Extreme fussy eating and food refusal

How do you know if your child's fussy eating is extreme?

Fussy eating is a normal part of development that usually starts around 18 months. Usually parents will report that their child previously ate a wide range of foods but now are picky and often refusing foods like vegetables. For all babies and young children I encourage families follow the "Division of Responsibility".

The parent's job is to decide the WHAT, WHEN and WHERE of feeding.

The child's job is to decide HOW MUCH and IF they will eat of the meal/snacks offered.

There are a lot of strategies you can put in place to help with fussy eating in your house and to make stressful mealtimes more peaceful. See my article on the Three key steps to happy meals for more information or contact Kathleen.

But what if your child is REALLY fussy? Maybe they only eat a handful of different foods, maybe they have a meltdown at even the sight of a new or disliked food.

There are some signs that your child may be more that a fussy eater:

1. They have a restricted range or variety of foods (usually less that 20 foods)

2. Foods that are lost are NOT regained. For example - one of your child's eaten foods might be yoghurt, but after eating that every day for 6 months they decide that they no longer like yoghurt. Generally a child regains a food after a few weeks but for an extreme fussy eater they might not eat it ever again. All of a sudden you are down to to even less accepted foods.

3. Cries and falls apart when offered a new food. Young children may get upset when a new food is on their plate - they might take it off there plate or just not eat it. For an extreme fussy eater just seeing a new food in the same room might cause a meltdown.

4. Refuses entire categories of food textures - When I see young children and go through a checklist of what foods they like/dislike often a fussy eater will still be eating a range of textures - crunchy foods, wet foods, hard foods. For an extreme fussy eater they may have difficulty eating certain textures  so limit themselves to soft foods for example.

5. Adds new foods in more than 25 steps. According to the SOS Approach to Feeding there are 32 steps to eating from tolerating the food in the room, on the plate, touching the food, smelling the food, licking the food all the way to chewing and swallowing the food. For most fussy eaters they can add a new food in 15-25 steps (most of which we don't even know they are doing). For extreme fussy eaters it may take a long time working up each of the 32 steps and celebrating the small positive steps.

*Adapted from picky eaters vs problem feeders - K.Toomey - SOS Approach to Feeding

Extreme fussy eating can be common where a child has a history of:


Choking or gagging

Tube feeding

Breastfeeding issues


What can you do if you think your child is an extreme fussy eater?

If you are concerned your child may have extreme fussy eating behaviours get help as soon as possible.

You may need input from a range of therapists including:


Occupational Therapist

Speech Pathologist


Kathleen is accredited in the SOS Approach to Feeding which is a therapy for extreme fussy eaters. She can can also link your family in with other therapies if required.

Remember if you think your child may be an extreme fussy eater - the sooner you get help the sooner your child will be progressing towards a better relationship with food. Give Kathleen a call or send a message to discuss how she can help your fussy eater.

Happy eating

Kathleen Halliday

Paediatric Dietitian & Lactation Consultant – Healthy Start Nutrition


 This website and information on this blog post is provided for educational purposes. It is not meant or intended to replace Dietetic assessment/ management or medical care for a child. It is recommended that you discuss any concerns or questions you might have about your child’s feeding/nutrition with Kathleen individually and develop an individualised plan specifically for your child.


About the author of this blog post

Kathleen Halliday is a Paediatric Dietitian & Lactation Consultant with extensive experience working with children and their families – especially around fussy eating, stressful mealtimes, growth concerns and nutritional management of many medical conditions.

Healthy Start Nutrition is a private practice based in Melbourne, Victoria.

You can connect with Kathleen via her website www.healthystartnutrition.com.au or follow Healthy Start Nutrition on Facebook and Instagram.