When Picky Eating is a Problem

Many people spent hours of their childhood at the dinner table, forced to clean their plate no matter how much they hated those green peas. While decades of research have shown that this method may do more harm than good, the issue of picky eaters vs. parents persists. We all have preferences and favorite foods (kids included!) but when is picky eating a problem? Let’s dive in.

If your child tends to be on the picky side, be wary of using labels. Children tend to live up to the labels we give them, so avoid naming your child “a picky eater” in the first place! Instead focus on relatable, specific tasks and phrases for them like using their “brave bites,” “crunching carrots like a kangaroo,” and “smashing tomatoes like a shark.”

It’s also best to avoid clapping or cheering when your child takes a bite. Sometimes the extra attention when trying something new backfires and can cause the child to shut down and not want to take subsequent bites. Instead label the action that the child accomplished, such as, “Wow! Did you see how splashy that grape was! I think it got in my eye! What strong muscles you have for chewing!”

Regardless of where you are on the feeding journey with your child, there are three key areas to keep in mind for encouraging healthy, happy eating: food exposure, food exploration, and food expansion. (A great book to check out is Raising a Healthy, Happy Eater by Melanie Potock, MA, CCC-SLP and Dr. Nimali Fernando, MD, MPJ). Frequent exposure, exploration, and expansion of foods builds a child’s confidence and overtime can help increase their number and variety of accepted foods.

• Food exposure starts during infancy/early childhood. It’s taking every moment to talk about and bring attention to the foods that we eat. One of my favorite food exposure activities that I do with my own children is letting them pick a new or favorite produce to try at the grocery store. They have picked some unique fruits and vegetables over the years such as dragon fruit, star fruit, and Romanesco broccoli. These are foods that they perhaps would have never tried on their own without this exposure task.

• Food exploration allows children to examine and investigate foods without pressure. It allows the child to lead the activity and build confidence in exploring unfamiliar or even non-preferred foods. Food exploration can be fun and messy! It allows the child to use their senses of sight, hearing, smell, touch, and sometimes even taste as their confidence builds. Some child-favorite exploration tasks include cooking/baking, using cookie cutters, using child-safe nylon knives to cut and slice foods, making kabobs, painting with foods, and using foods to string necklaces.

• Food expansion encourages children to try new foods that are similar to already accepted/preferred foods. This may be trying a new variety of broccoli (such as Romanesco) or apple (such as Pink Lady), a new brand of yogurt, a new seasoning on meat/vegetables, or a new fruit that’s similar in color or texture (cantaloupe vs. honeydew melon, nectarine vs. peach, or purple carrots vs. orange carrots).

If you’ve been working on exposure, exploration, and expansion of foods, and aren’t having much success, there could be a couple of things happening:

• Children go through a typical stage of development as toddlers called “neophobia,” a fear of trying new foods. This stage should be transient and brief, lasting just a few weeks to months.

• A feeding disorder could also be at play. Research indicates that 1 in 4 typically developing children will be diagnosed with a feeding disorder. A feeding disorder can be influenced by difficulty chewing and/or swallowing efficiently, or difficulty tolerating certain textures. It can be also be easily exacerbated by reflux and constipation, among other physical restraints.

A speech-language pathologist or occupational therapist who has expertise in feeding difficulties can help if you feel like you’ve tried everything, and your child is still struggling. A feeding therapist can evaluate and develop a treatment plan with you and your child’s pediatrician to reduce and eliminate the picky eating behaviors that are limiting your child’s diet and reduce the resulting mealtime stress.

Definite red flags that your child needs a feeding evaluation referral are choking or consistent coughing with drinks or foods, persistent stress and frustration surrounding mealtimes, and a food variety consisting of less than 30 foods.

BRG’s Baby Food Basics and Building Brave Bites feeding classes are free to families and held monthly. If you are interested in scheduling an evaluation with one of BRG's feeding therapists, request for your pediatrician to send a referral to (225) 381-6063.

Megan Davis Dewberry, M.A., CCC-SLP, CLC
Speech Language Pathologist, Certified Lactation Counselor
Baton Rouge General Pediatric Rehabilitation Therapy