Should You Be Concerned if Your Child Is a Picky Eater?

Source: istock/JTSorrell

This post was written by Gia Marson, Ed.D.

All parents know that meals can be a challenge, and when you’ve got a picky eater, it’s even more difficult. But it doesn’t have to always be tater tots or tantrums. With some science-based strategies, you can help your child expand their food variety.

“At the end of the day, the most overwhelming key to a child's success is the positive involvement of parents.” —Jane D. Hull

What contributes to picky eating?

For many young children who are picky eaters, mealtimes can be fraught with conflict and stress. Parents may fret over their child’s nutritional intake or how to handle avoidance of certain foods. Distress about food quantity and quality tends to start young and is often characterized by:

• New foods being limited by self-imposed restriction.
• A child's preference for certain characteristics, such as texture or consistency.
• A diet based on what is or is not deemed acceptable.

In a recent study (Marcus et al. 2020) of nearly 20,000 adults with severe food avoidance, researchers gained insight about what parenting strategies were perceived to be not helpful and most helpful to them as children when it came to eating.

What did not help

Participants stated that negativity, pushing, and punishing did not lead to curiosity, willingness, or openness around food. They also reported that the following parental tactics reinforced stubbornness and rigidity:

• Shaming
• Forcing
• Criticizing
• Comparing
• Using guilt

What did help

Participants reported that while they seemed staunch in their refusal of food, they would be more likely to agree to eat foods they previously hadn’t when encouraged with kindness.

“Come from a place of curiosity, rather than from judgment.” ―Evelyn Tribole

This study and others offer insights that parents can lean on for guidance. The following seven tips can help you help your child develop a more flexible relationship with food.

1. Keep a routine. Routine is key to helping your child be prepared to sit down and eat. Serving meals at approximately the same time every day and spacing snacks so that your child is hungry by the time dinner is served puts them in the best position to want to eat. This makes the most of your child's appetite.
2. Use encouragement. While it can be frustrating when a child refuses to eat a wide variety or try new foods, it’s best not to be coercive. Pressure inevitably leads to conflict and stress, which interferes with creating a positive social environment at mealtimes.
3. Promote trust. When parents make promises around food and stick to them, it can encourage trust. For example, it may be effective to promise that your child doesn’t have to continue eating a food if they don’t like it or if they feel full.
4. Repeat exposures to new food. By eating a wide variety of foods yourself in front of your child and offering them, you can gently introduce new options for discovery. This approach can foster their willingness to try new things at their own speed. Repeated exposures can also make a variety of foods seem less scary as they become more familiar.
5. Have patience. Picky eaters aren’t going to turn into adventurous eaters overnight, so stay patient and celebrate the little wins. Your child may start with just a sniff or a taste. With a bit of encouragement and perseverance, you may start to see a difference.
6. Mix familiarity and variety. Try incorporating a variety of foods into your child’s meal. Serving small amounts of your child's favorite foods alongside small amounts of new foods can help encourage young children to transition from being a picky eater to someone willing to try something new.
7. Partner with your child. Involving your kid in grocery shopping can help them feel more comfortable with new foods. Try allowing your child to choose foods in a section of the store where you want them to consider more variety. Maybe your child can even design one dinner menu. You can also involve an older child in the cooking and serving process, which can make them feel part of the process.

When to worry that your child's picky eating may be an eating disorder

While most picky eating does not involve limiting food severely enough to induce nutritional deficiencies or a too-low body mass index (BMI), it can be a central characteristic of an eating disorder known as avoidant/restrictive feeding intake disorder (ARFID). This type of restrictive, avoidant eating disorder can interfere in a child's health, feeding, growth, and psychosocial development. ARFID is characterized by an extreme version of picky eating. Unlike other eating disorders, restrictive eating occurs in the absence of weight, fitness, or body image concerns.

For children with ARFID, a parenting approach that is easygoing and encouraging may not be enough to improve food flexibility, increase intake, and maintain or restart healthy development. Though ARFID studies are still limited, they point to several factors relevant when it comes to onset and maintenance, including:

• A response to the sensory properties of certain foods.
• Avoiding aversive experiences such as choking, vomiting, gastrointestinal problems.
• Poor appetite or limited interest in eating.

These food and eating fears are often experienced psychologically, as well as in a visceral manner. ARFID may be accompanied by obsessive-compulsive disorder (OCD) and anxiety. Among others, one recent pilot study (Shimshoni et al. 2020) offers cautious hope to parents of medically stable children with ARFID. The intervention guided parents to systematically reduce their own tendency to go along with their child’s food avoidance and decrease their stress about eating, as well as to foster supportive responses. For children in this study, whose eating disorder was based on sensory-driven avoidance, changes in parenting responses led to an increase in flexibility, along with a reduction in family accommodation and impairment.

If your child’s picky eating is extreme or interferes in their growth, health, or socialization, it is important to reach out to your pediatrician or an eating disorder specialist. Eating disorders are very serious illnesses and outcomes are best when intervention begins early.

Stay positive

Parenting a child who has picky eating habits can be difficult, but gentle encouragement can help expand their eating habits. Rather than getting bogged down in frustration and fear, take a proactive approach. As long as your child’s growth and health are as expected for their age and development, there is usually little reason to worry. Creating a positive eating environment, reliable structure, opportunities for discovery, and a shared sense of pleasure when it comes to preparing and eating meals can make a big difference.