Tackling fussy eating in childhood
Poor diet and nutrition in children is linked to the development of several chronic diseases
Globally it is estimated that 340 million children are overweight or obese. In the UK, an Independent Report by the Chief Medical Officer noted that “on average, six children out of a class of thirty are obese and a further four are overweight, twice as many as thirty years ago.” These statistics highlight a public health issue which is related to poor nutrition and unhealthy food intake in children.
Poor diet and nutrition in children is linked to the development of several chronic diseases, including diabetes, cardiovascular disease and cancer in later life. Fussy eating has a recognisable impact on these statistics and is also a cause of significant stress and anxiety for many parents. However, interventions to improve child diet are not always accessible to many of the families who want help.
Claire Farrow is a professor of childhood eating behaviour and director of the applied health research group at Aston University. As a Chartered Psychologist, she specialises in the factors that influence eating behaviour and weight gain or loss, with a particular focus on children. She has longitudinal research expertise and is comfortable using observational and experimental designs with children.
During this project, Farrow has collaborated with Loughborough University academics Dr Emma Haycraft and Dr Gemma Witcomb. Together, the team have investigated fussy childhood eating behaviours and explored different methods that families can use to support children to eat more healthy foods.
The team began work through a body of research exploring which mealtime behaviours are most effective at promoting healthy eating and reducing fussy eating in children.
Through a series of over 20 peer-reviewed papers published during the project, the team have discovered that eating with children, eating the same food as them, and not having distractions such as toys and TV at mealtimes are linked with less fussy child eating behaviour.
Their research also identified the following successful techniques:
With Aston academic Professor Jackie Blissett, the team have also conducted pioneering research which was the first in the world to develop a paradigm for observing emotional eating in children. This research has demonstrated that parents who use food as a punishment or reward (either restricting or rewarding food) are more likely to find that their children emotionally overeat two years later.
Culminating a wide range of underpinning research, Farrow, Haycraft and Witcomb co-created the novel Child Feeding Guide, a resource for parents and healthcare professionals which provides evidence-based, simple advice on how to manage and respond to poor nutrition and fussy eating in children.
The guide was initially released in 2012 as a website and then in 2013 as an app. It was a first of its kind, and the team have since continued to update the resource with new research-based evidence over the years resulting in the Child Feeding Guide website, which was optimised in 2017 following funding from the Higher Education Innovation fund.
The team’s research has also been used to develop Society for Nutrition approved CPD training for healthcare professionals which has subsequently been delivered at multiple training events in the UK.
Research in this project has led to the development of an evidence-based resource for families, caregivers and practitioners which can support them with healthy child feeding and eating. The resource has had a notable influence on the NHS, parents, healthcare practitioners and international policy.
The Child Feeding Guide has been widely recommended throughout several areas of the NHS. Currently, it is the only recommended resource for parents as part of the NHS “Information Service for Parents” emails sent out to parents and caregivers when infants are 23 months old. Child and Adolescent Mental Health Services (CAMHS), Hampshire NHS, City and Hackney NHS, Mid Cheshire NHS, and North East Devon NHS are some of the services that have recommended the resource for their feeding and eating disorder services.
Over 46,000 people across the UK, Europe, America and India have downloaded the Child Feeding Guide as a website or app. It has been shared and endorsed by many parenting groups including a write up by the National Childbirth Trust and has been recommended in at least four books for parents about child feeding. Through feedback and questionnaires, 80% of parents noted that the Child Feeding Guide had helped them to understand their child’s eating behaviour better.
Approximately 300 healthcare professionals have been trained to understand and apply the research in the Child Feeding Guide at dedicated events organised by practitioner groups including Startwell (funded by Birmingham Public Health) and Riverside Cares (London) a leading child care agency specialising in training and education. When collecting feedback, 91% agreed the Child Feeding Guide contains useful information, 87% agreed it is a beneficial resource, 75% agreed it is useful for families they work with and 95% said they would recommend it.
The Child Feeding Guide training has been CPD endorsed by the Association for Nutrition.
Research in this project has been referenced in the US Policy Guide: Parenting Matters: Supporting parents of children ages 0-8. This reach is evidence that the Child Feeding Guide has changed awareness and behaviour of the US National Academy of Sciences. Their Division of Social and Behavioural Sciences commissioned the work and contents.
Research into childhood eating behaviours is relevant today because healthy eating in childhood is essential for healthy development. Fussy eating and childhood obesity are significant societal concerns which affect the health of millions of children in the UK.