Help for parents of picky eaters everywhere

Like many other areas of parenting, feeding our kids seems like something that should just “happen.” So, what if it doesn’t? Is your child just a picky eater or could it be a sign of a bigger problem?

As an occupational therapist, I work with children who have underlying medical, sensory processing or behavioral reasons for feeding difficulties. There is definitely a time when seeking the help of a therapist is a great idea. There is also the possibility that your child is “just a picky eater.”

Here are a few criteria to help you determine whether your child is a picky eater or whether it might be a bigger problem that will require help from your pediatrician and other specialists. (This list was adapted from Dr. Kay Toomey, who developed the SOS Approach to Feeding used by therapists nationwide.)

Some characteristics of a picky eater

• Decreased range or variety of foods that they will eat. Accepts about 30 foods or more.
• Able to tolerate new foods on plate and usually can touch or taste a new food (even if reluctantly).
• Eats at least one food from most all food texture groups.
• Frequently eats a different set of foods than the rest of the family, but usually eats with the family.
• Will add new foods.
• Sometimes reported by parent as a “picky eater” at well-child check-ups.

When your picky eater may need some extra help

• Restricted range or variety of foods, usually less than 20 different foods.
• Cries and “falls apart” when presented with new foods.
• Refuses entire categories of food textures (i.e. crunchy).
• Almost always eats different foods than the family.
• Persistently reported by parent as a “picky eater” across multiple well-child check-ups.

What you can do at home to help your picky eater

I’d like to offer up a few suggestions to try at home if eating is a struggle with your little one.  

• Create mealtime routines. Children do best when meals- like many other parts of their day- are presented within a structured routine. This will look different for every family, but in general it’s best to have kids sitting at the table with the family until the meal is complete. Having siblings and parents eating at the same time provides a model of what’s expected and will encourage them to try new foods. In addition, family mealtimes are a great way to develop your child’s communication skills without other distractions. If you have an extra wiggly toddler, consider having a few quiet activities at the table such as crayons, blocks or puzzles to keep then interested in sitting. Using a visual timer can also be a great tool. Start with 10 minutes and gradually work upward.
• Pick one meal to be your “challenge meal.” Use this meal to introduce a new food or a food they’ve tried but haven’t quite taken to yet. Choose the meal when you are least rushed and have the time and patience to be intentional about how you are interacting and responding to your child. Encourage your child to explore the new foods, and continue to remind them that foods are not scary and are meant to help them grow.
• During meals, limit distractions in the environment so that your child has no reason to want to leave the table. Turn off the TV and put favorite toys away until mealtime is over. Children love to have the captive attention of their parents. Mealtimes are a great way to give it to them.
• Place new foods on their plate
  • Leave it there for them to see and smell. They don’t have to taste it the first time or two it’s presented. Start with having them tolerating it on their plate.
  • Have them taste it without the pressure to take a bite. Even just lick or a very small nibble counts. Discuss similarities with other preferred foods.
  • Try one bite, give them lots of praise for achieving this without engaging in a battle.
  • Work up to taking three bites. Even if it never becomes a food they prefer, at least they are consistently trying new foods and textures.
• Engage your child in the cooking and set-up of the meal. Getting them involved in preparing the food is a way to build their interest in what they’re eating. Toddlers can help set spoons or condiments on the table. They can also help you do the mixing. Remember- it’s about enjoying the process so start with a “job” you know they can do.
• Messy is totally allowed. Eating has so many sensory components- taste, smell, a variety of textures. Allowing messy faces, hands and tables is one way to encourage self-feeding and getting familiar with the sensory experience of eating.
• Limit snacks to ensure hunger during meals. Small meals- like 6 per day (every 2-3 hours) can work great. If they really can’t wait for a meal to be ready, offer fruits and veggies, which are healthy and won’t fill them up.
• When fixing their plate, present a combination of preferred and less preferred foods. Only one challenge food at a time, please. When introducing a new food, only place a few bites on their plate. A great example would be a food that others are having at the same meal, so the child sees others enjoying the food. It looks a lot less threatening to have three small bites of carrots to try instead of three whole carrots. Remember- your goal is to develop your child’s willingness and ability to try something new on a regular basis. Increasing the quantity of the new food can come at later meals once that food has become more familiar.
  

Of course, always remember that no one likes everything. There will be foods that your child just doesn’t like no matter how many times they’ve tried it. Do keep in the back of your mind, though, that just because they didn’t like it six months ago, doesn’t mean that they wouldn’t like it now. Our sensory systems and taste buds are always growing and changing. But, as long as they have a variety of foods daily from all food groups including fruits and vegetables that they will eat on a regular basis, pat yourself on the back.

Hopefully this information has helped you determine whether or not if your finicky eater needs extra help and has given you strategies to make mealtimes easier. If you still feel like mealtimes are a battle, talk to your pediatrician about a referral to a gastroenterologist and/or an occupational therapist. An individualized occupational therapy evaluation can help identify underlying causes of feeding problems and formulate specific strategies that will help your child (and you) experience mealtime success.

For information about what types of foods your child should be eating and how much, visit these excellent online resources: choosemyplate.gov and your kid’s table.

This blog was written with contributions by Morgan Agosto, OTR/L