Food Fight! How to Nourish a Picky Eater

Judging by the number of comments and questions on FB parenting pages and other sites, finicky toddlers are a common concern for parents. As a parent I coped with one child who would eat anything that was even remotely identified as food and another who would eat any food, if it was the color of mashed potatoes. I, too, worried about their nutrition and was concerned about the effect of poor eating habits on their physical development. I am glad to report that both grew to healthy adulthood as competent, and sometimes adventurous, eaters. Seeing another generation of parents concerned about the same issues I want to communicate that this is a normal, if challenging, developmental phase. Although I am happy to share my own experiences, I consulted several sources to bring you the best information out there. So, let us get started.

A Feature of Normal Development

Jill Castle M.S., RDN (www.jillcastle.com) is a childhood nutrition expert and her site is a great source of information. She explains that after the first year of rapid growth and development, the toddler continues with a steady but slower course of development. Because growth is slower appetite shifts and becomes unpredictable, from voracious one meal to non-existent the next. Constant requests for snacks and refusal to eat at the table. Combine this with the universally observed developmental move to greater independence, exploration, limit testing, and self-control and, well, the result is predictable. The most common concerns are refusing or being afraid to try new foods (called neophobia), eating only certain foods or getting stuck on one food for a long period of time (food jags), and skipping meals or snacks entirely (food refusal). In addition to nutritional concerns, many parents find they must cope with mealtime meltdowns, usually at the dinner table when everyone is tired after a long day. Not a pretty picture.

Toddler Nutrition and Behavior

We have already identified two separate topics to explore. The first is nutrition. What does a growing toddler need in his diet to remain healthy? At what point should a parent become concerned?

Nutrition

What is good nutrition. We are told to provide balanced meals, but what does that mean? How do you select a variety of foods that provide the necessary vitamins, proteins, fats and other nutrients your whole family needs? I am always on the lookout for charts that make complicated bits of information like this easy to access. I found this useful chart at .Yummy Toddler Food (www.yummytoddlerfood.com.) You can print it out and put it on your fridge as you plan and shop for meals. The authors recommend that you use this as a reference to turn to for reassurance and information. Don’t get too hung up on your child accepting every food on the list. I love their advice to ,”use it as a guide, not a hard and fast rule, since kids aren’t robots and will not eat like a chart.” The information on this chart should be useful to you in offering your child a variety of healthful foods selections. It also reminds us adults that while we are conscious trying to limit certain fats in our diets to control our waistlines, healthy fats should be included for our children, since little kids need it for proper brain development.

When to Become Concerned

OK. You have mastered meal planning, shopping and cooking to provide a cornucopia of tasty and healthful meals that everyone in your family enjoys, but your toddle still won’t eat. Is it “just a phase”? When should you raise your level of concern from managing a phase to addressing a problem? Because picky eaters are so common at this stage, well-meaning friends and family may offer comforting but inappropriate advice along the lines of, “don’t worry, he’ll grow out of it”. It can be difficult to know when to raise the question to your pediatrician. I looked for guidance. This information comes from Healthline (www.healthline.com) who turned to Yaffi Lvova, RDN (babybloomnutrition.com) who provides a list of behaviors that are concerning enough for you to consult your doctor or a pediatric dietitian for help. I will say that I am not sure if you should become overly concerned about each individual behavior on this list. Certainly, if your child has several (more than 3) of these eating behaviors , shows anxiety about certain foods, goes several days without eating or is losing weight you should be sure to make your pediatrician is aware of the situation. To provide more guidance , based on my over 40 years of professional experience, I have placed **** next to those behaviors I believe are the most concerning in terms of health risks or as indications of possible deeper developmental concerns.

· accepts fewer than 20 foods

· is losing weight ****

· dislikes or refuses entire food groups (grains, dairy, proteins, etc.)

· goes for several days without eating at all ****

· is committed to certain food brands or types of packaging ****

· requires a different meal from the rest of the family

· is anxious in social situations because of food ****

· has a dramatic emotional response to disliked foods, such as screaming, running away, or throwing objects ****

Please do not limit your concerns to this or any other list you may find her, or online. Listen to your parental Spidey Senses. If you think something is not quite right, consult your child’s doctor. Keep asking questions until you have a plan that works for you and your child.

Battling Dinner Time Behaviors

Most of the stories I have found on parenting sites center around troublesome toddler behaviors that completely disrupt mealtimes to the point that the entire family is in crisis. Behaviors can range from simply refusing to eat anything except one or two favored foods to complete meltdowns that interfere with everyone’s ability to complete their own meal. I recently read a comment from a young mother who reported that she and her husband waited to eat their own dinner for over 3 hours as they dealt with a toddler food-refusal tantrum. I sympathized as I read her story, but I was equally alarmed that they were giving that much power to a three-year-old. That cannot go on! What to do?

Mary L. Gavin, M.D. in an article published by Kidshealth.org has some guidelines for managing mealtimes. Once you have addressed nutrition and are providing access to a variety of foods, both established favorites and new foods, rest assured that your child will not starve. Look at mealtime as an opportunity to help your toddler develop flexibility overtime. Allow him to choose from one or two favorites at each meal, don’t stress out about how much he eats, and have one or two new foods that your whole family can enjoy on the table. Seeing others enjoy something tasty, may be all that he needs to be persuaded to try something new. He may surprise you one day and ask for something new.

Here are some tips from Dr. Gavin:

Don't Bargain for Bites

Resist the temptation to start talking to your child about nutrition. You know, the Popeye speech about how he is “strong to the finitch cause he eats his spinach”. Your toddler doesn’t care about Popeye, yet. Don’t over-react and celebrate every bite of something “nutritious”. This can backfire and result in increased resistance. Don’t turn dinner into a never-ending negotiation. The use of desert or a special treat as a reward can make treats more important than good food. Not exactly the result you were hoping for. Threatening to withhold a favored desert or treat won’t work either. It just results, most often, in a power struggle. Just what you want to avoid.

So, what do you do? Dr. Gavin and Pediatric nutritionist, Jill Castle have similar Top To Do lists. I have added some thoughts of my own.

Keep food portions on the small side. A couple of table spoons or a quarter cup each of two to three foods at a sitting should be enough to keep from overwhelming your toddler. Portions that are two large can result in food resistance or over-eating. He can always have more if he wants.

Don’t negotiate. Offer, but don’t insist that your child eat a new or unfavored food. How would you like it if somebody insisted you eat something you don’t want? Respect his choice and offer again another day. (Note: My grandmother had a great line that worked on my picky eater. If he refused something, she would say, “I forgot. You’re not old enough to like that, yet.” It took a while, but it worked. He eventually tried everything. Kids aspire to be more grown-up.)

Have family meals at least once a day. It may be difficult in this day and age to arrange for the whole family to gather around the table for breakfast, lunch and dinner. Pick one meal that works for your family and stick to it. It is a great time for toddlers to see others enjoying lots of different foods. It is also a wonderful opportunity for forging close family ties through conversation and family games that support speech and language development.

Let toddler feed themselves. As young as nine months of age a child can be offered finger foods. By 15 to 18 months they can start to use eating utensils like a spoon and toddler fork set. Again, introduce the silverware, but don’t insist. Every new skill can be frustrating. If he chooses to switch to eating his spaghetti with his fingers, let him. Kids are washable. Don’t take control away form him by insisting on feeding him. He needs the practice in the mechanics of feeding himself. Let him decide what on his plate he will eat and how much. Offer more, but don’t insist on “one more bite”. He will learn to recognize his own body’s clues as to when he is hungry, when he is full, and the difference between thirst and hunger.

As much as possible, provide structure to your child’s day with regular mealtimes, about 3 hours apart, with perhaps a small mid-afternoon snack as you wait for all family members to be home for dinner. With my own children, I found that they were like squeaking baby birds if I did not. I would have a small snack of fruit or a small bowl of chips to offer them at about 4 pm. It kept the toddler happy, and the school-aged child had a snack as he finished his homework. Breakfast was usually small, but dinner was a family affair until their teenaged years brought another level of busy to our lives. We all function better with a good amount of structure to our day, especially small people. Keep control of mealtime by allowing 20 to 30 minutes for meals, and 10 to 15 minutes for snacks. In the old days, children asked to be excused from the table. That makes sense. It encourages polite behavior and allows the adults a few minutes of after dinner peace.

Structure will also allow you to use mealtime to your advantage when a toddler skips a meal. Not a problem. Aim for 3 small meals and 3 small snacks a day. Any skipped meal will be followed by another eating opportunity as part of your master plan. For snacks, give a choice between 2 pre-approved options. He has some control , but you have made an adult decision as to what is best for him. It also avoids the trap of on-demand eating, which is not a good life-long habit. If a snack is not appropriate, you can offer a cup of milk or juice.

The Junk Food Trap

Who doesn’t like a good piece of candy? How do you handle a child with a sweet tooth? How do you teach self-control, especially if you have not yet mastered it yourself? The experts advise that you don’t keep any in the house to avoid the temptation. I have mixed feelings about this. The world is full of candy and well-meaning people (grandparents, teachers, friends) offering it to your child. You can become the dragon at the gate, preventing him from a bit of enjoyment. One expert advised that you lie to your child and say you don’t have any candy. Never a good way to go, in my opinion. How can you build mutual trust and respect with a lie? Or, you can teach him how to control himself.

I am not a nutritionist, but I have taught children for a long time and raised two of my own. As a child my son would only eat foods the color of paste. My daughter was the opposite. She was a foodie from birth and a committed chocoholic. I found the best way to manage her constant requests for candy was to keep the chocolate on a high shelf in the kitchen cabinet, well out of her reach, so she would have to ask for it. I made sure that any candy was cut into small, bite-sized pieces. The stated limit was 2 pieces of chocolate, maximum, on any given day. She could decide when she would have the chocolate, but she could have no more than 2 small pieces total. It worked for me because I wasn’t the bad guy, saying no all the time. It worked for her because she had control over her access. If she already had her chocolate for the day she could have fruit as a snack. She practices similar restraint over her sweet tooth as an adult. Good Job!

So, there you have it. The best advice around for addressing picky toddlers and other picky eaters in your family. I have included many speech and language developing games activities that involve food, shopping, meal preparation and mealtime in The Gift of Gab (Simon and Schuster). You can have fun together as your child learns to enjoy food. Bon Appetite!