When Is Picky Eating A More Serious Problem?

Picky or fussy eating is a very common stage of development in the toddler. Toddlers will often have very strong likes and dislikes for different kinds of food. They also are not always hungry when it’s mealtime. When should you talk to your pediatrician about picky eating?

First, you should always feel free to talk to your child’s doctor if you think your child may not be getting all the nutrients he needs. This might be because he doesn’t eat enough. Or it might be because he will only eat one or two kinds of food.

The doctor may also have suggestions on how to handle picky eating and the behavior problems that can result. Many parents want to provide healthy foods but don’t really know what makes one food healthier than another. Your child’s doctor can give you material to read. He or she can also refer you to a nutritionist if needed.

There are a few things that might make your doctor think that intervention is needed to help your child eat more, or eat a broader range of foods. If you notice any of these, you should definitely talk to your child’s doctor.

In particular, please talk to your child’s doctor if your child: Is losing weight Is not gaining weight as he should Is not growing as he should Gags or vomits in response to food Has frequent diarrhea or constipation Seems to have frequent stomach aches Gets an upset stomach or allergic reaction to specific foods

Some children have food allergies or difficulty digesting certain foods. If you think that your child has this problem, please consult your child’s doctor about what foods to avoid.

If a child eats a very restricted diet, he may not get enough of some specific nutrients. For example, he may not get enough calcium or Vitamin D. These are needed for strong bones and teeth. He may not get enough protein; protein is a basic building block of the body.

Calcium is found mainly in cheese, yogurt, milk and calcium-enriched products like some cereals, breads, and juices. It’s also found in green leafy vegetables like kale and spinach. It’s also found in some other vegetables like broccoli, peas, and lentils. Some types of fish, especially sardines and salmon, also have calcium. In the United States, Vitamin D is added to milk, and to some cereals and some brands of orange juice. Vitamin D is also found in salmon and tuna. Check the nutrition panel on the container to see whether or not the foods your child likes provide calcium and vitamin D.

Good Sources of Vitamin D: Fortified milk Vitamin-D enriched cereal Vitamin-D enriched orange juice Salmon Tuna Good Sources of Calcium:  Cheese Yogurt Milk Calcium-enriched cereals, breads, juices Kale Spinach Broccoli Peas Lentils Sardines Salmon

If your child is not getting enough Vitamin D or calcium, he may need to take a daily children’s vitamin. There are many types of children’s vitamins on the market, and they’re made to fit children’s tastes. It is important to talk to your doctor about any vitamins or supplements before you give them to your child. Not only can giving too much of vitamins or other supplements be dangerous, but it’s not always possible to know that what’s on label is what’s in the bottle. Your pediatrician will know what’s best for your child.

If your child refuses most of the foods that are good sources of protein, talk to your doctor about whether he’s getting enough protein. Also, if your child refuses most fruits and vegetables, he may tend to become constipated. Constipation can lower a child’s appetite.

Good Sources of Protein:  Meat Chicken Fish Milk Cheese Yogurt Eggs Chickpeas Kidney beans Tofu, soy milk and soy beans, like edamame Almonds and almond milk Baked beans And, if your child is not allergic, peanuts or peanut butter

If you want to learn more about medical guidelines for healthy eating in children, there is plenty of excellent, parent-friendly information at the American Academy of Pediatrics website. This web page is also available in Spanish. Your child’s pediatrician should also have charts they can give you about the nutrient contents of different foods.

What To Do About Normal Picky Eating

If your child’s pickiness about food is not considered serious by you or the doctor, and he is getting the nutrition he needs, it’s best not to make too big an issue of it. It’s really important to keep mealtimes a happy, social occasion that everyone can enjoy.

Food and mealtimes are one of life’s great pleasures, and a great place to develop and enjoy relationships with family and friends. If there are foods your child really resists, but he is getting his nutrients from other foods, don’t try to feed him the foods he dislikes. And don’t ever try to force food into a child’s mouth. It could be dangerous. It’s also likely to make him dislike the food even more. Forcing children to eat foods they do not like tends to make picky eating worse.

Think about a food your family really enjoys but your child refuses to try. Keep serving it to others at the table. Just seeing others eat it may help him to get used to the sight and smell. It may even make him want to try it. Children feel safer with familiar foods. So, it’s a good idea to make the food familiar to the child and have him see others enjoying it. You can also put a very small piece of the food on his plate, but don’t make a big deal about it if he leaves it there and doesn’t eat it. Just allowing the food on his plate is progress.

Some children are more likely to try something if they’ve helped make it. Your child may feel a sense of pride when you tell the family he helped to make it.

What About Dessert If the Child Hasn’t Eaten Much of the Main Meal?

Some feeding experts suggest always serving a small, reasonably healthy dessert such as fruit, or a small cookie, or a small portion of sweet yogurt. They suggest you do this even if the child didn’t each much or anything at dinner. This may prevent a power struggle. Just make sure that the desserts are small. This way, he gets most of his calories from healthier foods. Other experts suggest getting ready of sweets altogether, and just serving fruit as a dessert. This is really up to you.

Remember, any concern about nutrition should be brought to your doctor. We mentioned the AAP website. There are many other excellent websites with information on how to handle “normal” picky eating and nutritional needs in general.

A few examples of these websites are:  Children’s Health Network, Healthy Lifestyles Zero to Three, Picky Eating

What To Do About More Serious Picky Eating

So far, we’ve been talking about the normal kind of picky eating that is common in preschool and even older children. But there are some children who have a very small number of foods that they will eat. And some children show very strong reactions to even the sight or smell of a food they don’t like. If this is the case with your child, you or your doctor may decide that some behavioral methods may be useful.

It’s really important to keep mealtimes a happy, social occassion that everyone can enjoy.

We want to talk about what causes this extreme pickiness and the behaviors that can result. Then we’ll discuss some general rules for how to get your child to eat more kinds of food. After we’ve talked about these simple, general rules, we’ll talk about some specific things you can try.

Children with autism and other developmental issues are especially likely to be very picky eaters. There are at least two reasons for this.

One is that children with autism often really like routines. They like things to stay the same. This is true of most young children. However, children with autism can take it to an extreme. They may react by getting very upset if things don’t happen the way they expect. You can see this in food and mealtime activities. For example, children with autism may insist on only eating very specific foods. They may only eat foods with a specific flavor, texture or color. They may want different kinds of foods far apart on the plate. If a parent tries to change that, the child may get very upset or have a tantrum.

Sensory Sensitivity

Also, sensory sensitivity is another part of autism that can lead to picky eating. Sensory sensitivity results in very strong reaction to feelings, foods, or things they see or hear.

Sensory sensitivity results in unusually strong reactions to:  Sounds Smells Tastes How things feel on the skin Bright lights

A taste or smell that another child might find a little unpleasant may seem to the child with autism to be really, really disgusting or even scary.

What if your child is extra picky about food and about eating routines? He might be very upset if you try to get him to eat foods he doesn’t like or change his eating routines. This can result in behavior problems. These can include tantrums, like screaming, throwing things or breaking things. Some children throw themselves on the floor, kicking and thrashing about.

Other problem behaviors might include dumping or throwing food, refusing to eat, or spitting. When a child is strongly told or forced to smell or taste the food he doesn’t like, he might gag, spit, or vomit. If the foods the child is willing to eat is very limited, then he may not get all the nutrition that he needs. He might not get enough calories, protein, fat, or enough vitamins and minerals. This doesn’t happen often, but it’s possible.

Next: What Maintains Problem Behavior Involving Picky Eating?