Feeding Toddlers, Part Two: The Picky Crowd

Photo by Martin Cathrae

After a lovely holiday hiatus, I am back, as promised, with part two in the series on feeding toddlers.  Today I’ll focus on kids who are choosy.  For this post I lean on professional experience.  We have no shortage of patients in our practice whom one could describe as “picky eaters” or who are sometimes diagnosed with “feeding problems”.  I have trouble with the diagnosis “feeding problems or mismanagement”, as it comes up in our electronic medical record.  Why?  Well, and this hopefully serves as a bit of comfort, toddlers who are picky eaters are pretty much the norm.  It is, in fact, an expected developmental stage.  If you have a toddler who refuses dinner, but then begs for chicken nuggets, this post is for you.  If you have a toddler who only takes two bites at each meal, and then runs off to play, this is for you.  If your child seems to refuse all vegies, this is for you.  If, on the other hand, you have a child with true “failure to thrive” or difficulty gaining weight and growing well, please consult with your pediatrician, as I won’t be addressing those problems here.

And so, a few tips for parents of kids in the picky crowd.  As I mentioned last post, check out Child of Mine: Feeding with Love and Good Sense by Ellyn Satter. Her division of responsibility works well for picky eaters. In short, parents decide what, when, and where to eat. The child decides how much and whether to eat. Here are some ways to implement these ideas with a toddler who is choosy.

  • Parents decide what to eat. I have met many families who become so worried about their child not eating that they become “short order cooks”. Parents end up making two or three types of dinner each night in order to placate particular palates. There are a number of problems with this approach. The first is obvious. It takes a lot of extra time and effort to make a number of different dinners each night. Most parents don’t have this kind of time. Secondly, it is not good for your child. Offering a special meal each night, catered to their desires, teaches them to continue to be picky. Offer balanced meals, with a mix of protein, grains, and vegetables. Offer new, interesting foods. Remember it can take 15-20 times of offering a certain food before your child may accept it and grow to like it. To encourage this, and make mealtime less of a battle, offer a new food paired with a familiar favorite.
  • Parents decide when to eat. Set three meal times and 1-2 snack times per day. Eat dinner together as a family. Avoid snacking throughout the day and avoid filling drinks. Kids will be even less likely to want to sit down for lunch if they are already full of juice or milk.
  • Parents decide where to eat. All meals and snacks should be eaten sitting down in a high chair or at the table. If a child starts throwing food or wants to leave the table, the meal is over. Don’t follow them around with a spoon trying to get in a few more bites.
  • Child decides how much and whether to eat. Again, this is the toughest part for parents to accept. Trust your child. Young children, even picky ones, are following hunger cues. You have done your part by offering a variety of healthy foods.  Don’t force your child to clean the plate. They may eat all of one food, and none of the rest. They may take one bite of each thing. That’s okay. Try again next time. Avoid turning mealtime into a battle or making deals with your child to get them to eat more. Avoid saying things like, “oh, that’s a food you don’t like”. Teach them how to refuse food politely. Think in the long term. Kids might have hungry days and not-so-hungry days. As pediatricians, we think about growth over months and years, not (usually) by days and weeks.
  • A couple extra thoughts. Many parents of picky eaters ask about vitamins. One thing to know up front is that vitamins will not increase appetite. The American Academy of Pediatrics does not routinely recommend vitamins during middle childhood, if the child is eating a relatively balanced diet and growing well. If you are concerned about lack of intake of certain vitamins and minerals, over the counter multi-vitamins (such as liquids or chewables) are generally safe. They must, however, be taken in the recommended dose. They are medications, and should not be treated as candy. Consult your pediatrician for advice more specific to your child. Finally, try not to give well-marketed, high calorie liquid supplements (e.g. Pediasure) in place of food (unless recommended by your child’s health care provider).

Why is this important?

Offering interesting foods of all different shapes and colors and flavors very early in life is an important parental responsibility. If we don’t, we only make it more difficult for our kids later in life. A good example of how this can play out is in the current debate about nutrition in schools. The importance of good nutrition in schools is clear, as many children eat two meals a day in the cafeteria. Much has been made of the overall poor quality of school breakfast and lunch, everywhere from Jamie Oliver’s Food Revolution, to grassroots efforts in many cities and states (including my own home state of Wisconsin). Interestingly, though, it is not only the food that has to change. It is the students’ palates. Recently, the LA school district revamped their school lunch program and they are finding that it is difficult to get children to eat the newer healthy food. Hopefully, with time and thought, we can make healthier food on a large scale that tastes good. But, we must also introduce children to these foods earlier in life, so they’ll be more likely to accept them later.

Finally, be kind to yourself. When a child doesn’t eat a meal that a parent has lovingly prepared, it can be hard. It doesn’t make you a bad parent, or even a bad cook. For most children, picky eating is a phase that will pass. If it doesn’t, or poor appetite seems to be affecting your child’s growth and development, talk to their doctor.

What feeding strategies have helped you to avoid mealtime battles with your toddler?

11 thoughts on “Feeding Toddlers, Part Two: The Picky Crowd

  1. An elegantly simple set of rules: awesome! The ‘division of responsibility’ is a great way to give parents the framework to provide a healthy diet and clear position of authority while still giving children the ability to make choices. This would be a good metaphor for many other sticky points in parenting: provide a healthy foundation, stay firm on it but offer a child some wiggle room and autonomy on the details.
    Parents shed the stress, children learn to eat healthy and everybody wins! (Also like the way you make a point to mention how the farm bill subsidizes grain crops and corn over fruits and vegetables in part one of this post…a big problem in terms of the food choices offered to Americans.)

    • The relative simplicity is one reason I love the division of responsibility- really easy to talk through with parents during a clinic visit. Thanks so much for visiting and sharing your thoughts!

  2. A friend introduced me to Satter’s book when Henrik was just a wee peep. I remember reading it with much concern as he was just that – a picky eater. Years later, he really has opened up to a lot of foods and like a lot of things I don’t even like (raw brocolli!) Now, with the second, I see the same game being played but now I can see it for what it is and how it will eventually phase out given how we feed our kids.

    I think the HARDEST thing is snack time. Snack time always comes when we are in the middle of something or out and about. It’s really hard time come up with portable easy foods without always resorting to crackers or something more processed. We frequently do bananas, apples, oranges- but even those get old…

    And then SCHOOL and other kids lunches introduce a whole new set of problems. While they don’t share (or at least aren’t allowed to), they DO see foods they haven’t seen before. I was happy to see that even Henrik could tell me when his little friends were eating mostly “treats” as opposed to “real food”.

    • Oh, I love that Henrik already knows the difference between “treats” and “real food”. What a testament to the healthy relationship with food that you have set up for him as a young eater. I can only hope our little guy will be the same at his age.

  3. Thanks for the advice! I ordered the book. Any tips for helping picky 9 month olds NOT become picky toddlers?? I really hope my little guy will love food and have an open palate.

    • My first advice for the early months of food introduction is repetition, repetition, repetition. Don’t be surprised if the first response to a new food is to move it around in the mouth a little bit and then spit it out. Don’t give up! Allow your little one to accept or reject certain foods on any given day, but try not to think of that as meaning they “don’t like it”. It often takes new eaters 15-20 times of trying a food before they accept it and grow to like it. Also, don’t be afraid of offering foods that have unusual tastes or spices. Offer a wide variety of tastes and colors. Start to allow them to play with the food and feed themselves, to explore food’s texture and well as its taste. Best wishes and thanks for reading!

      • thank you!! great advice. I was also wondering about always eating in a high chair… our babysitter takes food to the park in the afternoon and often feeds him there (in the stroller or sitting on the ground); I’ve done this too and it’s one way not to always be anchored at home during mealtimes AND naptimes. Do you think this could worsen eating habits? I must say he eats pretty well in the park!

      • Great question! I’m a big fan of eating outside. We often have “picnics” for snack time. In my opinion, as long as you pick a spot to sit together (on the ground, in the stroller, at a picnic table or bench) it is completely fine. It gets a little tougher when they are bigger and want to eat and run around at the same time. We try to differentiate eating time and playing time. If he is more interested in running around, then eating time is over.

  4. Pingback: Five ways to prepare your child for a doctor’s visit | My Two Hats

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