Picky eating and sensory sensitivity – what the research says

There are lots of reasons why children might be picky eaters – their temperament; problems with chewing or swallowing; a history of medical issues like reflux; to name but a few.

Equally, it is very common for toddlers to hit a picky patch, just… because. If you are parenting a picky eater, establishing what the root cause of your child’s eating issues might be, is essential. Without this information, it can be hard to help them move forward.

In this article, I’m going to talk about a root cause of picky eating which I see in my clinical practice a lot: sensory sensitivity. By ‘sensory sensitivity’ I mean how sensitive a child is to sensory stimulation; the information they get via their senses from the world around them.

In a really interesting recent study , researchers took a yoghurt and changed three of its properties: taste, texture and colour. They found that changing the flavour of the yoghurt had no significant impact on whether it was accepted by children, or not. Equally, when they changed its colour, this didn’t make much of a difference.

However, when they changed its texture – especially when they made the texture lumpy – the amount of yoghurt the children ate was much reduced. They concluded that picky eating may be related to ‘tactile sensitivity’ in children (Werthmann et al., 2015). In other words, how a food feels in a child’s mouth (and how an individual child’s brain processes that sense data) may be central to a child’s rejection of that food. Not only is texture important BUT it is potentially much more important than how a food looks and tastes.

As parents, I expect you already know this! You will have a strong sense of which textures your child finds hard and you will be more than aware of how even the most infinitesimally tiny changes to a food’s texture can lead to rejection. So what is going on for a child when they find textures difficult?

Well – let’s go back to the research evidence.  UK researchers, Claire Farrow and Helen Coulthard, carried out a study of almost 100 children,  in order to explore the relationship between sensory sensitivity, anxiety and selective eating. What they found was that children who were more anxious had higher levels of sensory sensitivity and were more likely to be picky eaters.

This is a complex picture and the researchers explain that more work needs to be done to establish precisely what the relationship between sensory sensitivity, picky eating and anxiety is. It is hard to know whether a child who is anxious generally, will be more likely to avoid new and disliked foods, thus eating a less varied diet, or whether their anxiety gives rise to challenging mealtime behaviours. In other words, is their diet limited because they are scared of tricky sensory experiences and new foods, or is it limited because their behaviour at mealtimes is problematic (Farrow and Coulthard, 2012)? Perhaps it is a bit of both.

What is important to note is that anxiety and sensory sensitivity appear to go hand in hand, so a child who is very sensitive to the sensory properties of their food is also likely to be anxious and to find novelty and change tricky.

Like the experiment with the yoghurt described above, Farrow and Coulthard also found that processing visual and auditory sense data (ie. what we see and hear) was not associated with picky eating. They found that how things feel, smell and taste were the key factors concerning sensory sensitivity and food rejection.

I wouldn’t discount auditory and visual sensitivity entirely, however. In my experience, when a child is in a crowded and noisy eating environment with lots going on in terms of what they can see and hear, if they are already struggling to process the sense data from their food, extra auditory and visual sensory stimulation can make things harder. Think crowded communal dining hall – not the easiest place for a very picky eater.

If your child has a high level of sensory sensitivity and food anxiety, here are my five tips:

• Respect their fears: They may seem unreasonable and hard to relate to from an adult perspective (how scary can a banana be??) but they are very real to your child.

• Understand their limited diet as a coping mechanism: They are sticking to a small range of preferred foods because that is their way of staying safe.

• Keep meals relaxed and positive: A child will not learn to accept new foods if the eating environment is stressful or they are pressured to eat.

• Help them tolerate tiny changes to their safe foods: this will help them gain in confidence with their eating.

• If their sensory sensitivity is extreme, push for a professional assessment: This could be by a speech and language specialist with the right expertise, an occupational therapist trained in paediatric feeding, a paediatrician (although some will refer on) or a feeding therapist.