zt: How to Handle Your Picky Eater

Do you know a “picky eater”?  “Picky” eating is when a child (or adult) refuses foods often or eats the same foods over and over.  Picky eating usually peaks in the toddler and preschool years.  Many parents worry that their picky eater is not getting enough nutrition to grow.  But in most cases, he is.  Keep a food diary for a day—writing down everything your child eats—and you will probably find that he is eating more than you thought. 

If you are worried or have questions about your child’s growth or nutrition, it is a good idea to talk to your child’s health care provider.  Keep in mind, however, that as long as your child is not losing weight and has the energy to play and interact, it is likely that he is eating enough to support his growth. 

Picky Eating and Young Toddlers
Picky eating often surfaces around one year—a time when many children are beginning to feed themselves.  They can now choose what and how much to eat, giving them  some degree of control over their lives.  So some days they may eat a lot of everything.  Other days they may not seem to eat much at all. 

In addition, while children usually grow a lot and quickly in their first year, growth slows down in the second year.  Toddlers are also learning lots of new skills, like talking, walking, running, climbing, and more.  During a time of great change, children often seek “sameness” as much as possible, including sticking  to the same small group of foods.  This consistency can help them feel safe and secure during a period of rapid change. 

Parents also need to be in touch with their own expectations about how much their toddler “should” eat.  It is unrealistic to expect a toddler to eat a large amount of food at each meal everyday; after all, a toddler’s stomach is approximately the same size as her clenched fist (Martins, 2002). 

Ellyn Satter, MS RD LCSW BCD, a researcher and practitioner in the field of pediatric feeding practices, explains that both parents and children have their own “jobs” to do when it comes to eating.  Parents are responsible for providing healthy foods at meal- and snack-times.  Children are responsible for what and how much they eat.  This helps children learn what it feels like to be hungry and then full—and how to make healthy choices based on this awareness, ie., eating when hungry and stopping when full. 


The Role of Parents
Research has found that parents’ food preferences are linked to their children's food preferences (Borah-Giddens & Falciglia, 1993).  This is probably not a big surprise since we are more likely to prepare the foods that we enjoy, so our children are more familiar with that group of foods than others.  Familiarity with foods is key, as a child may need up to be exposed to new foods more than 10 times before they try it.

What can you do to help your child enjoy a range of foods? 

• Eat a range of healthy foods yourself.  Make sure that your own choices are in line with the foods you want your child to eat and enjoy.
  
  
• Prepare meals together.  Having a hand in making the meal increases the chances that your child will taste her “creation.”  Have your little one assist with measuring, pouring, or stirring.
  
  
• Avoid showing disgust or disinterest when trying new foods.  A study found that mothers who showed (with their facial expressions, body language or words) that they didn’t want to try a new food had children who also tended to refuse new foods (Carruth & Skinner, 2000).  In short, your young child will probably be less willing to try something new if you haven’t tasted it.  And if you are a “picky eater” yourself, then your young child is likely to imitate you in this behavior, just as she imitates the way you talk on the phone or the way you wave good-bye to her each morning at child care.    
  

What to Do About Picky Eating
There are many reasons why a child may be choosier than usual at mealtime.  Listed below are some of the most common causes of picky eating and ideas for how to respond.  (Adapted from Lerner & Parlakian, 2007).

Some children are sensitive to the taste, smell or texture of food.  You can:

• Offer several healthy food choices—among the foods your child does like—at each meal.
  
  
• Gently but frequently offer new kinds of foods. Children need to be offered a new food as many as 10-15 times before they will eat it.
  
  
• Track your child’s food sensitivities and keep them in mind when preparing meals.  Does your child have trouble with “mushy” foods?  Then offer apple slices instead of applesauce, or a baked potato instead of mashed.  If you’d like your child to try a “mushy” food, combine it with a crunchy food that she does like.  Give her an animal cracker to dip in the applesauce.
  
  
• Talk to your child’s health care provider about any nutritional concerns you may have.

Some children are simply less likely to try new things based on their temperament—their individual way of approaching the world.  You can:

• Put new foods next to foods your child already likes. Encourage him to touch, smell, lick, or taste the new food.
  
  
• Avoid becoming a short-order cook and preparing special meals for your child.  But do make sure that at each meal, there is something he knows and likes on the plate.  Also give him what the rest of the family is eating in toddler-sized portions.  Over time, these choices will become as liked and familiar as her favorite mac-n-cheese.
  
  
• Gently but frequently offer new kinds of foods. Children need to be offered a new food as many as 10-15 times before they will eat it.
  
  
• Use healthy dips such as yogurt, hummus, ketchup or low-fat salad dressings to encourage children to eat fruits, vegetables, and meats.
  
  
• Involve your child in preparing the meal (like dropping cut-up fruit into a bowl for fruit salad).  Handling, smelling and touching the food helps your child get comfortable with the idea of eating it.

Some children can seem “picky” because they want to feed themselves.  You can:

• Offer safe “finger foods” that your child can feed herself.
  
  
• Offer your child a spoon to hold while you’re feeding her. This lets her feel in control.
  
  
• Let your child decide where foods go on her plate—the peas there, the turkey there.  If you’d like, you can also let your child serve herself (put your hand over hers to help her handle the bigger serving spoons). 

Some children are very active.  They may seem picky because they don’t like sitting for long.  You can:
Set your child’s meal out before he sits down.

• Keep mealtimes short—10 minutes or so.  Let your child get up when he indicates he is finished eating.
  
  
• Put healthy foods, such as a bowl of strawberries or bananas, where your child can reach them so when he gets hungry he can easily get to good foods.

Some children have medical issues that make it difficult to swallow or digest certain foods.  You can:

• Seek an evaluation by a health care provider. Sometimes children need special help with feeding.    

What NOT to Do About Picky Eating
There are two big pitfalls to avoid in order to encourage healthy eating behavior.  They include: 

Forcing your child to eat.  The fact is that forcing children to eat usually leads to the child eating less. Forcing also teaches children to rely on others to tell them how much to eat and what they are feeling.  This does not lead to healthy eating habits or good self-esteem.  In fact, some research has shown that forcing children to eat actually can make picky eating behavior worse (Sanders, Patel, Le Grice, & Shepherd, 1993).

When it comes to eating, it can be helpful to see it as you and your child each having your own jobs. Your job is to provide your child with healthy food choices and pleasant meal and snack times. It is your child’s job to decide which of these healthy foods to eat and how much to eat. When you approach feeding this way, your child learns to listen to his body and make healthy food choices. It also leads to fewer power struggles between parent and child around food (Satter, 1990).

Nagging or making deals with your child.  “Just two more bites, just two more bites!” “If you eat your vegetables, you will get dessert.” Strategies like these don’t work in the long run. Children who learn to make deals about eating quickly learn to make deals and ask for rewards for doing other things—like brushing teeth or getting their shoes on. And soon they won’t do anything unless there is a reward for it!    


What About Dessert?
Ah, dessert.  Many parents struggle with what to do about sweets.  Daniel, father of a toddler and kindergartner, shared his family’s dilemma:

I’m fine with letting them choose how much they want to eat.  But after they’ve basically eaten nothing, then they want dessert.  I feel like I’m getting taken advantage of if I give it to them.  If I try to get them to eat more, it’s worse because we end up negotiating the entire meal:  “Okay, if you have 3 more bites of meat, you can have a cookie.”  It’s gotten to the point that my 6-year-old will ask at the beginning of the meal, “How much do I need to eat in order to have a treat?” 

How do you handle the “cookie cravings” in your little ones who insist they are done with dinner (after 3 noodles) but still have room for something sweet?  The following are some ideas for handling this common dilemma.

• Serve a small treat with your child's dinner (for example, one cookie or a small muffin).  Yes, he may eat it first or he may eat only that.  That’s okay.  Over time, your child will come to see that sweets are part of a meal, but not the only part.  He will get hungry for other foods.  Soon, you might even find that he leaves the sweet on the side opting to eat the healthier foods first.
  
  
• Serve a small treat at the end of the meal regardless of how much your child has eaten.  Again, this teaches your child that sweets, when eaten in moderate servings, have their place..  It also takes away the power of the dessert being a big, special reward that they are constantly pining away for. When you avoid negotiating “if you eat this, you get that”, you also eliminate a big power struggle.  You may find that your child eats more on his plate as a result.
  
  
• Eliminate sweets altogether.  Some families believe that cookies, cakes, etc. are not appropriate for their family’s diet.  Instead, try offering fresh fruit or cheese to end the meal.