Should you worry about a picky eater?

picky eater cartoon

Growing up in an Italian family where food was a big part of most celebrations and meal time an important time for families to be together, I have no memory of anyone who suffered from picky eating. So when I started to work on the “Feeding Team” at a children’s hospital, I was very surprised by the children that were brought in to be evaluated. The team consists of a Psychologist, Occupational Therapist, Speech and Language Pathologist and Dietitian who all play a role in evaluating the patient. The team evaluates issues with chewing or swallowing, texture and sensory issues, behavioral issues and of course nutritional deficits and growth adequacy. A common scenario is the toddler whose parents are concerned because he only eats 5 foods. These limited food choices vary from child to child however we do see many children refusing most meats (except for chicken nuggets!), all vegetables, most fruits and sometimes even dairy. Of course every child is different, and the reasons for the picky eating and food refusal are different also. It could be a sensory issue the child was born with, or maybe a choking incident which left the child fearful of eating some foods, or a history of reflux and feeling bad after eating. Whatever the reason, the parent’s reaction is often predictable: pressure the child to eat! It feels like the thing to do if you care about your child, they need to grow, right? How can they be healthy if they don’t eat?

Sometimes parents are so afraid for their child they may actually force feed them! You can imagine the child’s reaction. This does not lead to a pleasant feeding experience! It is more likely the child will dig in his heels and become even more resistant. The affect on health if left untreated (and if parents do not learn appropriate ways to deal with this problem) is the child may grow up to continue to eat just starches, no fiber, inadequate protein, vitamins and minerals and end up not having the healthiest body they could have had. Even worse, their relationship to eating and food can develop into a disordered one.

What should you do instead of forcing? First, tell your pediatrician or doctor about any extremes in your child’s eating. They should be able to refer you to a specialist for an evaluation (such as an Occupational Therapist who specializes in feeding issues, or psychologist or feeding team). Or, you can educate yourself as there are plenty of great books on the topic. One of my favorites is by Kate Samela, MS, RD, CSP who is an expert on the topic. Check out her book “Give Peas a Chance: Give Peas a Chance by Kate Samela, MS, RD, CSP

Another expert, Anne London, MS,RD has a wonderful website with great resources. Check it out at: PetiteNutrition

Finally, check out Ellyn Satter’s Website which is filled with great information on helping your child develop a healthy relationship to food and eating.

So if you child won’t eat his vegetables, don’t worry. It is most likely a phase. But if he starts to eliminate more and more foods over time and eventually entire food groups, don’t ignore it! You can help your child be the healthiest he can be!!

One thought on “Should you worry about a picky eater?

  1. It’s interesting to think about how associations to food can work the other way too, like how sometimes you have pizza and it’s amazing and so you assume it’ll be amazing next time. But sometimes it doesn’t feel as good as it used to, and it’s like instead of listening to your body you are listening to your minds memory of what experience a food gave you. Or at least that happens for me, with pizza, especially 🙂


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