BY LINDA STEVENSON, PhD, RN, FNP-C, PEDIAQ Chief Nursing Officer
What happened to your wonderful child who would happily eat whatever was put in front of them? Now “it tastes funny” or “it’s orange”, or “I only want macaroni” is all that you hear. They seem to live on air. It can be very frustrating and worrisome for any parent.
Toddlers are seeking independence, developing skills to feed themselves and exerting control over their food choices. They are developing food preferences and eating habits. They love the feeling of success when they can control at least one small aspect of their lives. All this is happening at a time when there are increased energy and nutrient requirements. Strategies such as nagging or making deals don’t work in the long run. Children who learn to negotiate and make deals for eating, learn to make deals and expect rewards for doing other things such as going to bed on time or brushing their teeth, or getting ready for school. They quickly learn everything is negotiable and they have power.
So what is a parent to do? First, remember that mealtime is more than about eating. It is a time of socialization, a time to build relationships as a family. Create routines around meal and snack times. As soon as they are able, have infants and toddlers sit at the table for family meals. This is a time for conversation that involves all, learning about everyone’s day, and a time for electronics to be off (phones, TV’s, computers).
Serve small portions. Serve new foods along with favorite ones. Try serving veggies with a favorite dip or sauce. Cut foods into shapes. Set your menu for the week and have your picky eater help with choosing the foods. Let them help with prep based on their age; even toddlers can help set the table, arrange carrots on a plate with a dip, or put fruit in a bowl after you have cut it up. Adding finely chopped or pureed vegetables to spaghetti sauce, or adding cauliflower, turnips and squash to mashed potatoes are a great way to get extra veggies to your child. The ‘polite one bite’ rule that many parents have is great but don’t push it farther. Remember that you have to offer a new food at least 10-15 times before children will become accustomed to the taste and eat it.
Other parents are a wonderful resource for finding ways to get your picky eater to eat healthy. One mother shared that she would puree chicken with a little unsalted chicken broth to add to the cheese sauce for mac & cheese. It was a great way to get protein in to her child who would only eat mac & cheese. Her child is now 13 and he eats everything but there was a lot of worry early on. Roasting vegetables can bring out their sweetness and using lemon can decrease the bitterness of some vegetables such as broccoli or brussel sprouts. Young children have many more taste buds than an adult; this plays a role in why they refuse certain foods.
Dessert is often used as a bargaining chip with children. If dessert is a part of your family meals then treat it as a part of the meal not something special that you get after you have eaten what you really don’t want. You want to take away the power of the sweet. You can also try substituting fruit and cheese as a last course.
What about school lunches? Is it okay if your child wants the same chicken or pbj sandwich every day? As long as you add other nutritious foods to the lunch such as fruit or cut up veggies for dipping etc. they will be fine. And at some point they will venture to other foods, particularly if they have been exposed at home. Also, sometimes they want a particular food because they know they can get it eaten in the short time they have for lunch, or because their best friend also eats that meal at lunch.
But what about the child who never wants to eat at the table with the rest of the family? Keep a journal about everything your child eats and drinks daily for a 2-week period. Sometimes what you will find is that your child drinks juice or milk or Gatorade all day and so they get full on all the liquid and sugar and are not interested in food at mealtime. Others may be snacking on goldfish or other small crackers and so they really do not feel hunger and consequently don’t want to eat. Set meal and snack times so your child has a chance to get hungry. Kids do not need to walk around with a tumbler of juice; this sets them up for eating problems as they age.
When should you be concerned? Most picky eating behaviors are part of normal growth and development but if your child is not meeting their developmental or growth milestones your pediatrician will have noticed and will be discussing therapy options particularly if there are sensory issues. When eating preferences make it difficult for your child to eat with others, or they have increasing social anxiety with meals, or other altered behavior it is time to explore working with a therapist, both nutritional and psychological.
Remember most of the time picky eating resolves as your child ages. Although it is your job to provide healthy food choices and pleasant meal and snack times, it is your child who gets to decide which of the foods and how much to eat. Try to keep mealtime from becoming a battleground, as research has shown that forcing a picky child to eat worsens the picky behavior. Your goal is to teach that all foods are okay in moderation; this creates a healthy eater who knows when they are full and enjoys a wide variety of foods.