Published on May 01, 2017

What to do if your child is a picky eaterWhat to do if your child is a picky eater

When a child refuses to eat healthy foods, parents worry that he or she is missing out on important nutrients and vitamins.

It’s a common problem for parents to bring up to their pediatrician, according to Emily O’Connell, MD, of Falmouth Pediatric Associates.

“I give the picky eating talk at least a few times a week and sometimes a few times a day,” she said. “Generally parents who are adventurous eaters are a little bit more likely to have children who are adventurous eaters, but that is not true across the board. There are some kids who are naturally pickier than others.”

Dr. O’Connell knows about picky eaters first-hand. Her 15-month old son is very particular about what he eats.

“This is one of those topics that I thought was easier when I was just a pediatrician,” she said. “When the picky eater is sitting in your own high chair it’s much more frustrating than when they are in your office. I always thought that if you just offer the right variety of food, the kids would eat. Well sometimes they do, but sometimes they don’t.”

Even with personal experience, Dr. O’Connell hasn’t changed her medical advice on how to deal with this problem. Her advice falls into two categories: toddler eating and older children.

Toddlers Want Control

Picky eating usually first shows up when children are toddlers. There are several reasons for this timing.

“One reason is that toddlers are busy individuals, physically and also mentally and developmentally,” she said. “So sometimes they are interested in eating and other times they would much rather be playing with the ball they just learned about or working on some other skill that they are in the process of developing.”

The second reason has to do with issues of independence and control. Food and food choices are a great way for kids to test their independence. They quickly figure out that the parent can present food, but the parent can’t really make them eat it.

“Toddlers and young children don’t have control over much in life but one of the things that they have control over is what they eat,” Dr. O’Connell said. “I always say, don’t make food a battle. That is not one of the things you want to fight with a toddler about.”

She advises parents to keep offering a wide variety of healthy food. That includes offering choices that toddlers have previously rejected, because it can take 15 to 20 tries to get a child to eat a new food or learn to like a new texture.

For frustrated parents, it helps to remember that parents and kids have two very separate jobs concerning food, she said. The parents’ job is to provide a good variety of healthy foods. The child’s job is to decide what, when and how much to eat. If you’re doing your job, you have to trust that eventually your child will do theirs.

Keep All Plates The Same

For older children, Dr. O’Connell said it’s important to make sure that the food on the child’s plate is the same food that everyone else is eating.

“I try hard to encourage parents not to be short order cooks,” she said. “The technical term for it is parallel cooking, but essentially it means providing a second meal to the child in addition to what everyone else is eating.”

If you are making a dinner you know your child isn’t fond of, it’s OK to also cook something complimentary that you know they will like. But continue to put the unpopular food on the plate and encourage them to try it again. It’s good exposure and eventually they may eat the food, she said.

No one is perfect and exceptions can be made when occasionally dining out or if a child is sick or you’ve had a bad day. No child has ever suffered from the occasional meal of chicken fingers and French fries, but it shouldn’t be a steady diet, warned Dr. O’Connell.

Kids are very sensitive to figuring out if their parents will eventually cave in and offer them a second option that they would prefer. It’s better for your child if you don’t fall into that trap. With any age, the more variety you can provide them with and the more frequently, the better they will do.

There Are Exceptions

The exception is the special population of children who have true disordered eating or eating phobias. Signs of this include a child who will only eat certain brands of foods or only eat one particular food. Children with disordered eating usually also exhibit significant anxiety.

“Those children get treated a little bit differently, with counseling, with occupational therapy, with speech therapy, a sort of multi-disciplinary approach where the kids rethink and approach things from a different angle,” she said.

She always assures parents that having a picky eater doesn’t mean that a parent did something wrong. It just means that it’s going to be a little bit more challenging to get the child to accept the variety of foods that they would like them to have.

“If parents are worried, they should always talk to their pediatrician just to make sure their child doesn’t fall into one of those special categories like they are not gaining weight for some reason or they have a particular pattern of eating that would be concerning,” she said. “But in general, if they are hungry enough, they will eat.”