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"He's such a picky eater, we dread mealtimes!"

D. is a 7-yo male who has always been a picky eater, unlike his siblings who eat anything and everything. Mealtimes are a constant battle, with his parents trying to nag him to eat more vegetables, and try different things. 

What’s wrong with D.? Can anything be done to help? 

What is a Picky Eater?

On one hand, it is good to be at least a bit picky about what one eats. If someone ate anything and everything, then they might be at risk of getting sick from things that might be rotten or even poisonous. 

On the other hand, if a person is so picky that it prevents one from getting enough healthy foods, then this is a problem. Excessively picky eaters may have trouble getting enough calories (thus ending up underweight) or even develop nutritional deficiencies by not eating enough variety of foods. 

What Causes Picky Eating?

Many issues can contribute to someone being a picky eater:

Self-Help Strategies: Parent Strategies for the Picky Eater 

Principles

Eating is a skill like any other. Some skills are easy to learn. Other skills take more time and may even take special help from a professional to learn. 

However, the following things can help make it easier: 

• Make one change at a time.
• When you make a change, make it gradual. 

Strategies

• Eat meals at a table as a family, in the kitchen or dining room, if possible. Avoid distractions to encourage your child to use all of his/her senses to experiment with new food.
  
  
• Everyone should eat together as much as possible. Express gratitude for your child's behaviours ("Thank you for ___") and ensure successful and pleasurable meals to keep mealtimes positive.
  
  
• Place a non-preferred food next to the child’s preferred food to change the appearance of their meal. Having a favourite food on her plate will help attract his/her attention to her plate. Remember, it can take up to 20 positive exposures to food before a child accepts eating it.
  
  
• Children will eat and drink the same as their parents and siblings. Learning by imitation is a powerful tool. Be a good role model for them by serving and eating healthy foods.
  
  
• Offer three meals and two to three snacks per day. There should be two hours between each meal and snack, with nothing in between (except water) to ensure that your child is hungry.
  
  
• Gently remove unfinished food within 20 to 30 minutes of serving, and do not allow other food until the next planned meal or snack.
  
  
• Encourage fluid intake. 
  • Ideally, this might include 2 cups of milk, ½ cups of juice (which may be diluted with water), and 2 to 3 cups of water per day. 
  • Milk may be added to fruit smoothies if it is not a favourite beverage, be persistent and keep offering milk every few days.
  • Are there persistent issues with milk? Ask the primary care provider if there might be issues with dairy intolerance. 
    
    
• Respect tiny tummies. The portion size for children is ¼ to ½ of an adult portion.

• Expose your child to new foods. 
  • Find ways for your child to be exposed to different types of foods. Perhaps they can go shopping at an outdoor market (with natural lighting). 
  • Leave food lying around. 
  • Store food in clear containers.
  • Label cupboards and shelves with pictures of foods. 
  • Make healthy foods easily accessible to your child.

• Grow food. Growing your own vegetables in a garden helps build a connection to it.
  
  
• Cooking food. Involve your child in baking and making meals. Consider cooking classes for your child.

• Use the power of familiarity: 
  • Use condiments such as ketchup and mayonnaise.
  • Does your child have a favourite (waterproof) toy, like a toy train? If so, put it on the plate along with the food.  

• Food play activities can increase a child's acceptance of food. Allow your child to see, touch, and smell a variety of foods. 

Sensory Strategies 

These strategies help provide the child with a multi-sensory experience of food.

Sight

• Help unpack vegetables/fruits and place them in a bowl or sort them by color, etc
• Bring your child grocery shopping and encourage them to feel the fresh produce (touch). 
• Have your child help serve the food; build a rainbow of colours on the dinner plates.
• Find books and games with pictures of food and introduce them to your child
• Describe the color, taste and shape of a food.
• Encourage your child to participate in meal preparation, children love to stir.

Touch

• Have your child help arrange cut vegetables or fruits on a plate
• Have your child wash fruits and vegetables in the sink
• Ask your child to add fruit to a fruit smoothie
• Use raw or cooked foods during craft activities:
  • Spaghetti can become a road for cars, or hair for a happy face
  • Cucumber slices can become wheels for a car or eyes for a happy face
  • Bread or carrot sticks can be used to make a fence
  • An orange slice can become a sun
  • Finger paint with pudding or pureed food, and make Jell-O gigglers
  • Use peas, cherry tomatoes, orange slices, crackers or other food for a counting or stacking activities
  • A potato or other firm fruit can be used to make a stencil
  • Dried fruits can be used to make a walking path
  • A cucumber can be used as a rolling pin
  • Rub foods on hands, arms and progress to cheeks and mouth area. 
    • As child builds acceptance to touch, you can rub tastes along the lips and encourage your child to lick the food.

Smell

• Expose your child to a variety of scents (vanilla, lemon, spices) and discuss whether they like/do not like that smell. 
• Make a sheet with pictures of “Nice Smells” vs. “Not-so-Nice Smells”.

Hear

• Game: What noise does this food make?
• Exaggerate the sounds of biting, chewing, and swallowing.

Does the child have troubles with oral motor skills?

• If so, then your child may benefit from activities and exercises to improve their oral motor skills. 

Food Chaining

Does your child like food in one form? If so, then consider serving it in other forms. 

Example: Does your child dislike boiled eggs? Try serving them in other ways, e.g. scrambled, poached, etc.

Strategies for the Toddler with Food Aversions 

Consider sensory-based food play strategies, which helps the child become accustomed to the sensory experiences of food. 

Examples of food play strategies

• Does the food cause a strong visual reaction?
  • Play peek-a-boo with a napkin.
  • Small glimpses of the food may be tolerated, and over time, the visual interaction with the food can be lengthened. 

• Is touching the food or food textures an issue?
  • Place food in plastic bags and drawing letters or shapes is one approach that can be effective. 
  • Using an object such as a stick-shaped vegetable to touch or manipulate unfamiliar foods.  

Do’s

• Do be patient. It can take up to 15 or more positive food experiences for a child to accept a new food.

Don’ts

• Don’t pressure the child to eat during the time that is meant for food play and exploration. 

When and Where to Find Professional Help

Is your child still struggling despite trying various strategies on your own? If so, consider seeing a professional. 

• Are there medical issues such as constipation, reflux or autism spectrum disorder?
  • See a primary care provider.
• Are there oral/motor issues?
  • See a speech-language therapist (SLP) or occupational therapist. 

Recommended Readings

The following books may be helpful with your selective eater.

Food Chaining: The Proven 6-Step Plan to Stop Picky Eating, Solve Feeding Problems, and Expand Your Child’s Diet. Fraker, C., Fishbein, M., Cox, S., Walbert, L. (2007). 

Just Take a Bite: Easy, Effective Answers to Feeding, Ernsperger, L., Stegen-Hanson, T. (2004).USA: Future Horizons.

References

Crosby B: Super-Tasters and Non-Tasters: Is It Better to Be Average?

Retrieved Dec 18, 2020 from https://www.hsph.harvard.edu/nutritionsource/2016/05/31/super-tasters-non-tasters-is-it-better-to-be-average/

Bartoshuk, L. M., V. B. Duffy, I. J. Miller, PTC/PROP Tasting: Anatomy, Psychophysics, and Sex Effects. Physiol Behav, 1994; 56: 1165-1171.

Hutchins, H. L., N. A. Healy, and V. B. Duffy, PROP Bitterness Associates with Dietary Fat Behaviors and Risk for Cardiovascular Disease (CVD) in Middle-Aged Women. Chem Senses, 2003; 28:551-563.

About this Article

Written by the eMentalHealth.ca team. Special thanks to Krista Waddell, Registered Dietician, CHEO; Carrie Owen, Occupational Therapist, CHEO. 

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.

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