Picky Eaters: What Works and What to Skip

If dinner at your house has turned into a standoff over three green beans, you are in good company. Picky eating is one of the most common worries parents bring to the pediatrician. The good news is that most picky eaters are healthy, growing well and simply going through a normal stage. Some common tactics, like bribes and battles, tend to make it last longer. This guide covers what usually helps, what to skip, and the signs that something more than pickiness might be going on.

Why so many kids are picky

Picky eating often shows up in the toddler and preschool years and can last into grade school. There are good reasons for it:

• Growth slows down. After the fast growth of the first year, children need less food for their size, so appetites shrink and can vary a lot from day to day.
• Caution with new foods is natural. Many young children are wary of anything unfamiliar. It is a normal stage of development.
• Independence. Saying no at the table is one of the few things a small child fully controls.
• Taste and texture. Children may notice bitter flavors more, and some are sensitive to mushy, slimy or mixed textures.

A child who eats a lot one day and very little the next is usually balancing things out over the week. Look at what they eat over several days, not one meal.

Split the jobs: you decide, they decide

Many pediatricians and dietitians recommend an approach often called the division of responsibility. It takes the pressure off everyone.

• Your job: decide what food is served, when meals and snacks happen and where the family eats.
• Your child's job: decide whether to eat and how much from what is offered.

In practice, this means you serve a family meal that includes at least one food your child usually eats, such as rice, bread, fruit or milk. Your child can eat as much or as little as they want of what is on the table. You do not cook a separate meal on request, and you do not push them to finish. It can feel uncomfortable at first, but children are good at listening to their own hunger when adults step back.

Repeated exposure works, slowly

Children often need to see, smell, touch and taste a new food many times before they accept it. A food refused today is not a food refused forever.

• Serve new foods in small amounts, next to familiar ones.
• Keep offering foods that were turned down before, without comment. Try them prepared in different ways, such as raw, roasted or in a soup.
• Let your child see you eat and enjoy a wide range of foods.
• Count small steps as progress. Letting a food stay on the plate, touching it or licking it all count.
• Involve your child in shopping, washing produce, stirring and setting the table. Children are more likely to try food they helped make.

What to skip

These common tactics usually backfire, even though they come from a caring place.

• Pressure. "Three more bites" or "you can't leave until you finish" makes mealtime stressful and often leads to eating less, not more.
• Bribes and dessert as a prize. "Eat your broccoli and you get ice cream" teaches that vegetables are a chore and dessert is the real goal.
• Punishments. Taking away privileges over food turns eating into a power struggle.
• Short-order cooking. Making a custom meal every time a child refuses dinner teaches them to wait for something better.
• Constant snacking and sipping. Kids who graze on crackers or fill up on milk or juice between meals often are not hungry at mealtime. Offer meals and snacks at set times, with water in between.
• Screens at the table. Distraction makes it harder for children to notice food and their own fullness.

Make meals pleasant

Keep the focus on time together, not on food. Talk about your day, keep meals to a reasonable length of about 20 to 30 minutes, and end calmly. A relaxed table is the setting where children are most willing to try something new. The AAP has more ideas in its tips for parents of picky eaters.

Do picky eaters need vitamins?

Most picky eaters get what they need over time. Some children who eat very few foods, avoid entire food groups or follow a special diet may benefit from a supplement. Ask your pediatrician before starting one, since some vitamins and iron can be harmful in large amounts. Keep all vitamins out of reach, as children can mistake gummy vitamins for candy. If your child swallows too many, call Poison Control at 1-800-222-1222.

When it is more than picky

Sometimes eating problems point to something else, such as a feeding or swallowing problem, a sensory issue, reflux, an allergy, or a feeding disorder called ARFID (avoidant/restrictive food intake disorder). Talk with your pediatrician if your child:

• Is not gaining weight, is losing weight or is falling off their growth curve
• Eats fewer than about 15 to 20 foods in total, or the list keeps shrinking
• Drops a whole food group, such as all fruits and vegetables or all proteins
• Gags, chokes, coughs or vomits often while eating
• Has pain with eating, or ongoing constipation or diarrhea
• Becomes very upset, panicked or has meltdowns around new foods
• Takes a very long time to eat most meals
• Has a developmental delay or autism and very limited eating

Your pediatrician can check growth, look for medical causes and, if needed, refer you to a feeding therapist, dietitian or specialist. For general information on healthy eating for kids, see MedlinePlus on child nutrition.

When to call us

Call your A thru Z Pediatrics office if you notice any of the warning signs above, if your child seems tired or pale, or if mealtimes have become a daily battle and you would like help with a plan.

Call 911 if your child is choking and cannot breathe, cough or talk, or has trouble breathing, swelling of the lips or face, or hives after eating, which can be signs of a serious allergic reaction.

To talk through your child's eating, request a visit.