52: A Gentle Approach to Picky Eating in Childhood

While there is no exact definition of picky eating, children who frequently refuse vegetables, eat a limited variety of healthy food, have restricted intake, are unwilling to try new foods (neophobia), are slow eaters, or have strong food preferences are often identified by parents as picky eaters. Picky eating is a very common problem in early childhood, affecting up to 50% of young children. Picky eating habits may become a source of parent-child conflict. Along with making mealtime feel like a battlefield, picky eating can lead to constipation or other health issues.  

What can parents do to prevent the development picky eating? One comprehensive study concluded that offering fruits and vegetables early (at 4-6 months of age), repeating them frequently, and providing a rich variety of food in general are important strategies for avoiding picky eating. Note that when it comes to green vegetables, 8-15 exposures may be required for babies to accept them. If your child spits out peas on the first or second (or third) try, don’t give up! Patience and repetition are extremely important for training a young palate to accept green vegetables and other healthy foods.

In my office, a small unpublished study suggested that giving green vegetables to babies for two weeks prior to the introduction fruit helps to prevent picky eating habits down the road. A much larger study would be needed to make a definitive statement on the ideal order of solid food introduction.

Importantly, picky eating is not always preventable. Some children are born with strong likes and dislikes regarding food, and these preferences may persist into adulthood. Nonetheless, strategies can be employed to encourage children with rigid eating habits to broaden their horizons. Occupational therapists, for example, have developed programs to desensitize children to different varieties of food. Children are asked to take a tiny bite of the goal food. The size of the bite is gradually increased over time. By offering miniscule “doses,” the food becomes less threatening to the child. Another therapeutic intervention is asking children to “play” with goal foods (i.e. building things out of food or creatively arranging food) to desensitize them to the color and texture of the food. These types of interventions can easily be done at home.

Be aware that bribing or nagging kids to eat healthy food can sometimes backfire. Children who are constantly pressured by parents to eat nutritious foods may act out by rejecting desirable foods. Excessively restricting children from eating “junk” food can have a similar unwanted effect—children may become drawn to the restricted food. The ideal strategy seems to be consistently offering healthy food in a gentle way and allowing the child to make unpressured food choices.

Interestingly, picky eating seems to be protective for preventing at least one health problem: obesity. Because picky eaters tend to eat fewer calories overall, they are more likely to be underweight than obese.

Picky eating in childhood is definitely an arena that is calling for more research. Recently I had the pleasure of collaborating on a whimsical children’s book about picky eating called, PRISCILLA THE PICKY PORCUPINE, with artist Julieta Gomes from Quinnipiac University. The story, which contains plenty of playful alliteration, is perfect for preschoolers. To access the book on Amazon, click the link below: