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Picky Eaters/Problem Feeders

Angela Grant-Cerasaro-squareBy: Angela Grant Cerasaro MS, CCC-SLP

 

 

Toddlers are notorious for being called picky eaters.

“He won’t try new things.”

“She lives off of Goldfish crackers and toast.”

 

Like many things, children’s eating habits are a spectrum that ranges from those who will eat anything that is put in front of them, and those who refuse to try new foods and have difficulty with different tastes and textures. In some cases, children may even have a physical reaction to certain foods.

Studies have shown that children do have stronger bitter taste receptors than adults, and they tend to prefer foods that are sweet or salty. Studies have also found that genetics influences taste sensitivities in both children and adults. Other environmental factors can override genetic factors, however. This is shown when people from different cultures are able to tolerate different tastes, spices, and foods regardless of their genetic predisposition to taste preferences.

In other words, even if your child is predisposed to be a picky eater, there are things you can do help them.

 

Picky eaters versus problem feeders

If a child has a decreased range of foods that he or she will eat, but eats 30 or more foods, and is able to at least touch or taste a new food when it is presented (even if they do so reluctantly), then he or she is considered a “picky eater.” Picky eaters are able to eat at least one food from most texture groups (chewy, crunchy, etc.) and food groups (dairy, meat, vegetables, fruit, grains).

If a child eats less than 20 different foods, will lose foods that are on their approved list, and will not gain them back over time, and if he or she becomes distressed when presented with new foods and will refuse to try them, then he or she is considered a “problem feeder.”

Problem feeders often refuse entire food groups (for example, avoiding all meat, or all vegetables). They may also refuse entire texture groups (e.g., they will avoid all mushy foods). They often have difficulty tolerating different tastes, textures, or even smells.

 

How to increase variety

Some tips to increasing the variety of foods that a child will eat include:

  • Eat with your child and share the joy of eating with them.

A trap that many families fall into is to prepare food for the kids and different food for the adults. The “kid-friendly” food is often bland and carbohydrate rich, such as macaroni and cheese, peanut butter and jelly, chicken nuggets, pasta or pizza. If this occurs on a regular basis, it reinforces the idea in the child’s mind that they are not expected to eat what their parents are eating, and therefore they don’t try new things.

  • Have at least one food your child likes, and one food that is new or less preferred

Instead of offering an entire meal of new and potentially scary foods, make sure you have at least one or two nutritious things on your child’s plate you know they will eat, and then you can add a new food or a food that is less preferred

  • Keep mealtime light and carefree

Imagine that you are sitting down for a meal and instead of experiencing a relaxing, nutritious and delicious meal, you are watched anxiously and pressured to eat. Even well-meaning encouragement like “good job eating your carrots” or “eat two more bites before you can get up” can backfire and make mealtime a power struggle. Instead, present the food, and enjoy it yourself. If he or she complains, acknowledge their feelings. “Yeah, I hear you. You don’t like that there is broccoli on your plate, but you do like the pasta and the apple slices. This is what I made for dinner. I am going to eat, and you are free to join me or you can wait and eat later.” Don’t force them to eat. Use mealtime to talk about everyone’s day and reconnect, and don’t focus on how many bites of food your child is eating or whether or not they tried a food.

  • Have fun with foods

Involve your child in meal planning, shopping and cooking. Let them choose the ingredients at the store. Have them to do some of the meal preparation, such as letting them stir, add spices, or crack eggs. Allow children to explore their foods, such as poking them, touching them, smelling them, and licking them. Make a healthy version of a gingerbread house with pretzel sticks and veggies. Paint with hummus, yogurt, or guacamole.

  • Food chaining

For children who have limited foods that they will try, food chaining is a technique where a similar food is offered to try to slowly and gradually expand a child’s diet. If a child will only eat Burger King chicken nuggets, then the goal would be to gradually expose the child to different fast food chicken nuggets (Wendy’s, McDonalds, etc.), then store bought, then eventually homemade chicken nuggets, and finally even un-breaded, baked or grilled chicken. The process has specific steps and procedures, and a pediatric speech language pathologist and/or occupational therapist specializing in feeding can help guide families who are interested in taking this approach.

Food chaining was developed by a team of specialists that included a pediatric speech language pathologist, pediatric gastroenterologist, dieticians, and lactation consultants. Their book can be found here.

And a brief handout with the basics of the program can be found here.

  • For children with true problem feeding, consult with a pediatric speech language pathologist

A pediatric speech language pathologist specializing in feeding can evaluate your child for a potential underlying cause to your child’s problem feeding, such as oral sensory differences, oral motor weakness, or incoordination. There could also be a digestive component, as some children avoid foods that make them feel sick because of food intolerances, food allergies, or acid reflux. Consult a gastroenterologist or allergist to rule out these possibilities. Occupational therapists also work with children who have sensory differences, such as sensory processing disorder (SPD), and can help children tolerate new sensations when eating.

 

 

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