Picky eating in children is a difficult topic for most parents.
As a pediatrician, I tell parents that they have little control over what goes into their child (what they choose to eat) and how it comes out (potty training). Certainly, there are things that we can do as parents to encourage our children to eat healthy foods and use the bathroom, but not everything is under our control.
Some days, it might seem like your toddler is existing on air and unicorn tears alone or your elementary school child only wants you to pack hot Cheetos in their lunch everyday. While some amount of picky eating is part of the normal progression of childhood development, there are times that you should become concerned about your child’s eating habits.
In this article, we will define picky eating, talk about why we should care about it, think through possible causes and learn some strategies to conquer this difficult behavior.
What is Picky Eating in Children?
Toddlers can certainly be picky eaters. This is a common behavior among young children that involves a limited range of foods they are willing to eat. It is extremely frustrating for parents when their child refuses to eat anything. Parents often grow weary of watching their child eat the same foods over and over. In addition, they worry that their kids are not getting enough nutrients to grow.
Picky eating is often a normal phase of development and is influenced by a variety of factors. These factors include a child’s sensory preferences, developmental stage, and their relationship with food.
However, in some cases, picky eating can become more severe. It is important to know the signs that indicate a medical issue or feeding disorder.
Why is it Important to Address?
As we saw earlier, picky eating can be a common phase that many children go through. Introducing your child to a variety of foods early in life will help to prevent picky eating in the future. However, it is not fool proof. Once your child is old enough to make their own decisions about their food intake, you can’t force them to eat. Your job is to offer a variety of healthy choices and your child’s job is to choose what to eat.
Parents and pediatricians often worry about a child who only wants their favorite foods and nothing else. Their limited food options also limit their nutrient intake.
While this is often a concern, unless your child has weight loss or is dropping percentiles on the growth chart, likely they are getting enough nutrients to continue to grow. Often, parents perceive that their child is eating very little calories, when in reality they are eating appropriate amounts for their age.
Eating enough calories is important for sure, but the quality of those calories also matters. Even if your child refuses to eat everything, it is wise to continue to offer healthy meals.
Identify the Underlying Causes of Picky Eating in Children
Sometimes there are identifiable reasons why your child chooses to eat a limited number of types of foods. If you can take a moment and think through ways in which your child not only interacts with food, but also interacts with the world around them, you may find clues as to a solvable cause to their limited food preferences.
There are several possible reasons why a child may be reluctant to try new foods:
- Developmental stage where children become more cautious
- Result of sensory food aversions where certain textures or smells are overwhelming
- Medical issues, such as food allergies or eosinophilic esophagitis, that make eating certain foods uncomfortable or even dangerous
Physical Causes
If you’re struggling to get your child to eat anything, consider the possibility that there may be physical causes.
Common medical issues such as:
- Acid reflux: causes discomfort or pain in the esophagus with consumption of certain foods, especially spicy, acidic or fatty foods, symptoms usually occur right after eating or when your child lays down for sleep
- Constipation: common cause of tummy discomfort in childhood, can also decrease a child’s appetite
- Food allergies or sensitivities: if your child has had an allergic reaction to a food, they may be reluctant to try new foods for fear of these reactions in the future, your child may be sensitive to a food or it may upset their stomach even if they are not truly allergic
- Eosinophilic esophagitis: a rare condition that leads to chronic inflammation of the esophagus, it is painful to swallow foods
- Sensory processing disorders: some children don’t like to try new foods due to the sensory experience. They may have a disdain for crunchy foods or maybe soft foods or maybe they don’t like the smell of a particular food.
These are some of the more common physical causes of limited dietary intake. If your child has symptoms of any of these conditions, be sure to tell your child’s doctor about their food refusal and associated symptoms.
Emotional Causes
Children are small balls of emotion a lot of the time. They express their emotions differently than we do as adults. Your child may have a negative food association because of something that happened to them several months ago that may or may not have been related to the food that they ate.
Emotional causes of limited intake:
- Fear of new foods: new things can be scary for kids
- Negative association with a food: A patient of mine once refused to eat fish for several months after she had a choking episode during a meal where she ate fish for dinner
- Anxiety or stress: If a child is feeling anxious or stressed, they are looking for ways to control their environment. Often, they can’t control the cause of their stress so they control what goes into their body and how it comes out.
To address these emotional causes, parents can:
- Create a positive and relaxed mealtime environment.
- Avoid pressure or forcing your child to eat.
- Involve your child in meal planning and preparation.
- Allow them to have some control and autonomy over their food choices. (offer a choice between two healthy options, “would you like carrots with dinner or broccoli?”)
- Gradually introduce new foods, while acknowledging and respecting their fears and preferences.
- Offer a wide variety of foods during family meals
- Encourage positive associations with food by praising their efforts
- Be patient and understanding
By addressing the emotional causes of picky eating and implementing these strategies, parents and caregivers can help their child develop a healthier relationship with food. These strategies also promote a more varied and nutritious diet.
If concerns persist or significantly impact your child’s growth and well-being, consult with a healthcare professional. Your child’s pediatrician is a good place to start. They will likely send you to an occupational therapist or feeding therapist who can work directly with your child.
Social Causes
My daughter came home one day during the first week of school this year and asked me to order a particular snack from Amazon. All of her friends were eating it at recess and she wanted to have some of her own. Our children (and us if we are being truthful) can be influenced by our peer group in many ways, including food choices. This can be good or bad depending on which direction it goes.
Social causes can play a significant role in picky eating behaviors in children:
- Peer influence: A child’s friends may have particular food preferences or display picky eating behaviors. This can influence your child to imitate them. Social pressure to conform to limited food choices can result.
- Family dynamics: If parents or siblings have selective eating habits or strong food preferences, children may mimic these behaviors. Additionally, mealtime interactions within the family can impact a child’s eating habits. If mealtime is tense or negative, it can create a negative association with food and discourage exploration of new tastes and textures.
- Observed eating behaviors of others: When children consistently see people around them avoiding certain foods or exhibiting picky eating behaviors, they may believe that it is normal or acceptable.
Now you can pay close attention to social cues in your child’s environment and assess whether they influence your child’s eating habits. Social interactions around food are very important.
Strategies for Dealing with Picky Eating
As with any parenting challenge, picky eating is one of those habits that you can tackle with a few simple strategies. While your child may not jump up and down for joy when they see that piece of brussel sprout sitting on their plate, you can move them towards trying new foods.
Routines and schedules:
- Consistent meal times provide structure and help regulate hunger and fullness cues.
- Aim to have regular meal and snack times throughout the day
- Limit grazing between meals
Meal planning and preparation:
- Involve your kids in the weekly meal plan
- Take them with you to the grocery store to pick out the food
- Encourage them to choose their favorite fruits, vegetables, or other nutritious foods to include in meals
- Give them a sense of ownership over what they eat by choosing between two or three healthy options
- Allow them to help you prepare the meals
Regular family meals:
- Create a positive dining environment.
- Social interaction around the dinner table can influence children’s willingness to try new foods
- Provide a relaxed atmosphere by avoiding pressure or forcing them to eat
- Focus on enjoying the meal and engaging in positive conversations
These ideas may not solve all of your child’s fussy eating, but they will contribute towards establishing healthy eating habits. Enjoying healthy food choices takes time and consistent effort. Be patient with your child and with yourself as you navigate this picky eating phase.
Concluding Thoughts
Parenting is tough. It is especially tough when you are trying to convince a small human that food is good for them.
If you want a pediatrician who can empathize with you and be there for you when you need parenting advice or just a shoulder to cry on, I am she. Schedule a free meet and greet today to see if 127 Pediatrics is the right fit for your family.
© 127 Pediatrics; October 2023
This article is for informational purposes only and should not be construed as medical advice.
Dr. Andrea Wadley is the owner, pediatrician, and breastfeeding medicine specialist for 127 Pediatrics. She has an established house-calls-only concierge pediatric practice in Colleyville, TX. She is also the owner and operator of the 127 Pediatrics Online Breastfeeding Medicine and Education Center.
