising in fussy eating, feeding difficulties and childhood nutrition. Lauren Pike is an occupational therapist working in fussy eating and feeding difficulties. They have a private practice called Mealtime Building Blocks in Perth, Western Australia. You can connect with Kyla and Lauren on their website and sign up for their newsletter, and the Facebook page or on the Instagram page. You can also email them.