Supporting essential childhood development by tackling fussy eating

Aston University supporting healthy childhood development by tackling fussy eating in young children.

Why is this research needed?

Poor dietary intake in childhood is a significant public health issue; globally 340 million children are overweight or obese and up to 50% of parents in the UK describe their children as fussy eaters at some point. Poor diet and nutrition are related to several chronic diseases including diabetes, cardiovascular disease and cancer. Fussy eating is also a cause of significant anxiety and stress for many parents. However, interventions to improve child diet are not always accessible to many of the families who want help.

Underpinning research and resource development 

Claire Farrow is a Professor of children’s eating behaviour and Director of the Applied Health Research Group at Aston University. She specialises in the factors that influence eating behaviour, particularly during childhood. In collaboration with Professor Emma Haycraft and Dr Gemma Witcomb at Loughborough University, Farrow has developed the Child Feeding Guide. It is the first resource of its kind for parents and healthcare professionals which provides evidence-based, simple advice about how to manage and respond to poor nutrition and fussy eating in children.

The Child Feeding Guide is based on years of research, both from the team but also from other researchers about the most effective ways to support children with healthy eating. For example, children are more likely to try new foods if parents and caregivers:

• Repeatedly offer children foods in a non-stressful way 
• Avoid using any pressure or force to eat as this predicts greater food refusal
• Allow children to see other children or adults eating and enjoying new foods
• Involve children with preparing or cooking foods to increase familiarity and make food fun
• Consider using books or games such as messy food play which make new foods more familiar and associate them with pleasure 
• Avoid distractions such as toys and TV at mealtimes 
• Use small tangible rewards, such as stickers, to encourage children to taste new foods

With Aston academic Professor Jackie Blissett, Farrow and Haycraft have also conducted pioneering research to better understand the development of 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.

Impact

Parents and the NHS 

The Child Feeding Guide has been used by over 100,000 unique users and has been widely recommended throughout several areas of the NHS. It is currently the first of only 2 resources recommended on the main NHS landing page when parents search for fussy eating and is disseminated by the NHS as part of their Start4Life Information Service for Parents. It has also been disseminated by various NHS services including NHS South West Yorkshire Partnership; NHS Northamptonshire Healthcare; NHS PW Patient webinars and NHS Wirral Community Health and Care. It is recommended in the Oxford Handbook of General Practice as resource for feeding and weaning problems and has been described as a support resource in multiple parenting books about child feeding and weaning. Through feedback and questionnaires, 80% of parents noted that the Child Feeding Guide had helped them to understand their child’s eating behaviour better.

Healthcare Professionals and International Policy 

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. The underpinning research in the Child Feeding Guide has also been referenced in the US Policy Guide: Parenting Matters: Supporting parents of children ages 0-8. 

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.

Related publications 

• Haycraft, E., Witcomb, G., & Farrow, C. (2020). The Child Feeding Guide: a digital health intervention for reducing controlling child feeding practices and maternal anxiety over time, Nutrition Bulletin. DOI: 10.1111/nbu.12445  
• Haycraft, E., Witcomb, G. & Farrow, C. (2019).  How to improve kids’ eating habits.  SEN Magazine, 100, 44-45.  
• Haycraft, E., Witcomb, G. & Farrow, C. (2018). Mealtime help at hand. Early Years Childcare Magazine, 8, 22-23.
• Haycraft, E., Witcomb, G. & Farrow, C. (2017). Happy eaters: The story behind the Child Feeding Guide. Perspectives (NCT’s online magazine), 37, 13-17.

Why is this research relevant today?

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.