Many kids have picky eating, but there are ways to help them still get a well balanced diet. If these tips aren't successful, talk to us. Some picky eating can be a sign that something underlying is going on that needs to be addressed.
(Content is adapted from posts on Dr. Stuppy's blog: My child won't eat! - by Dr. Kristen Stuppy (substack.com) , Food Strike! What can I do when my child won't eat anything anymore? (substack.com) and Nutrition for the Picky Eater - by Dr. Kristen Stuppy (substack.com) )
Some reasons kids don't eat:
They're really getting enough food, parents just have unrealistic expectations.
This is very common.
Portion sizes are smaller than many parents think. They vary with age and size of a child as well as his activity level. If your child is growing well and has plenty of energy throughout the day, why should he eat more?
Kids tend to eat small meals frequently and even on holidays they don't overeat like the adults tend to do.
When offering snacks, think of them as mini meals to help balance out the nutrients of the day. Don't let them snack all day long though or they'll never really be hungry.
Schedule meals and snacks and allow water in between.
We have an obesity epidemic in this country, so if you're comparing your child to another child, chances are that your thin child is healthy and normal, but the other one is one of the 30% who is overweight.
Or maybe not.
It doesn't matter. Just be sure your child is getting a proper variety of nutrients. Parents can choose what foods are offered, but kids should determine how much to eat.
Talk to his doctor about growth at regularly scheduled well visits (more often if you're concerned) to be sure it's appropriate.
They're sick and it's temporary.
When kids are sick they lose their appetites.
This is normal.
It usually returns with a vengeance when they're feeling better. They need to drink to stay hydrated and can eat what they feel up to it, but don't force it. See their doctor if you're worried.
It's a new food and they just aren't sure yet.
I encourage that kids over 3 years old take one bite of a food.
Kids often hear me say, "taste a bite without a fight." The bite needs to be enough that they taste it. If they like it, they can keep eating. If they don't want more, resist trying to convince them to eat more.
Allowing them to take ownership of the decision of what to eat empowers them. Kids like power, right. Give it to them while modeling healthy eating behaviors yourself. They learn from what you do, not what you say -- and not from what they're forced to do.
When preparing a new dish, include familiar foods they like to balance out the meal so they can enjoy at least something on the plate.
They're picky eaters.
Aren't they all?
Most kids go through phases where they love a food, then they suddenly dislike it. They might dislike a certain texture or a whole food group. While there are kids with real problems eating, most picky eaters can be encouraged to eat a healthy variety of foods as described above.
Some children really suffer from being overly restrictive. Children with autism, sensory problems, food allergies, and other issues are not included in this "typical" picky eater category.
A great series of blogs on picky eaters (typical and more concerning) is found on Raise Healthy Eaters.
They're more interested in something else.
Make meals an event in itself.
Sit together and talk. Turn off the television. Put away your phone.
Have everyone focus on the meal, which includes the food and the conversation. Try to keep the conversation pleasant and not about the food. Take the pressure off eating!
They've filled up already.
If kids have access to snacks all day, they won't be hungry for meals.
Make sure they have set meal and snack times, but no foods between. They'll come to the table hungry if they haven't snacked all day.
Some kids drink too much milk, juice, or other calorie-filled drinks. While it might seem that milk or juice are healthy, the reality is that they do not have a variety of nutrients that our kids need. Milk at least has protein, but it's missing iron and other key nutrients. Juice is mostly sugar and really should be avoided. Don't let your kids fill up on drinks.
When they're hungry, they're more likely to eat what's offered.
A medicine makes them not hungry.
Some kids take medicines that decrease their appetite.
If your child is on one of these, their physician will need to follow their growth carefully, but it doesn't automatically mean they shouldn't take the medicine. Most kids can get the calories they need for healthy growth despite these medicines.
In summary...
In general, parents should choose what foods kids are offered so that there's a balance of nutrients, but kids determine how much they eat.
If they're hungry, they'll eat. If they're not hungry, they shouldn't eat. Learning to eat when not hungry is something that causes many of us to struggle with weight. Most kids are able to limit intake to needs. Don't force them to change that great quality!
If you're worried about your child's appetite, talk to your pediatrician. The physician will need to see your child to check the growth pattern and to examine him or her for signs of illness. Labs are usually not needed, but can be done if there are concerns for some medical conditions. Medicines are rarely used to stimulate the appetite.
A few quick "rules" to healthy eating
Don't offer junk
Don't make it easily available at home... most kids can't drive to the store!
Hungry kids will eat what's offered
Let them get hungry between meals. No grazing.
Use snacks
Not every food group will be eaten at every meal, so use the day to space foods to incorporate a range of nutrition over time.
Think of snacks as mini-meals.
Keep meal time fun
Turn off the tv and have a family conversation about something other than the food.
Plant + Protein
Offer a "plant and protein" every meal and snack to get kids to the 5 a day of fruits and veggies and to give a protein for "staying power".
This also fills kids up with the good things so they aren't hungry for junk.
Try it
Enforce "Taste a bite without a fight" after 3 years of age.
Kids should at least taste a bite before they decide if they like it or not.
Forcing more than the bite might cause more problems, so start with just a bite.
Hide it
It's okay to be tricky and fun: add pureed vegetables to things, use yogurt or hummus dips, put food on a stick, arrange food into fun shapes, be creative.
Limit juice
Juice is not a food. It is mostly sugar - even if it's 100% fruit juice.
Offer the fruit instead. It comes with more benefits than the juice alone!
When is a food strike a real concern?
Most of the time picky eating is a normal phase. Sometimes it's simply that toddlers and young children don't need as many calories because they're not growing as fast as during infancy. Or it could be that they're filling up with empty calories due to inappropriate snacking. Of course there are some instances that are cause for concern.
Red Flags include:
- Recurrent or persistent illness
- Frequent vomiting or diarrhea
- Food allergies
- Very limited food types over an extended period of time
- Problems swallowing or choking
- Falling off growth curve
- Sensory issues (trouble with textures, tastes, smells, and more)
- Anxiety about eating or around foods
- Body image problems
There is a great series of posts covering picky eating on a dietitian's blog. Some articles are authored by a nutrition therapist. I will include some of my favorites below, but you can find them all on the site.
- Picky Eating (Part 1): How To Tell If Your Picky Eater Needs Help
- Picky Eating (Part 3): 8 Things Picky Eaters Wish Their Parents Knew
- Picky Eating (Part 4): 10 Pitfalls To Avoid When Feeding Picky Eaters
If you notice one or more of the red flags above, be sure to talk with your child's pediatrician.
Encouraging healthy eating
If hungry, kids will eat. Don't let them fill up on things that aren't giving a nutritious balance. Even just milk all day can be harmful because it lacks many vitamins and minerals. A little milk with other foods is better!
Healthy food choices
Offer veggies, fruits, cheese, nuts, etc at scheduled snack times. Think of snacks as mini-meals. If kids are offered healthy foods at meals and snacks, they will eat them when they're hungry.
Limit pre-packaged foods
Many prepackaged foods are preferred over fruits, vegetables, dairy products, nuts, and other healthier options. If kids have a choice between cucumbers and hummus or a bag of chips, what do you think they'll pick?
Healthy drinks
Limit drinks other than water and milk. Drinks fill kids up and don't offer balanced nutrition. Limit milk to no more than 24 ounces per 24 hours.
Too much is overwhelming
Put only a small amount of each food on the plate. It might be overwhelming to have a full plate. Different personality types can even respond differently to different plate sizes. See Children's Personalities & Bowl Bias: Extravert and Introvert Children Are Not Equally Influenced by Plate Size!
Turn off the tv and put down the screens
Have a dinner conversation with the family. This not only sets up healthy eating habits, but also healthy family dynamics. Teens who eat with their families are less likely to have risky behaviors!
Set a good example!
Talk about how much you are enjoying the healthy foods at the table. (Not how healthy they are, but rather how good they taste.)
Keep foods separate on the plate
Kids might eat a food if it's not touching another but refuse it if it's contaminated.
Scheduled eating
Set a time for meals and stick to it. If your child doesn't eat, clear the table. When they complain of being hungry, don't be condescending. Simply say, "I know how you feel. I'm hungry too when I don't eat. Dinner is coming up soon. I'm sure you'll be ready!" Don't offer filler foods. Keep the discussion calm and without blame or judgement. Kids are smart, they'll pick up on the fact that they need to eat at meal time or be hungry. They won't starve to death!
Hide healthy foods
Puree a can of beets into spaghetti sauce. It makes a cool color without changing the flavor much at all. Blend carrots, spinach, kale, or cauliflower into smoothies. I've even used frozen peas when there was nothing else. Strawberries, bananas, kiwi, and other fruits are much more flavorful than many veggies and kids tend to like their tastes. If your kids balk at the color, try to match the fruit and vegetable colors to hide the vegetable. Puree onions, carrots, zucchini, spinach, and other vegetables in recipes rather than chopping them... kids won't pick them out! With all of these hidden foods, chances are they won't even know they're there.
Try foods in different forms
Frozen peas are crunchy-- maybe they don't like the squishy texture of cooked peas. Raw broccoli is much different in taste and texture than cooked broccoli. Many kids love cheese over vegetables or foods dunked in ketchup or yogurt. It's fun to eat with fingers for a change. Let them get messy! Try cutting things into pieces and serve with toothpicks. Everything's more fun on a stick! Cut sandwiches with a large cookie cutter for fun shapes. Use small cookie cutters for bite sized sandwiches or fruit pieces. Take a look at Pinterest to find ideas on how to make foods fun if you really have a lot of time on your hands.
Rewards?
Try not to use food as a reward. This can set up unhealthy eating habits. Don't reward for eating. Most kids will get the intrinsic reward of satiety. They don't need stickers or dessert for eating a meal.
Praise small steps
If kids try a new food (whether they like it or not) praise the fact that they tried!
Set realistic expectations
Don't expect kids to eat as much as infants/toddlers or teens/adults. Calorie needs go down when not in growth spurts. Just make the nutrition needs balance. Don't worry as much about volume as variety of healthy foods! Parents can decide what kids eat, but kids should decide how much to eat. Most kids don't need supplemental meals in a can (Pediasure and other brands) ~ they are getting the nutrition and calories they need, there is just an imbalance of perception of what they need. I always prefer a healthy, active, thin child over a child who is overweight and not active (and often undernourished due to poor quality foods).
Will they get enough vitamins?
Vitamin supplement use and need is debated. It's very difficult to study vitamin supplements. Baseline diet variations could make a big difference as to whether or not the supplement is needed. The time that needs to be studied is very long, because many health issues develop over many years. This means we need to wait a long time to see results and there's a bigger potential that study participants are lost to follow up. Vitamin D is one vitamin that I believe should be supplemented by all. Very few foods have vitamin D. Milk and a few other foods have been supplemented, but that alone will not give sufficient levels. Sunlight is a great way to raise vitamin D levels. But sunlight availability is unreliable and amounts needed vary based on skin type and quality of the light. Not to mention that sunlight can damage our skin. In general I think it's a good idea to give a multivitamin with iron if kids aren't eating well. I prefer for them to get nutrients from foods, but if they refuse, then there's no need for them to become deficient in nutrients. Iron deficiency actually causes anorexia, which increases the problem by not eating well! If your family uses vitamins, be sure to lock them up as if they're medications so kids don't accidentally ingest too much.
Last thoughts
Most kids grow well during their picky eating and food strike phases. Just be patient and aware of any red flags that need to be evaluated. If you are concerned, schedule an appointment to discuss foods, growth, nutrition, and concerns. Bring a typical food log of foods and drinks (with approximate volumes) for at least one week. Your physician can either identify a concern and develop a plan of action or reassure you that your child is normal!
