What Causes Food Aversion?

The older you get, the more eating seems second nature by putting food in your mouth and chewing. As a child, though, trying and experiencing new foods isn’t that simple.

Food aversion describes food refusal by a toddler or young child despite having the fine motor skills to do so. Children with food aversion typically have a limited diet and are highly selective in what they eat. They may have a particularly strong dislike for a food while also enjoying other foods.

What causes this and what can you do about it? In this blog, we speak to Jenny York, a speech pathologist at INTEGRIS Health Jim Thorpe Rehabilitation Center. Read more to find out what you need to know as parents.

The complex dynamics of eating

Most people know about the five senses – visual (sight), olfactory (smell), tactile (touch), gustatory (taste) and auditory (hearing) – but there are also three additional senses researchers continue to learn about. They include proprioception (movement), vestibular (balance) and interoception (internal body signals).

Eating is the one activity that engages these senses, as the brain is hard at work to process different sensations.

How children learn to eat

The basics of eating can be broken down into 32 steps grouped into six subcategories. These skills must be learned for a child to eat. They include the following:

• Tolerates: The brain processes what food looks like, whether from afar or on a plate. Children explore the shape, size and color of food with their eyes.
• Interacts with: Once viewed, children learn to interact with food by using utensils or objects. For example, using cereal to play dump and fill games or helping to wash fruit.
• Smells: Some foods smell aromatic or fragrant and they can even smell bitter. In fact, humans can identify one trillion smells.
• Touches: Touching is one of the most complex senses for a child to master. It usually begins by touching a food with a finger or two and evolves into them holding it in their hand to understand the texture.
• Tastes: At first, they may only place their tongue on a food. Other times, they may taste it and spit it out.
• Eats: Once a child gets past these five stages, they’re finally ready to bite, chew and swallow.

What is food aversion?

Food aversion is one of many feeding, eating and nutritional problems children can experience. You may also see food aversion lumped in with picky eating, selective eating, restrictive eating or problem feeding, but it’s specifically used to describe a dislike for particular foods.

Here are some signs your child may have food aversion:

• Poor weight gain
• Cries or throws temper tantrums when exposed to new foods
• Won’t eat certain food groups or textures
• Chokes or gags when eating certain foods
• Vomits during or after mealtime
• Slow eating (meals take longer than 30 minutes)
• Mealtimes are generally unpleasant for the entire family
• Your child may have a specific routine and limited flexibility 

Children with food aversion usually won’t eat foods with a specific texture, smell, taste or color. For example, your child may only eat soft foods, such as bananas or oatmeal, and avoid anything with a hard or crunchy texture. Others may only eat sweet foods and avoid savory or bitter foods.

A true food aversion isn’t something your child typically grows out of. These children can’t be coerced or bribed into eating. Instead, intervention from a pediatric feeding therapist can help improve eating habits.

In more complex cases, food aversion can contribute to avoidant restrictive food intake disorder (ARFID), a type of eating disorder that leads to weight loss, nutritional deficiency or failing to grow.

The difference between food aversion and picky eating

If you’ve ever parented a toddler, then you have first-hand experience of the eating challenges that come with raising a young child.

Most toddlers will go through a picky eating phase due to food neophobia, a natural phenomenon that occurs when kids reject foods that are new or unfamiliar. This fear of food is actually a part of natural development that helps prevent children from putting dangerous things in their mouths. Neophobia is most prominent between 18 and 24 months old and usually improves as children grow older.

Therefore, food aversion shouldn’t be confused with picky eating, which is something most children grow out of. For example, most children will try foods after 10 to 15 exposures. Children with food aversion don’t. Additionally, children with food aversion may eat fewer than 20 different foods.

What causes food aversion? 

Food aversion isn’t usually about the food itself. Instead, it’s tied to a sensory problem, behavioral issue, traumatic experience or a physical issue.

Sensory

Sensory problems are one of the most common causes for food aversion. In most people, the brain is hard at work to process what you see, taste, hear, smell and touch. However, some people, especially children, have a condition in which the brain has trouble interpreting and responding to sensory information. In other words, their senses are overstimulated compared to others.

Difficulties with the senses can range from the texture of foods to how foods sound when they’re eaten (think of crunchy foods). Because the sensory system is overstimulated, it negatively affects the enjoyment of food. It can even cause some children to gag or vomit.

In children, this can be because they’re still developing their senses and they can become easily overloaded. Sensory issues are also common in children with autism spectrum disorder. Most often, the texture of foods affects these children negatively.

Physical

Some children have physical medical problems that can be attributed to food aversion. Examples include Crohn’s disease causing gastrointestinal symptoms, food allergies, intolerances or sensitivities, acid reflux, enlarged tonsils or enlarged adenoids.

Some children may have a history of chewing or swallowing issues that have led to choking or gagging. Others have difficulties absorbing nutrients from food, which can create additional stress on the body.

In any of these situations, the discomfort, pain or trauma associated with eating creates a negative association that leads to avoidance. Sometimes, it can be as simple as an illness that causes vomiting. The negative recollection of throwing up after eating a certain food makes the child reluctant to try that food in the future.

These types of food aversions are more common in children who have a history of medical problems, such as hospitalization or surgical procedures that require feeding tubes or intubation.

Behavioral

Some children have underlying behavioral problems, such as attention hyperactivity deficit disorder (ADHD), that makes it more difficult to eat a meal. Depending on their condition, children may be hyperactive, easily distracted or require a specific feeding routine. 

Food aversion may also occur because of dysfunctional parenting. Eating is supposed to be a pleasurable experience, but many parents focus too much on growth and physical development and place unrealistic expectations on eating. 

As a result, children can be force-fed, bribed or reprimanded for not eating what is cooked for them. One of the most common examples involves children not being allowed to leave the table until they clean their plate. This creates a negative association and a conditional aspect of eating.

Treating food aversion

Food aversion doesn’t have to be a chronic issue if it’s dealt with properly. If left untreated, it may develop into a restrictive eating disorder that becomes harder to treat. That’s why it’s important to stay on top of things.

In the event your child has food aversion due to sensory challenges, your child’s doctor may recommend a type of therapy called the Sequential-Oral-Sensory Approach to Feeding (SOS). Children learn to use a 32-step process to slowly acclimate themselves to foods. Parents also learn how to create a comfortable environment that allows children to enjoy mealtime.

Food chaining is another way to treat food aversion. The idea is to take foods a child eats and build off them with foods that are similar in shape, size, texture, color and taste.

Here’s an example: Your child may like only eating oatmeal for breakfast but refuses to try fruit due to textural differences. To put food chaining into practice, you can start by offering oatmeal mixed with a few pureed blueberries. The food will have the same texture with minimal changes in taste and smell (the oatmeal is still the star of the dish). 

You can then progress to oatmeal with chopped blueberries to add a visual and textural element. Then you can move away from oatmeal and offer blueberries with granola. Finally, you can offer just blueberries.

If you suspect your child may be dealing with food aversion, contact a pediatrician and request an evaluation from a speech therapist or feeding therapist at INTEGRIS Health Jim Thorpe Outpatient Rehabilitation Baptist. 

“Our speech team uses responsive feeding techniques,” York says. “Responsive feeding facilitates discovery of internal cues, curiosity and motivation to experience foods while building skills and confidence.”

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