How to take the pressure out of mealtimes without giving up on nutrition

The short answer

Start by separating today's meal from the longer-term work of expanding variety. At an ordinary meal, provide at least one food your child can usually eat, serve a manageable amount and allow more, make the timing and ending predictable, and keep comments away from bites, bravery, body size and dessert. Do not hide ingredients or remove reliable foods to create hunger. You can still set calm boundaries around where food is served, what is available and what happens after the meal. Keep a brief record of intake and symptoms, and seek assessment when there are swallowing signs, pain, poor growth, nutritional concerns or serious restriction. Low pressure is not a treatment for every feeding difficulty, and the research on responsive feeding therapy remains developing. Its immediate purpose is to make eating safer and more understandable while the right health, nutritional or feeding help is arranged.

• Separate eating enough today from learning about other foods over time.
• Include a reliable food without requiring it to be earned.
• Replace bite-by-bite persuasion with a clear beginning, available choices and a predictable end.
• Keep health, swallowing and nutritional concerns on a separate assessment track.
• Agree the same essentials with school and other regular carers.