food into a child as possible. We focus too much on short-term quantity – kidding ourselves that if they are pacified with enough baby rice they’ll sleep better – and not enough on building long-term tastes. ‘The only mums we see who talk about developing a child’s palate are French,’ in Cooke’s experience.
From four to seven months, it seems that there is a window when humans are extraordinarily receptive to flavour, but by following current guidelines on exclusive breastfeeding, parents tend to miss it.55 Several studies have shown that when vegetables are introduced at this age, babies are more open-minded. It takes fewer exposures to persuade them to like a new flavour and the effects are long-lasting. When seven-month-old babies in Germany were exposed to a vegetable purée that they particularly disliked – such as spinach or green bean – it took only seven attempts for them to like it as much as their once-preferred carrot purée.56 Two months later, all but 10 per cent of the children still enjoyed the once-hated vegetable, even though they had now reached an age of greater wariness. The flavour window is only fully open for a short time and seems to decline even from four to six months. A 2014 study found that when babies were introduced to a single vegetable at six months – pea purée – they ate significantly less of it than babies who were introduced to a range of purées at four months.57
For this reason, Cooke disagrees with the 2001 directive from the World Health Organization (WHO) that said babies should be offered an exclusive diet of breast milk for six months, with no additional solid food. This WHO report forms the basis of official guidelines to mothers in most countries, even though the statistics it was based on were mostly from the developing world, where the risks of moving away from exclusive breastfeeding before six months – such as an increased chance of gastroenteritis and faltering growth – outweigh the benefits. In rich countries, however, the norm is for most mothers to stop breastfeeding, exclusive or otherwise, well before six months. In the UK just 1 per cent of mothers are still exclusively breastfeeding at six months after birth.58 In the US it is 18.8 per cent.59 The main effect of the official guidelines is to hold back many formula-fed babies from experiencing any flavour except for milk from four to six months. Here, the real risk is in producing children with limited tastes who will be set up for a lifetime of unhealthy eating. As so often, we fail to see the long-term picture.
It’s not that a four-month-old baby is likely to grow any better in the short term when their diet includes a spoonful here and there of veg. It’s that waiting until six months to wean is to miss two months in which a child could be tasting different vegetables every day, preparing them for a recognition – and hence liking – of those same vegetables at a later stage.
The second mistake parents make – and they are encouraged to do this by those baby feeding guides with their brightly organized charts of first foods – is starting children off with bland, honeyed tastes, such as carrot, butternut squash and sweet potato. Start with those vegetables that are naturally sweet, urges the UK’s bestselling author on baby food and save stronger flavours for later.60 The really useful thing, however, would be to get a baby used to more bitter or challenging vegetables: cauliflower, courgette, spinach, broccoli, even sprouts. Weaning guides often advise sticking to a single vegetable for a whole week before switching – for fear of food allergies – but Cooke advocates lots of variety and daily changes to maximize exposure before the child enters the age of neophobia. When novel vegetables are offered to a six-month-old, the baby will often make the most dramatic expressions of horror and woe, screwing up the mouth and nose in ways that, on an adult face, would suggest torture. The hardest thing for parents is to press on with offering the food. ‘We have to persuade mums to ignore the face,’ explains Cooke. Unlike Clara Davis, who wanted to see how babies would eat away from parental influence, Cooke has devised pragmatic experiments recognizing that parents are part of the feeding process. Her starting point is always looking at what parents already do when feeding children and trying to find evidence-based techniques to help them do it better.
What if you have missed the ‘flavour window’ and are now attempting to feed a toddler who fears anything green? Is all hope lost? Cooke and colleagues found that even with school-age children, there was a great deal that could be done to change apparently fixed hatreds of certain foods. Their first revelation was that much of what manifests itself as fussiness is a response to the stressful situation of mealtimes. It can get to the extreme point where lunch itself is a ‘dislike’ – the pressure, the heightened emotions – no matter what is served. Cooke found that if parents could do tasting sessions with children outside meals, it could take emotion out of it. In addition, they only asked children to try pea-sized amounts of food, which reduces the feeling of pressure. ‘The demands on the child have to be very low.’ A whole plate of cauliflower is a horrible prospect if you don’t like it. A minuscule fragment might just be OK.
Cooke helped devise a new system for encouraging more vegetable ‘likes’ called Tiny Tastes.61 It was trialled in both schools and in homes and has proved remarkably effective in making children actually like raw vegetables such as carrot, celery, tomato, red pepper and cucumber. I used the scheme on my own youngest child – then aged four – and was startled how quickly it turned him from someone who said ‘yuck’ when he heard the word cabbage to a happy nibbler of raw green leaves. It works like this. The parent and child together select a vegetable that the child currently moderately dislikes (as opposed to feeling deeply revolted by). Each day for ten to fourteen days, not at dinnertime, you offer them a pea-sized amount. If they taste it – licking counts, it doesn’t have to be swallowed – they get a tick in a box and a sticker. If not, it’s no big deal; there is always tomorrow.
The usefulness of Tiny Tastes is that it provides a non-stressful way to enact the multiple exposures that we seem to need to develop new tastes. In our house, it changed the whole conversation around mealtimes, from one of stress and anxiety to something – mostly – more positive and mellow. Because he chose the vegetable himself, my child seemed to feel less trapped. Plus, he really likes stickers. Lucy Cooke said that before they started using stickers in their experiments, there would always be a few children who would refuse to take part; with stickers, participation went up to 100 per cent. Cooke’s research overturns the previous orthodoxy that offering rewards for eating would make children like the food even less. Her hunch is that rewards only work first when they are not themselves food and second when the child feels they have genuinely worked for them. If you reward someone for eating a healthy food that they already like, it confuses them. But it takes a real effort for a child who dislikes raw red pepper to put that first morsel in their mouth, hence they feel they deserve the sticker.
This approach to creating new, better likes sounds almost too good – too simple – to be true. For one thing, it only addresses vegetables, which is a good place to start, but there’s a lot more to a healthy diet than just greens. For many children, it is the protein foods – eggs, meat, fish – that are the hardest to love. Tiny Tastes also presumes that a child will willingly cooperate, once stickers are proposed. What about the hardcore food refuseniks? Some people have very definite dislikes with their roots in complex conditions, which surely can’t be wished away with a sticker.
When children have learning difficulties or other disabilities, one of the many daily tasks they often tussle with is eating. Children who are slow to speak also tend to be slow to master the skills of eating, because there is a strong relationship between the muscle control needed for language and for chewing and swallowing. Eating can also become a problematic business for those whose condition involves rigid behaviours and routines. Those on the autistic spectrum are far more likely to have a wide range of problems with food than other children. It’s been estimated that 75 per cent of children diagnosed with autism have severe feeding difficulties.62 They may demand exclusively ‘yellow’ food (crisps, corn, biscuits, popcorn, fried chicken), or refuse to eat a meal unless none of the components are touching. Above all, autistic children are likely to have a very narrow range of foods that they find acceptable.63
Jim,fn1 aged three and a half, was an autistic boy with serious eating problems by the time he arrived at the Penn State Hershey Medical Center in Pennsylvania. He ate only two foods, toasted cheese sandwiches and hotdogs, supplemented with frequent glasses of milk. In addition, Jim tended to