Help! My child is a picky eater!

The picky eater phenomenon is not uncommon, and can be quite challenging and stressful for parents.

Picky eaters have the following characteristics/behaviors

• Eat a limited number of foods (20-30).
• Avoid classes of foods such as red meat or green vegetables.
• May reject foods they previously accepted, but will re-accept these foods after a two-week break.
• Will try some new foods after being exposed to the food several different times.
• Will touch and play with new foods, although they may not eat it at first.
• Picky eaters usually eat enough to support growth within normal ranges.  (1, 2)

How To Encourage Your Picky Eater, To Eat More:

To alleviate some stress, first examine if your expectations for your child’s eating is realistic. Kids are naturally wary of new things (think “stranger danger”), including new foods. Their first reaction to something they have never seen, smelled, touched or tasted before is to not trust it. Do not be discouraged if your child doesn’t love hummus, spinach, and salmon right away. It takes an average of 8-15 exposures to a new food before the child will actually eat it (2). Also, toddlers and teens particularly want to exert their sense of control and opinion, including what they will (and won’t) eat. In other words, sometimes a strong-willed child will refuse to eat what you want them to just because it gives them control over that aspect of their environment.

Typically developing young children will eat according to their innate hunger and satiety cues. That is, they will eat what they need when they are hungry and not when they are satisfied. Imagine how you might feel if you were full from dinner, and someone comes at you with a spoonful of food telling you to take another bite. Imagine you are really full, and the thought of taking another bite makes you sick. Now this person starts yelling at you and threatening to punish you. How would you feel? It can be difficult to let go and trust your child’s appetite. Your job as the parent is to provide healthy meal choices, regular mealtimes and snacks, and a positive eating environment without toys or TV.

Finally, using bribes like “one more bite and you can have dessert”, and punishments such as “you can’t play outside if you don’t finish your plate” are not effective in the long run. Doing these things negates children’s natural ability to eat what they need. It also creates a negative, untrustworthy dynamic between the child and the caregiver at the table. Picky eaters will continue to thrive and meet their nutrition needs when provided an optimal mealtime environment. A dietitian at North Shore Pediatric Therapy can counsel families to help picky eaters.

However, there is a difference between a picky eater and a problem feeder. Problem feeders have more rigid food preferences, a dwindling number of accepted foods, and will refuse food (and drinks) that are not part of their repertoire to the point of malnutrition. These children require more intensive evaluation and therapy, and benefit from multidisciplinary treatment available at North Shore Pediatric Therapy. I will further discuss problem feeders in my blog next week.

• Carruth BR, Skinner J, Houck K, Moran III J, Coletta F, Ott D. The phenomenon of “picky eater”: a behavioral marker in eating patterns of toddlers. J Am Coll Nutr 17:180-186, 1998.
• Carruth BR, Ziegler PJ, Gordon A, Barr SI. Prevalence of picky eaters among infants and toddlers and their caregivers’ decisions about offering a new food. J Am Diet Assoc. 2004 Jan;104(1Suppl1):s57-64.