• Picky Eaters: How to prevent and manage the problem in your child

    by Juliana Nahas, MD
    on Oct 20th, 2018

According to Volker and Piazza in 2012, up to 45% of children experience some mealtime problems. This is due to fluctuating hunger, picky eating patterns, strong food preferences and behaviors aimed at ending meals prematurely, as well as a reluctance to self-feed.

A picky eater is a toddler or child who has a low dietary variety, and is unwilling to eat either familiar or novel foods. They typically have a low vegetable intake, but are not typically compromised in their overall nutrition.

Most children prefer sweet foods to bitter or sour ones, and many adults do as well (part of the problem leading to the obesity epidemic in the developed world). But why does nature make our taste buds like so, when these foods are good for us? The answer is two-fold:

1- Some bitter and sour plants are actually toxic or poisonous, so our ancestors had to develop a way to discern which plants were edible and nutritious, and which ones were poisonous.

2-In the last 100 years, the food manufacturing industry has sweetened all of the foods and altered what our taste buds are accustomed to having.

About 10% of infants and children have a true feeding disorder, and may have an underlying condition that needs to be managed by a team of doctors and feeding therapists, but that is a topic for another article. Also, if your child has been prescribed a specialized diet such as gluten or dairy free or ketogenic, his or her nutrient intake may be compromised and needs to be supplemented from another source. In this article, we will look at the typical healthy but picky eater, and what to do to improve their palate.

Besides fat or triglycerides and lipids, there are 5 other food groups that really matter and provide different key nutrients:

Fruits

Vitamin C, potassium, fiber, carbohydrates

Vegetables

Vitamin A, E, C, K and fiber, carbohydrates

Protein

Iron, Zinc ,Magnesium, amino acids

Dairy

Vitamin D, calcium, amino acids

Grains

Vitamin B variety, fiber, iron, carbohydrates

 

When a baby of 4-6 months becomes a sitter, he or she develops an innate ability to learn and want to eat solids, and this guides them how much to eat for their body metabolism. The parent is mainly responsible to provide the choices and the timing of the meals, and the child then decides how much and whether to eat. Normal picky eating typically emerges at 18 months of age, but there are steps you can take as a parent to prevent or diminish the impact on your child.

Remember, infants and toddlers learn by imitation. They follow the “ Do as I do”, not “Do as I say” motto. They want to belong to the family culture, and later on, to their peer culture when they start school.

According to Ellyn Satter, RD , a prominent dietitian who has written many books on the subject, here are some simple tips to implement at mealtime to minimize food battles:

Parent’s feeding job

Children’s eating job

Establish a meal and snack schedule, and limit meals to 30 minutes

Young children require 3 meals and 2 snacks, spaced 2.5-3 hours apart.

Choose and prepare the food at home

Children will eat

Serve meals in the kitchen or dining area, use a booster seat, and limit media distractions (TV,tablets, etc..)

Children need to be seated and not walking around

Model the behavior of eating a wide range of foods, and do not express a dislike to a particular food in front of the child

Children will learn to eat the food their parents eats

Repeatedly offer new foods. Exposure to a flavor or texture 30-40 times, increases the liking of that food.

They will grow predictably

Provide enthusiastic attention and praise immediately following a good behavior (ex: smelling or licking the food)

They will learn to behave well at mealtime

Ignore refusal behaviors and age-appropriate messiness, including saying anything, sighing or facial expressions

 

Start with a single bite on a separate plate or on a plate with preferred foods

Children feel overwhelmed by large quantities of new foods

Do not let children have food or beverage ( except water) between meals and snacktime

 

 

Snacks should be nutritious, comprised of a protein and one other food group, such as a vegetable, grain or fruit. Examples of protein snacks include hummus, peanut butter, deli meats, eggs, yogurt or milk, cheese and nuts.

Remember, as a parent you are empowered to make a difference in your children’s lives, so try some of these tips today and enjoy watching your children transform their picky eating habits into good ones!

Author Juliana Nahas, MD Pediatrician at Covington Pediatrics

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