One wonders if fussy children abound in the developing world.

During my 60+ years on this mortal coil, I have never seen so many clinical diagnoses — excuses — made for children’s behaviour.

On June 30, 2023, I was appalled to read an agony aunt column in The Guardian, ‘My daughter will only eat junk food. How can I get her on a healthy diet?’ The child in question is eight years old.

Guardian readers are not the only ones with this problem, I hasten to add.

Having no children, these bewildering issues have passed me by, thankfully. However, I was intrigued to learn that there is a clinical condition called ARFID. The agony aunt, the wonderful Annalisa Barbieri wrote (emphases mine):

Arfid stands for avoidant/restrictive food intake disorder. Dr [Gillian] Harris [registered with the British Psychological Association] told me it generally starts to manifest around the age of two, when children become more aware of the sensory properties of their food. “If food doesn’t look or smell right,” explains Dr Harris, “or isn’t easily identifiable or consistent then children can drop those foods.” Harris says Arfid is related to sensory reactivity and anxiety and is largely genetically determined. Those with Arfid are also not overly interested in food.

For children with Arfid, certain foods are unbearable, so they are not just being “fussy”. It’s no surprise your daughter is going for foods that look and taste consistent. Dr Harris says she always sees chips from a certain fast food manufacturer on the “accepted” list, precisely because “they are always the same”. Arfid children don’t like surprises, and anxiety will cause their sensory reactivity to increase.

What to do? First make a list of what your daughter does eat. It’ll probably be more than you think. Second, as Dr Harris says, “pushing your daughter is not going to help; the more anxiety [there is around food] the worse it’s going to get. Her height and weight are fine and she’s active.” Dr Harris didn’t think your daughter’s diet was that bad, but strongly recommends you don’t “make her go hungry, because she will go hungry; this won’t tempt her to eat”.

With help your daughter may develop beyond Arfid (many children do) and that help starts with not making any of your issues her issues. In time she may be motivated to try more foods (Dr Harris said it takes about 10 tries to get to like a food).

Dr Harris also said “talking about her weight is an absolute no-no. Forget talking about healthy and unhealthy food, just go with it.”

Don’t try to trick your daughter either. It’s important you remain calm and don’t force; if she learns she can’t trust you around food that will work against you. Otherwise, just go with what she’ll eat.

Dr Harris did wonder about your daughter’s protein and iron sources. So you could say something like “you could have a bit more protein. Let’s look at where you can get that from.”

If you’re still worried you could try to see a dietitian, who understands Arfid. Try through your GP or if you want to go privately via the British Dietetic Association –if they are worried about her, they might prescribe a supplement.

I reckon that a child in the Congo, India or Venezuela is unlikely to develop a sensory reaction to food. They will be only too happy to eat a meal.

This is a first world problem. It seems Western children have a lot of first world problems, which I won’t go into here, but the reader comments brought up autism as being linked with ARFID. Someone professional needs to do a deep dive into autism and find out why so many Western children — particularly in English-speaking countries — seem to have it. I doubt that there are many French, Italian or Iberian children who are diagnosed as being autistic.

Anyway, as much as I like Annalisa Barbieri’s columns, the readers comments are also useful.

I was happy to see that I am not alone in being appalled at children and their parents. These three comments are from page 5:

  • ‘Stop serving her crap on demand.’

That might have been the advice thirty years ago, but it certainly wouldn’t fly now. Somehow, parenting has come to mean letting kids make all their own decisions. I had one young family – my dinner guests – start to pack up their things before the meal because their six-year-old suddenly said, “I wanna go home”. Another time, the kids were tasked with deciding where our two families would go out for dinner … a junky chain restaurant, of course (and where the mom and dad left much of their food – mostly fries – on their plates). Maybe this never-say-no philosophy builds decisive character, but I have had to step back because it feels like dishonouring myself to submit to it.

  • My husband was with family a while ago for a meal. The seven year old nephew didn’t like what was on offer and used his Dad’s phone to ‘Deliveroo a Happy Meal’. No one batted an eyelid. It’s beyond me, to be honest.
  • Standing firmly with you. I bet there are lots of us out here, not least because the kind of things you … describe here are completely and utterly indefensible.

This comment went beyond the eating issue and straight to the mother concerned. It makes a lot of sense. It seems to come from someone whose first language is not English, so is worth noting for a different perspective:

I totally disagree with this advice.

A child needs a strong, reliable grown up with clear rules and boundaries. This allows them to trust, let go and be children. But when this is lacking, things get complicated. Because it leads to the really complicated reality, that these children then have to do the work of the grown ups (like for example choosing their meals ALL the time aka being responsible for their own care). Sadly it it not rare, but happens all too often, that children are forced to do emotional, social grown up stuff.

In truth I think, that to change what your daughter eats, you first have to look at yourself.

Your very first sentence of your letter makes sure to mention how good a mother you are. Which tells us just one thing: that you are very unsure/insecure about this. And of course your daughter knows this, too. How could she not?

I have a strong feeling that you never quite stepped up to really be reliable for your daughter, if it involved setting boundaries or stress or tough choices. If you could dodge that, or compromise, you did. Which then led you to compensate this in other ways. And I have a strong feeling, that this whole muddle is exactly the emotional work you have to do. On yourself. My questions to you therefore would be: is judgment from outside for you extremely stressful/important? Do you have problems with (what you conceive as) disapproval? Do you think you have a good self esteem? Can you say “no“?

Part of your problem you explain yourself in the part of the letter about your own weight. And of course such problems are not restricted to one part of one‘s life, like weight, they are about oneself. The WHOLE self. That is simply the way we function. If we are insecure about our weight, we are not in all other areas totally secure. No, if we are insecure about our weight, we are insecure. Period.

Look, I think deep down you know all this. It almost springs at one when reading the letter. And you want things to change or you would not have written. So I want to say to you: it really is ok. This is not about fault or guilt. Do not feel bad. Nothing is lost forever. It will take hard work to turn things around, but it is possible. And there are also good news: the more you work on it, the easier it gets. The more energy you put into it, the faster it costs you less and less energy. And: it is well worth it.

I will not write here the full program/steps you have to take. Professional help is available everywhere. The truth is: Your child eats fast food/decides herself what she thinks is ok to eat, because you have not taught her differently. She has refused your lesson, because she has not enough trust in your expertise and choices to follow your example or do what you tell her to do. And why not? Because YOU do not have this kind of trust in yourself! Children pick up all these emotional signals in an instant. After all, this is their job for all their childhood: watch and learn. And they do. The good and the bad.

And I think she really would be more than thankful to have not to care for herself at that age. I know some of this might sound harsh, but to acknowledge the reality and not shy away from it, because it is unpleasant is part of being a grown up and especially a parent. And is it not also a relief to have things out in the open? No hidden doubts, fear and shame.

We all try our best with what we know. The good thing about being a human being is, that when we know more, we can try our best anew with this new knowledge. That is all it is. Do not feel bad about it. Instead just try it better. I know you can.

Maybe some of this rings a bell for you and then I hope it is helpful. If it does not and is not, I am sure some other comments do and are. I wish you all the very, very best.

P.S. Of course you must make sure there are no food allergies or other health issues with food, but I am pretty sure this will not be the case. It just has to be ruled out.

Unfortunately, most of the comments said that the girl should eat whatever she feels comfortable eating. People who are older said that they had to eat whatever was put in front of them, e.g. when rationing was still in place after the Second World War or when growing up in the 1950s, ’60s and ’70s.

This food fussiness is recent, dating from the 1980s or ’90s. It is unfortunate that it is being classified as a clinical condition, but such is the way of the world.

Several readers suggested that the mother refrain from buying junk food in the first place. Excellent!

Others said that the mother should involve the daughter in preparing the daily meal. That is also excellent advice, because I know from a former neighbour of mine that her young son ate mushrooms only when he sliced them himself.

We are too indulgent a society. That’s all.

That said, everyone is allowed something they really can’t stand to eat: bananas, broccoli or even chicken, which I couldn’t eat between the ages of seven and 18 without getting ill. Somehow, when I went to France at age 18, I had homemade creamed chicken and rice as a dinner guest and couldn’t get enough of it, even though I had only a single portion. Since then, my enthusiasm for chicken has been huge.

How do French mothers get their children to eat vegetables? Purée them and add them to a sauce. The kids don’t know the difference.

The Guardian reader who pointed the finger at the mother has it spot on. Perhaps anyone doing a deep dive into autism should also look at the parents and their skills in raising children. Harsh, maybe. But it’s worth considering along with other factors.