Lessons on picky eating and how to deal with fussy eaters

picky-eater-babyPicky eating and fussy eating are often terms used interchangeably in order to describe toddlers, children and teens who are so selective in their food choices that it affects them on one or more levels; either physical health, socially, emotionally and developmentally.
For the sake of this article we will use the term picky eater. A picky eater can be defined as a toddler, child or teenager that avoids a number of foods from each food group or one or more food groups all together. The most common food groups avoided by picky eaters include the veggie and fruit group and the protein, meat group. The dairy food group is normally not a casualty of picky eating and most picky eaters will eat some form of starch.

Reasons behind picky eating are numerous. It may be due to a baby being born prematurely and being fed via a tube for extended an period of time. It may be due to a trauma like a severe gastro-baby-doesnt-like-veggiestummy bug or prolonged illness. It may merely be developmental in that around 18 months the quantity of taste buds in a toddlers mouth are double to that of an adult or older child. The implications of this is that sweet food tastes super sweet and bitter foods taste super bitter. Green veggies for example, have a slight bitter taste but to a toddler they taste extra bitter.

This explains why a toddler who ate everything as a baby suddenly decides he doesn’t like the veggies anymore. Coupled with the drive to independence and ego development this is fertile ground for picky eating.

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.

How you manage this phase as a parent will determine how long this phase lasts.

If your child has sensory processing challenges then some occupational therapy may be required alongside some nutritional therapy ensuring they are able to eat their basic nutritional requirements.

Here are some practical strategies to assist you in managing your child’s picky eating:

mom-feeding-babyParents 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.

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, i.e., 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 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.

feeding-babyYou want your child to eat the spinach you serve; your child drops it on the floor. Your well-meaning impulse may be to start talking up nutritious foods, saying how big and strong spinach will make your child. Or you might start bargaining: “Well, if you eat three more bites, I’ll give you a cookie.” The problem is that these tactics don’t work in the long run. Who hasn’t used the line about spinach making you strong? But this approach may build dislike for the healthy food rather than acceptance. This doesn’t mean you shouldn’t teach kids about the benefits of healthy foods, but don’t push too much by celebrating every bite of spinach your toddler eats or disapproving when he or she refuses.

For some kids, dinner becomes a negotiation session from the very start, and parents have been using dessert as an incentive for decades. But this doesn’t encourage healthy eating. Instead it creates the impression that “treats” are more valuable than mealtime food. Foods like candy and cookies are not essential to a child’s diet and it’s not a deprivation to not serve them during the toddler years.

eating-dinner-as-a-familyThreatening a punishment, much like bribing a child with dessert, ultimately isn’t effective either. It creates a power struggle.

To encourage healthy eating, continue offering your child an array of nutritious choices — and keep the mealtime pleasant.

  • Serve right-sized portions. Parents often overestimate how much food a child should eat. Especially with foods that aren’t yet favorites, a couple of tablespoons is plenty to start with. Small portions are less overwhelming, while bigger portions may encourage overeating.
  • Don’t negotiate. It’s fine to encourage kids to “try one bite” but don’t fall into the negotiating trap. Prepare and serve healthy meals and let them decide what to eat.
  • Have family meals together. Set your toddler’s place at the family table — it’s good for kids of this age to see their parents and siblings eating together and eating healthy foods. Kids eat a more nutritious diet, with more fruits and vegetables, when they regularly have family meals.
  • Create positive peer pressure. Toddlers are more likely to eat fruits and vegetables if they see their peers eating them, so look for opportunities where they can eat healthy with friends.

And remember this too will pass!

Kath MegawKath Megaw holds four medical qualifications including a paediatric dietetic qualification from the prestigious Johns Hopkins University in Baltimore, USA. She has been published in the Epilepsia journal on the use of the paediatric ketogenic diet in third-world settings and frequently speaks to groups of both professionals and parents on infant and childhood nutrition. She also speaks on television and radio. She is the co-author of Feeding Sense (Metz Press, 2012), has been in private practice for the past 15 years and is the founder of Nutripaeds, a paediatric dietetic practice.