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Children’s eating patterns and food preferences are established early in life. They accept or reject food based on the sensory qualities of the food, such as taste, texture, smell, temperature or appearance. Environmental factors also play a role. The setting in which the food is presented, as well as the presence of others and the anticipated consequences of eating or not eating, all contribute to children’s reactions to their food.
During feeding time, infants and caregivers establish a partnership in which they recognize and interpret both verbal and non-verbal communication signals from one another. This forms the basis of an emotional bond or attachment.
Feeding problems are caused by a number of interacting biological and environmental factors and it is often hard to define specific contributors. Biological factors may include early experiences with medical procedures, chronic hospitalization or medical problems that cause eating to be painful. In addition, children may experience oral motor deficits (e.g. difficulty swallowing) that make eating difficult.
When feeding skills are impaired and/or appetite is poor, problematic feeding behaviours such as refusal to eat may occur. Refusal to eat may lead to failure to thrive. Ironically, failure to thrive contributes to poor feeding skills, as undernourished children lack the energy to become capable eaters. Thus, a vicious cycle develops in which children refuse food, fail to learn that eating is no longer painful, miss opportunities to practice and develop oral motor skills, and fail to gain weight.
For essentially healthy children, the issue of why some children have selective food preferences (the so-called “picky” eaters) is becoming an important area of study as it relates to the epidemic of obesity in developed nations. As a child makes the transition to family food, internal regulatory cues regarding hunger and satiety are often overridden by familial and cultural patterns. Unhealthy family dietary habits and frequent exposure to fast foods are likely to establish negative eating patterns and put many young children at risk for nutritional deficiencies and overweight.
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