Picky Eaters and How to Handle Them

One of my kids is good at eating: New flavor? New color? New texture? Bring it on! However, my second one is very particular in his food choices: don’t you dare surprise him with anything new and exciting! How can two siblings be so different?  Where do the picky eaters come from and how to handle them? This puzzled has been laid for ages for me, but recently I had a chance to ask Katja Rowell, M.D., a family doctor specializing in childhood feeding and Jenny McGlothlin, MS, CCC-SLP, a speech pathologist and pediatric feeding therapist a few questions. Together they recently published a book  Helping Your Child with Extreme Picky Eating: A Step-by-Step Guide for Overcoming Selective Eating, Food Aversion, and Feeding Disorders

Does picky child mean spoiled child? 

Young children are naturally neophobic, meaning that they are wary of new food. This stage usually begins around 18 months of age, just as they are also learning the power of “no!” These two normal developmental phases come together to create what we see as “picky” in about one in three children, which usually goes away around Kindergarten. Sometimes, when parents worry about a child’s nutrition or growth, or money is tight, children may be served only foods that the parents “know” they will eat. Parents end up short order cooking, which makes it harder to learn to eat a wider variety of foods— and children change their minds anyway. We recommend that parents eat with their children as often as possible, and provide a variety of balanced food choices along with 1-2 of the child’s familiar foods. Having a generally liked food on the table, like rice or bread or apple slices, allows the child to come to the table knowing they won’t go hungry. Seeing parents enjoying the foods they are expected to grow up and like to eat allows children to see how foods look and smells, to explore, and eventually branch out. Mealtime negotiations, bribes, pressure, nutrition lectures, arguments about food, and short-order cooking confuses the parent’s job of deciding what foods are served and when, and the child’s job of deciding how much to eat (or not eat) from what is available. (Known as the Division of Responsibility in feeding, widely considered best practice by Headstart, feeding experts and public health programs, WIC nutrition and more…)

Why does one of my kids eat anything and the other one is extremely picky?

Children, like adults, can have very different feeding temperaments, in other words, how they approach and are interested in food. Some folks enjoy food, and look forward to meals, others have a less intense appetite, could skip meals and don’t really seem to get much pleasure from eating. They also come to the table with different sensory systems and different early experiences with food. There are five basic “reasons” that we believe contribute to picky eating. These include medical challenges (“It hurts!”) like reflux, or anything that causes pain or discomfort around eating; oral motor challenges (“I can’t!”) that make it difficult to chew and swallow food comfortably; sensory challenges (“I’m uncomfortable, I don’t like how this feels, smells, tastes…”) that lead to discomfort with different textures and sensations; temperament and mood: high levels of independence (“I want to do it!”), general anxiety (“I’m scared!”), or a highly sensitive nature; negative experiences such as choking, repeated gagging or vomiting, force-feeding, or a history of traumatic medical interventions like oral surgery or ventilation.

Your ‘omnivore’ likely has a feeding temperament that is adventurous, curious, and laid-back while your picky eater is cautious, possibly anxious, and skeptical about new foods. He may also be very strong-willed and want to do things his own way and in his own time. Both children can be raised and fed the same way, even with these strong differences.

How can I make sure my “I only want Nutella and toast” son gets proper nutrition?

Variety is the best way to achieve nutrition, but when registered dietitians analyze children’s diets, even picky eaters, parents are usually happily surprised that their child is meeting their basic nutritional requirements. For example, many parents worry about protein, but most children in America get more than enough. Iron is one nutrient that children with extreme picky eating may need more of; work with your doctor or a pediatric dietitian if you have concerns. Many foods are fortified these days, however, so your child may get better nutrition than you think.

Many children eat a small variety of foods but those foods provide the nutrients they need. Nutella toast (2 Tablespoons on wheat bread, served with a glass of milk) would provide 12 grams of protein, some fat and carbohydrates, and has less sugar than jam— a pretty good start to the day. In other words, put the goal of better nutrition NOW on the back burner while you set the stage for eating success. This is the best way to get to improved nutrition.

Want to know more about Picky Eaters and How to Handle Them? We will be back with more answers from Helping Your Child with Extreme Picky Eating book in two weeks.

 About the Book:

Helping Your Child with Extreme Picky Eating: A Step-by-Step Guide for Overcoming Selective Eating, Food Aversion, and Feeding Disorders (New Harbinger, May 1, 2015) is a new book by Katja Rowell, M.D., a family doctor specializing in childhood feeding, and Jenny McGlothlin, MS, CCC-SLP, a speech pathologist and pediatric feeding therapist. This is not just another pickyeating book. Suzanne Evans-Morris Ph.D., internationally renowned pediatric feeding therapist and author, described it as “… a perfect union of relational insights and understanding with deep therapeutic knowledge and many practical strategies that empower parents to help their children where it’s needed most—in the home—and in the presence of even serious eating challenges.”