Support with eating and feeding

Contents

• Understanding feeding and eating in early childhood
• STEPS and framework
• Feeding and our senses
• Food chaining
• Feeding differences table
• Frequently asked questions from parents of children with extreme picky eating.
• Cheyne feeding support service. 
• Website and links to useful information:

Understanding Feeding and Eating in Early Childhood

Feeding is more than just eating—it’s a social and developmental journey.

Every family has its own way of doing mealtimes, shaped by culture, routines, and expectations. Just like learning to walk or talk, children learn to eat over time, with support and space to explore. Some children face early challenges—like trouble with breastfeeding or moving to solid foods—which may signal deeper developmental needs. While many feeding issues are temporary, others can be more complex, especially for children with sensory or communication differences. As mealtimes become more stressful, it’s easy for parents to feel overwhelmed. But with calm routines, positive support, and the right help when needed, families can make progress—one small step at a time.

This page is here to support you. We offer information, guidance, and practical strategies to help your family navigate feeding challenges with confidence and care.

Feeding as a Developmental Milestone

Feeding is an important part of a child’s development, just like learning to crawl, walk, or talk. In the early months, babies rely on reflexes to feed—such as suckling and latching onto the breast or bottle. Around six months, many families begin introducing solid foods while continuing breastfeeding or formula. Some choose smooth purees, while others offer lumpier textures or soft finger foods.

During this stage, children begin to explore food in new ways. They learn to accept different tastes and textures, use their fingers to feed themselves, and show curiosity about what others are eating. Families naturally start sharing their own food habits, introducing children to the meals they enjoy. Over time, we expect children to progress steadily so that by around one year of age, they are eating a variety of family foods alongside everyone else. 

Feeding challenges in children with social communication and sensory differences

Children with social communication difficulties—including those on the autism spectrum or with sensory processing challenges—often face unique hurdles during feeding transitions. These children may struggle with different things:

Feeding difficulties often observed:

• Resistance to new foods (food neophobia)
• Strong preference for sameness (e.g. only eating foods of a certain brand, shape, colour, or texture)
• Limited food variety (very restricted diet with few accepted foods)
• Aversion to specific textures (e.g. mushy, crunchy, mixed textures)
• Difficulty with transitions (e.g. moving from purees to solids, or changing mealtime routines)
• Overreaction to smells, tastes, or visual appearance of food
• Avoidance of messy or sticky foods (reluctance to touch or self-feed)
• Gagging or vomiting in response to certain foods
• Extreme distress at mealtimes (crying, tantrums, refusal to sit at the table)
• Lack of hunger cues or difficulty recognising fullness
• Delayed development of self-feeding skills (e.g. finger feeding, using utensils)
• Disrupted family mealtimes due to prolonged or stressful feeding routines
• Negative impact on parent-child relationship due to ongoing feeding struggles

Recognising these patterns early—especially in children with autism, social communication disorders, or sensory sensitivities—can help families seek appropriate support. With thoughtful strategies and professional guidance, feeding can become a more positive and manageable experience for everyone involved.

Identify Underlying Causes

• Medical issues (e.g., reflux, allergies, constipation)
• Oral motor challenges
• Sensory sensitivities
• Anxiety or temperament
• Past negative food experiences

Every family approaches feeding in their own way, shaped by culture, values, and personal experiences. While some strategies can be helpful, it's common for parents—especially when feeling desperate for their child to eat—to try approaches that unintentionally increase stress and make mealtimes more difficult. This can lead to power struggles, anxiety, and even further food refusal. The good news is that there are evidence-based strategies that can support both children and parents, helping to create a more positive, relaxed, and successful feeding environment.

Ellyn Satter’s Division of Responsibility (sDOR) in feeding outlines clear roles for parents and children to support healthy eating habits and reduce mealtime stress.

The Division of Responsibility in Feeding, developed by dietitian and family therapist Ellyn Satter, is a widely respected framework that helps families create positive mealtime experiences. It emphasises a balance of structure and autonomy, allowing children to develop trust in their own hunger and fullness cues while parents provide consistent guidance.

Parent's Responsibilities:

• What food is offered
• When meals and snacks are served
• Where the child eats

Parents are encouraged to offer regular, structured meals and snacks, provide a variety of nutritious foods, and create a pleasant eating environment without pressure or coercion.

Child's Responsibilities:

• Whether to eat
• How much to eat

Children are trusted to decide if they want to eat and how much, based on their internal cues. This helps them develop self-regulation and a healthy relationship with food.

 Benefits of sDOR:

• Reduces mealtime battles and stress
• Encourages intuitive eating and food acceptance
• Supports growth and development
• Strengthens the parent-child relationship around food

This approach applies across all stages of development—from infancy through adolescence—and is especially helpful for children with feeding difficulties or selective eating patterns.

Focus on These 4 Nutrient Groups

Try to make sure your child eats something from each group — even just one item counts!

What You Can Do

• Make a simple list of what your child eats in a week.
• Check if there’s at least one item from each group.
• Don’t worry too much about variety — coverage is more important.

In children with extreme picky eating, progress takes time. Be gentle with yourself and your family, and focus on building a new, trusting relationship around food. The goal isn’t just to expand your child’s diet—it’s to reduce stress and create positive mealtime experiences. Always consult your healthcare professional if you have concerns about growth, nutrition, or issues like constipation.

STEPS and Framework:

• Support your child with love and structure
• Trust your child to eat
• Establish regular meals and snacks
• Pressure-free feeding
• Step-by-step exposure to new foods

Feeding Steps

1. Lower stress at mealtimes

• Keep meals calm and relaxed.
• Try not to worry too much or pressure your child to eat.

• Have regular times for meals and snacks.
• Avoid letting your child eat all day long (grazing).

• Sit down and eat together without screens or distractions.
• Show your child that eating can be fun and enjoyable.

• Give familiar (safe) foods along with new ones.
• Don’t only serve what your child likes—keep offering variety.

• Let them touch, play with, and try food at their own pace.
• Support their development with chewing and tasting.

How should I interpret my child’s growth chart?
Growth charts are tools to track a child’s development over time—not to compare them with others. Any centile between the 3rd and 97th is considered within the normal range. What matters most is the trend: is your child growing steadily along their own curve? Some children are naturally smaller or larger, and that’s okay. The key is consistency over time. If you notice a sudden drop or plateau in weight or height, or if you’re concerned, it’s always best to speak with your GP or healthcare professional for guidance.

Feeding and our senses

When we eat, all eight senses work together to shape our experience with food. These include:

1. Sight – We first judge food by its appearance: colour, shape, and presentation can influence willingness to try it.
2. Smell – Aroma plays a major role in appetite and flavour perception; many children reject foods based on smell alone.
3. Taste – The tongue detects sweet, salty, sour, bitter, and umami. Picky eaters may be hypersensitive to certain tastes.
4. Touch – This includes both how food feels in the mouth (texture, temperature) and how it feels in the hands (tactile defensiveness).
5. Hearing – The sound of crunching or chewing can be either pleasing or overwhelming, especially for sensory-sensitive children.
6. Proprioception – Awareness of body position helps with chewing and swallowing effectively.
7. Vestibular – Balance and coordination are needed for safe sitting posture during meals.
8. Interoception – This sense helps us feel hunger, fullness, and discomfort, which guides when and how much we eat.

Feeding challenges often arise when one or more of these senses are over- or under-responsive, especially in children with sensory processing differences or autism. Understanding this sensory interplay is key to creating positive, low-pressure mealtime experiences. The steps to feeding is based on our senses.

Food chaining:

Food chaining is a gentle, step-by-step strategy used to help children expand their diet by building on foods they already accept. It works by introducing new foods that are similar in taste, texture, shape, or colour to their “safe” foods, gradually increasing variety without triggering anxiety or refusal.

• Start with a safe food your child already eats (e.g. plain crackers).
• Make small changes—like switching to a similar brand, shape, or flavour (e.g. from round crackers to square ones).
• Introduce a new food that shares a feature with the safe food (e.g. toast fingers if they like crunchy textures).
• Repeat exposures in a low-pressure way—no forcing, just offering.
• Celebrate progress, even if it’s just touching, smelling, or licking the new food.

Patience is powerful when supporting extreme picky eaters. Change doesn’t happen overnight—it often takes months or even years to build trust and reshape feeding behaviours. By making small, gradual changes and removing pressure, mealtimes can become more positive and less stressful. Some children may take longer than others, and that’s okay. The goal isn’t just to get them to taste something—it’s to help them feel safe, curious, and in control. Over time, with consistency and compassion, even the most hesitant eaters may surprise you.

Why pressure doesn't work:
When you try to influence how much or what your child eats, it usually backfires.

• Urging her to eat more may lead to eating less.
• Trying to limit her food may cause overeating.
• Pushing her to eat specific foods often results in refusal.
• Expecting neatness might cause more mess.
• Tolerating poor behaviour to encourage eating just worsens both behaviour and appetite.

Clinical Presentation:

Feeding challenges in children can look very different from one child to another. The table below describes some of the different clinical presentations—from mild picky eating to more complex feeding disorders. Understanding these differences can help parents know when to seek support and what kind of help might be needed.

Feeding Differences Table

Sometimes, the terms ARFID (Avoidant/Restrictive Food Intake Disorder) and PFD (Paediatric Feeding Disorder) are used to describe similar feeding challenges in children. This can be confusing because they often share symptoms and may even occur together. Whether a child is diagnosed with ARFID or PFD can depend on the hospital, the healthcare team, or the country. ARFID is a psychological condition, while PFD is a medical and developmental diagnosis. Despite the different names, the assessment and support offered to families is often very similar, focusing on nutrition, feeding skills, and emotional well-being.

Frequently asked questions from parents of children with extreme picky eating.

Is my child getting enough nutrition?:

Many parents worry their child’s limited diet lacks essential nutrients. Experts recommend tracking intake over time rather than a single day, and consulting a health care professional if growth or energy levels are affected. Remember:

• Appetite varies, some days they eat more, some less. That’s normal.
• Growth: if your child is growing as expected, it is a good sign.
• If you are worried of particular nutrients and nutrition, speak with your GP.

Should I force or bribe my child to eat?

No — forcing, bribing, or tricking your child into eating can make mealtimes stressful and damage their relationship with food. Instead, focus on exposure without expectation, like having the food nearby or playing with it.

Many children — especially those who are extremely picky — find mealtimes overwhelming. Imagine being asked to sit at a table that feels tense, with food pushed into your mouth or hidden in other foods. That can feel scary and confusing, no matter your child’s age or developmental stage.

Why won’t my child eat certain foods, even if they used to?

Children may develop aversions due to sensory sensitivities, negative experiences, or developmental changes. It’s common for preferences to shift over time.

How long does it take to see progress?

Progress is often slow and non-linear. It can take months or even years to build trust and expand a child’s diet, especially with sensory or developmental challenges.

What if my child only eats beige or crunchy foods?

This is common in sensory-based feeding issues. Gradual exposure to new textures and colours, without pressure, can help over time.

What if my child never eats vegetables or fruits?

Start with food play and exposure—let them explore the look, smell, and feel of fruits and vegetables without pressure to eat. Use food chaining to gradually move from preferred to new foods with similar properties. Sometimes multivitamins can be useful.

Is it okay if my child eats the same foods every day?

Yes—many children with extreme picky eating rely on a small set of familiar foods. Instead of focusing only on what they eat, try to build a calm, structured environment around when and where they eat. A peaceful, predictable mealtime helps reduce anxiety and builds trust. If their preferred foods include at least one item from each of the four key food groups (protein, carbs, fruits/veg, dairy or alternatives), even if repetitive, that’s a good starting point. Over time, small, low-pressure exposures can gently expand their diet.

Can picky eating be linked to autism or sensory processing disorder?

Many autistic children or those with sensory differences experience feeding challenges. Understanding their sensory profile is key to supporting them.

Can I still go out to eat or attend social events?

Yes, plan ahead. Bring safe foods, communicate with hosts, and set realistic expectations. The goal is to help your child feel safe and included, even if they don’t eat the same foods as others. Speak with the family, child should feel safe everywhere.

Should I see a professional?

If your child’s eating is affecting growth, nutrition, or family life, it’s helpful to consult a health care professional.

Cheyne feeding support service

Website and links to useful information:

• Fussy eaters - NHS
• Eating
• The Feeding Trust - The UK charity for Paediatric Feeding Disorders
• Award-winning tools and support to make mealtimes with children easier | Child Feeding Guide
• Autism Charity | Ambitious about Autism
• Ellyn Satter Institute |
• Microsoft Word - Picky Eaters vs Problem Feeders - Color-white text