Kids that are Picky Eaters – Is Your Child a “PICKY EATER”?
Toddlers are no longer in a period of rapid growth as they were during the first year of life. Children between the ages of 2 and 5 years gain an average of 4-1/2 to 6-1/2 pounds annually. This is a huge growth decline when compared with the first 2 years of life during which time the child is expected to quadruple his or her birth weight. As the toddler’s nutritional requirements decrease, their appetites decline, and their feeding patterns may become unpredictable. It is unrealistic to expect a toddler to eat a large amount of food at each meal every day. After all, a toddler’s stomach is approximately the same size as his or her clenched fist.
Picky toddlers require several exposures to new food items before they will accept them. Increasing exposure frequency helped determine child preferences, and therefore, influenced what the child agreed to eat. Many children require as many as 10 exposures to new food choices before they were willing to accept it. Food exposure is not the sole determinant of young children’s food acceptance-the method in which it is introduced is also very important. The new food should be introduced in a positive way, not forcing the child to eat it.
Young children need frequent exposures to new food items both at home and away from home to have the opportunity to learn about them. A child cannot learn to accept a new item without frequent exposure. A child may have a tendency to reject additional food items that have a similar appearance to that initial item to which he or she was not adequately exposed.
Frustrated parents will often describe their toddlers’ mealtimes as a battle of wills filled with annoyance, anger, and disappointment. These power struggles overwhelm a parent’s attempt to exert control on the young toddler who is willful and stubborn. Parents need to know that forcing a toddler to eat by punishment or threats may only serve to worsen the picky eating habits and the power struggles. Children who are consistently punished or have food forced upon them will come to associate hunger and mealtime with anxiety and frustration, rather than pleasure. Over time, this frustration and anxiety will continue to escalate and worsen those picky eating habits.
Parents of children with eating difficulties were more likely to use unsuccessful coercive techniques at mealtimes, which ultimately led to persistence of the child’s feeding problems. As the parents used negative prompts, negative physical contact, and negative feeding comments, their children engaged in more disruptive behaviors throughout the meal. These children developed more patterns of food refusal, which escalated the use of coercive techniques by parents. Although the parents’ intentions were positive and well meant, mealtimes tended to become virtual war zones as a result of the significant power struggles.
In addition to worsening the picky eating behaviors, an exorbitant amount of control over consumption patterns may lead to an inability to respond to self-regulation cues and an increase in distaste for certain foods. Children who are highly encouraged or forced to consume foods may not be able to use internal signals of hunger and satiety as a means of adjusting energy intake as readily as other children.
It is very important for frustrated parents to realize that their job is to determine what, where, and when their child is fed. It is the child’s job to determine whether or not he or she will eat and what he or she will ingest. When the well-meaning parent bribes, punishes, demands, or forces the child to eat, they cross the line into the area that the toddler controls. This practice results in the negative behaviors, power struggles, and temper tantrums that characterize mealtimes of picky eating toddlers. If the child is not given a sense of autonomy and independence, the child will not take in foods and the parent would have “lost” not just the battle, but also the war.
During the infancy stage, children are typically demand feeders, meaning they demonstrate hunger cues when they are ready to eat so the primary caregiver offers them a bottle or the breast and their demands are satisfied. Later, as a child reaches the toddler years, he or she becomes mature enough to accept a schedule and should be expected to follow a routine. Accommodating to the daily schedule of family mealtimes is an important aspect of development that allows the toddler to begin to fit into his or her enlarging social world. The child should be expected to sit with the family at designated mealtimes regardless of whether or not he or she chooses to eat. In addition, the child should be offered the same foods prepared for the entire family as a means of providing exposures in an attempt to diversify the diet. We do not want the parent to become a “short order cook” and make different meals for each different family member.
A toddler may test the limits parents imposed in every aspect of feeding including quantity consumed, preferences ingested, and tempo of food intake. It is the parent’s responsibility to allow the developing child to express him or herself in an acceptable manner. The child may choose to not consume particular foods offered at mealtime, but he or she is expected to remain at the table during the designated time. The toddler can choose to merely push around and play with the food on his or her plate, but he or she is not allowed to leave the table to play a different game. Allowing the toddlers’ desires to override the limits imposed by parents will result in an exacerbation of negative feeding behaviors and an escalation of picky eating.
Many parents admit to “giving in” to the desires of their toddlers. Tired and frustrated parents report that they serve their child precisely what he or she demands in an effort to get the child to ingest some nutrients, even if it is not the ones the parent desired. A child will always take the familiar, easy way out at mealtime if the parent continually fixes the child’s entrees of choice. As the parent, you must continually serve healthy food choices as part of the family meal until these choices become the familiar and preferred items. Although short order cooking is a quick fix to the power struggles in the present, it may further ingrain new food aversion behaviors that will only become more and more challenging and difficult to change as time goes on.
Juices and in between meal snacks are NOT nutritious. If children are allowed to fill up on juices and snacks in between meals, their appetites for other foods will suffer significantly. Juices and snacks contain excessive amounts of sugar, little or no calcium or iron, no fiber, minute amounts of fluoride, and a high concentration of carbohydrates. Drinking too much juice and eating too many snacks can contribute to under-nutrition, diarrhea, and the development of dental caries. Children aged 1 to 6 years old should be allowed to drink only 4 to 6 ounces of juice per day. In addition, experts recommend that toddlers drink 16 to 24 ounces of whole milk daily…
Portion control in managing mealtimes and snack times is important in picky eaters. As mentioned earlier, a toddler’s stomach is about the size of his or her clenched fist. When toddlers are able to clean their plate and ask for more, they have successfully controlled one aspect of the mealtime and have made their own decision to invite the parent to serve them more. We recommend that children aged 2 to 6 years old eat 5 servings of grains daily, 3 servings of vegetables, 2 servings of fruits, 2 servings of dairy, 2 servings of meat, and sparse amounts of sweets and fats. In addition, serving sizes must be appropriate for children in this age group. For instance, a half of a slice of bread, 2 cups of cooked vegetables or canned fruits, 2/3 of a cup of yogurt, and 2 tablespoons of ground meat represent adequate serving sizes from each of the respective groups on the food guide pyramid.
Routine television viewing during mealtime may cause a variation in overall food consumption patterns of young children. Children from families who watched television during at least 2 meals per day derived 5% more of their energy from pizza, salty snacks, and soda than those children from families in which television viewing was not a normal part of the mealtime routine. In addition, those same children derived nearly 5% less of their energy intake from fruits and vegetables than the children in low television use families. Television viewing is a powerful influence on a child’s eating behavior. There are improved mealtime behaviors if the television is turned off when sitting at the table. Toddlers are easily enticed by the bright colors and loud noises in commercials and may, therefore, choose not to eat the food provided to them in lieu of demanding what they see on the television. A simple remedy to this is that mealtime should be television free.
The structure of the family meal, that is whether or not the family partakes in meals together, is an important aspect for the picky eater. The habits that parents model will help their children to develop in childhood which will influence patterns that children will demonstrate as they grow up. Research has shown that meals prepared in the home tend to be higher in fiber, calcium, and iron, and contain less fat, saturated fat, cholesterol, and salt than meals obtained outside the home. If children are exposed to these healthier foods during family mealtimes, they may continue these healthy habits in adolescence and adulthood. In addition to improving the intake of nutritious food, the family dinner provides an avenue to give the toddler structure and security. It is a time to foster stronger relationships and to improve family function. It is important to reiterate all these points to parents of picky eaters when recommending the implementation of the family dinner.
Parents need to focus on the positive and exciting developmental milestones their youngsters achieved. Young children engage in the picky eating habits and the negative mealtime behaviors as a means of demonstrating a sense of control and autonomy over an environment that is very new and scary to them. Parents struggle to provide the tools necessary for their children to grow into healthy, well-adjusted adults.
HOW TO REMEDY THE PICKY EATER
If your child does not take vegetables, the most common form of pickiness, try doing the following. Go shopping with your child and when you get up to the vegetable aisle, let them know that they are big enough to make a BIG decision. Ask them to pick out a vegetable. They may balk at this, but get them to make a decision. Praise them immensely and tell them what a GREAT DECISION they just made. Let them know that they can make this for dinner-don’t yet tell them that they have to eat it. Let them know how EXCITED you and Dad will be to enjoy this food. Measure out the spices needed to make the vegetable and let the child HELP YOU COOK it. They should add the spices and stir it. While the vegetable is cooking, tell the child that you are REALLY LOOKING FORWARD to tasting this DELICIOUS vegetable that YOUR CHILD (not you) are making. Tell Dad to also make a big deal of the child helping and PRAISE, PRAISE, PRAISE. When you sit down for dinner, give the child their portion and tell them how WONDERFUL the vegetable tastes. This way, the child has some ownership of the dinner before it is served. Most children love cheese, so you can add a little melted cheese (like Velveeta) to the vegetable. You must be persistent and reintroduce the vegetable MULTIPLE TIMES-one meal will not change the kid’s mind but will help foster acceptance of the food.
If your child does not take meats, the next most common form of pickiness, know that meats can be added to soups and pasta sauces. A child does not have to take a bolus of meat to gain nutrition, they merely need to swallow meat-so if it is hidden in soups, and pasta sauce, ravioli, then it should be viewed as a win for you. Again, you need to introduce it multiple times-one rejection should not change your zeal to introduce the “offending food”. All kids like fried chicken nuggets, but these are usually chicken parts, not white meat. The parts are then battered and fried-not good nutrition to us.
When you make your menu, consider nutrition, not just offer what you know your child will eat. Do not feel like your child is starving if they don’t eat. Remember that if you offered the offending food to a “starving child” in a third world country, they would readily eat it up. The reason US children are picky is that there are thousands of food choices. If left up to a child they will eat from three food groups-sugars, fat, and salt and we know that you agree that good nutrition has limited amounts of these ingredients.
If you still have problems feeding your child, we will check the growth curve and further discuss your child’s eating habits.