Picky Eaters

Most children until the age of about 18 months will eat just about anything, including the ladybugs they pincer grasp up off the floor and place in their mouths like a delicacy!

Between 18 months and 2 years, children’s growth slows dramatically.  Infant typically will triple their birth weight in the first year, and then put on an average of 5 pounds and 4-5 inches in the second year. After that, they will gain about 4-6 pounds and grow 1.5-3 inches a year until puberty (this is an average- we will chart your child’s growth yearly,and share any worries if we feel they are not growing at the right pace.)

As growth slows, appetite will diminish as well.  In addition, growth will happen in spurts, so your child may eat little one week, and a lot the next.  In general, a toddler will eat one meal, one half meal and one “no” meal daily- sometimes a few cheerios and a swallow of air seems to fill them.

Key to feeding children is Ellyn Satter’s “division of responsibility”- YOU offer 3 meals and 1-2 snacks (of meal like food) a day.  Your CHILD decides if they will eat or not.  

This is a MUST READ:

The Satter Division of Responsibility in Feeding:  https://www.ellynsatterinstitute.org/wp-content/uploads/2021/12/sDOR-tasks-cap-2022-Ellyn.pdf

Many parents start offering “kid food”- like nuggets and puffs- simply to get their child to eat.  Kids (and adults) will often eat foods that are overly fatty, salty or sugary even if they are not hungry. Don’t supply these foods simply to get your child to eat- if offered rounded, healthy foods on a regular basis their body will determine if it needs the calories or not.

Teach kids that their meal plates should have about ½ filled with fruit/vegetable, ¼ protein and ¼ complex carbohydrate.  If they eat their carbs first, don’t keep filling that section- encourage kids to eat what is left on the plate. If they refuse, that is their choice- ultimately hunger is a great resource to encourage your child to eat a rounded diet.  

Here is a great plate to try:

https://www.superhealthykids.com/parenting/myplate/

SNACKS

Toddlers often need smaller, more frequent meals- though you can limit these to 5 per day (the equivalent of 3 meals and 2 snacks.) Avoid a lot of carbohydrates in these snacks- they should be “meal-like” and incorporate at least 2 categories of carb/fruit-veg/protein.  Make sure that at least one of the items has protein/fat as that is what keeps your child full beween meals. Some examples: banana with peanut butter, crackers or soft vegetable with hummus/cream cheese, smoothies with yogurt/peanut powder/fruit, protein waffles with fruit, hard boiled or scrambled eggs with fruit.

Toddlers are wary of newness– they like the same bedtime book, songs and other rituals over and over again.  The same goes for food- they like eating things that are familiar and taste the same each time (hence the appeal of the McD’s fries or dino nugget- they look and taste the same everytime, not to mention the fat and salt that makes these super tasty and appealing.) When introducing new foods (or healthy foods your child used to eat and now avoids), focus on:

  • Frequent presentations, even if not eaten
  • Various textures (raw, cooked, pureed)
  • Various preparations- with dips, cheese melts/sprinked parmesan, lemon squeeze, in muffins/quickbreads
  • Encourage them to use all senses, even if not eating the food- what does it look like, feel like, smell like. 
  • Encourage licks or small tastes.  
  • Don’t force a bite- just keep presenting the food, and ideally let the child witness you and other family members eating and enjoying it.
  • Congratulate every bit of progress, even if your child just takes a smell of something!  Avoid punishment for not trying- just ignore any refusals, no “clean plate clubs”.
  • Provide healthier foods when children are most hungry- for the post school or pre dinner “hangries” when kids are most motivated to eat, offer cut up vegetables and fruits with various fun dips (hummus, yogurt based, even ketchup).  Or if your child is protein averse, this is the time to try shredded chicken, turkey roll ups, hard boiled eggs, cheese sticks and the like.

Older Picky Eaters

Sometimes a child is a wonderful eater even through toddlerhood, then suddenly regresses.  This is often due to anxiety around food, or sensory issues that make a child avoidant of certain tastes and textures.  

Involve them in the shopping and preparation.  Even young toddlers can learn to:

  • Cut soft foods with a butter knife.
  • Measure with cups and spoons (great for math skills!)
  • Crack eggs
  • Mix/mash foods

Make sure there is a safe food on the plate (in a reasonable amount, no need to provide enough to fully fill them up.)

Try “food chaining” where you take an accepted food (such as a specific brand of meatball) and slowly make changes- first make your own with a similar recipe, then swap out beef for turkey, add pureed vegetables, etc.  The same can be done to make any food healthier- such as nuggets (switch to baked instead of fried, with whole grain crusts, etc.)

Add new foods with frequent presentations and encouraging your child to use all their senses to assess a food (sight, touch, smell and then a small taste if ready.)

Try foods similar to ones they like- do they prefer crunchy or smooth, red fruits, etc.  Remind them that these foods are likely to have similar tastes.

Start small and reward small gains– that means one new food at a time, one that is close to a food they already like, and celebrate even licks of a new item.  This rewards their brain, and makes it more likely your child will try it again.  No punishments for foods not eaten, just keep trying.

AVOID:

  • Making separate meals- you can put one “safe food” on their plate, but try to also present some of what everyone else is eating, even if on a separate plate.
  • Pressuring your child to eat during a meal (remember, you present the food, THEY decide to eat or not)
  • Allowing multiple favorite snacks throughout the day- such grazing will diminish their appetite for meals, and lessen the hunger drive which normally helps promote trying new foods.
  • Serving the same preferred foods many days in a row, without new foods (or the converse, of only serving new foods without a safe food on the plate.)

If your child is an extreme picky eater (the above tactics are not helpful), please schedule an appointment to discuss with your pediatrician.  We may want to add vitamins to supplement a restricted diet, and possibly refer to an eating therapist to help your child conquer their fears.

Resources:

Websites-

Books-

  • Can’t Eat, Won’t Eat, Brenda Legge
  • Child of Mine, Feeding With Love and Good Sense, Ellyn Satter 
  • Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook, Ellyn Satter
  • Food Chaining, Cheri Fraker, Mark Fishbein, Sibyl Cox, & Laura Walbert
  • Food Fights, Laura A. Jana & Jennifer Shu
  • Give Peas a Chance, Kate Samela, MS, RD, CSP
  • Helping Your Child with Extreme Picky Eating, Katja Rowell MD & Jenny McGlothlin MS, SLP
  • The Pediatrician’s Guide to Feeding Babies & Toddlers, Anthony F. Porto & Dina M. Dimaggio

Instagram-

  • @solidstarts
  • @chikidsfeeding
  • @takingcarababies

Terrific article by Dr Shulamit Lerner on Picky Eating:

https://shoutout.wix.com/so/9fNzK-Rz1?languageTag=en&cid=2cf9b4db-437a-49e1-b992-5ee7af7bddf2#/main

First: The child needs to feel calm around food. This takes practice! This means getting used to being around foods that they don’t yet tolerate. Smell is closely associated with taste, so if they are around the smell of the food, in a calm setting, they will learn to feel calm around the food. Start by having the novel food only on others’ plates, but your sensitive child in the same room. Then, place the food on a small plate NEXT to your child’s plate. Finally, put a small amount of the food ON your child’s plate. No need to eat. Just to become familiar with it – smelling it.

Second: Taste. Food tastes better when a person is hungry – our saliva breaks down carbohydrates so the food is sweeter. So new foods should be tried at the beginning of a meal, rather than the end.

How much food? Three bites. Why three? Because kids are really, really smart, so will take the teeniest, tiniest little bites they can. Taking three bites ensures that the taste is experienced for a long enough time to have a real taste, allowing eventual desensitization to happen.

Third: Ice! Yup. If the taste is too strong, desensitize their tongue with ice to make the taste is milder. They still get the taste trial in, since their tongue still learns the flavor, but it’s gentler on their system. Over time, you and they will be able to tray it at a more typical temperature.

Fourth: Natural reward – Follow the new food up with the food they DO like, in order to both pair and associate the new food with something they already like – AND wash down any temporary discomfort from the novel food.

Fifth: Real reward: Yep. The discomfort is real, so rewarding bravery helps tamp down anxiety, setting your child up for better and better results – tomorrow, next week, and next year. If they’re little, stickers are magic. Hugs and praise. Lots and lots of praise. Consider  chocolate chips as chasers. Recognition of bravery is key.

Feedback: “But they didn’t like it.” Well, no, they didn’t! It can take a sensitive child 50 tries of a food before their tongue learns to tolerate it, let alone like it. That means once a week for a year! So, remember that this is a LONG process, not a short one. The goal is to desensitize, and that takes time – for trust to build, for gag reflex to relax, and for tastes to become familiar.

There are many more tricks and techniques I’ve used to help a child who “doesn’t eat anything.” I’ve used the above with success for many – but there are other paths to try for everyone, since each child has their individual anxieties and motivations. The vast majority of sensitive souls CAN acclimate to new foods, if encouraged gently, and with these few basic tricks – grounded, of course, in science.