Picky Eaters

Picky Eaters

By John P. Sotos, M.D.

Several times a month I field a question from a parent whose toddler has become an extremely picky eater.  The story usually goes that the child used to eat everything presented and now has become very finicky.  One day he may like peas and the next time presented with the peas, he shuns them.  Or now he won’t eat anything green.  The parents then relay their concerns about growth and development, possible starvation, and dehydration.  These parents have tried all of the different ways to get their child to eat.  Some parents have even become so frustrated that they have instituted a “you’ll sit there until you eat it” approach.

Once I have examined the child and determined that he/she is indeed growing and developing normal, my advice has always been the same:

First, our job as parents is to provide our children with a good variety of healthy foods.  Their job is to eat it.  If we our doing our job, don’t worry about their job…. assuming they’re not filling up on milk, juice, or junk.  The sugar from the juice or junk food bathes the appetite center of the brain and lessens the hunger pangs.  Thus the child can afford to be picky until the parent gives in and gives them what they want in order to prevent their child from starving or dehydrating.  If given the option, most toddlers (many adults too) will pick junk food over healthy food every time.

There was a study done in the first half of the last century that looked at normal toddlers’ behavior when presented with a whole smorgasbord of healthy food.  What they found was: the toddlers ate when they were hungry, stopped when they were full, and ate 5 small meals a day.  They also found that the children which were low in calcium picked calcium-rich foods, those low in potassium picked potassium-rich foods and so on.  In short, toddlers are more in touch with what their body needs than we are!!!!  I think it is also beneficial to think of a toddler’s nutritional requirements on a “month to month” basis rather than from a “daily requirement” basis.  These kids may eat very little for the majority of the month, but for 7 days or so throughout the month they seem to eat everything in site and thus over the course of the month get everything they need.

Secondly, a toddler’s body will not allow him to starve to death or dehydrate when adequate nutrition and fluids are available.  Basically what happens is the toddlers’ self-preservation mechanisms kick in and override their pickiness.  This doesn’t happen overnight and I’m not suggesting it is an easy process.  Also keep in mind I am not suggesting some type of “prisoner of war” type scenario.  The child still has access to the proper amount of milk (up to 20- 24 ounces a day), water, and healthy food choices; even some of his past favorites can be presented.  However, it is imperative that everyone in the home that has the responsibility to feed the child is “on the same page”.   Most parents who have followed this advice state it was the most difficult one or two weeks of their life, but now their child is not opposed to trying any new foods and will eat whatever is presented.

Finally, if you get in a power struggle with your child about anything that goes in their mouth, or comes out their bottom (another subject for another time)… you will lose.   Therefore, it is a waste of energy and time to continue this type of situation.  With the process outline above, this eliminates the power struggle.  The mindset is “It’s ok if you’re not hungry now, but this is all we have… come back when you’re hungry.”  Remember, picky eaters are a phenomenon of the developed world…there are no picky eaters in the parts of the world where food is scarce.    

I sincerely hope that the above guidelines are as helpful to you parents out there with picky eaters as they have been to the parents in my practice.  Feel free to discuss the above with your Pediatrician so they can counsel you on the most appropriate approach for your child.