The holidays of come and gone with family togetherness, delicious foods, and sweet, sugary treats always at our fingertips, and most of those have gone back to our normal daily routines. It is always this time of year that I feel parents commonly come to me with the same question: "Why is my child such a picky eater?"
We spent the last several weeks decorating cookies and eating delicious meals and treats that sometimes we forget to keep our meals well-balanced and limit the sweets. But as we get back to reality of normal daily routines, some parents find it a little bit more difficult for their kids to want to eat those well-balanced meals.
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Selective eating aka "picky eating"
Selective eating, often referred to as "picky eating", is a very common problem for young children. While we often take a "watch and see" approach, hoping that our children will grow out of this phase of life, it can be very frustrating for parents. One thing that I have found extremely helpful in my practice, and one thing I tell my patients and their families, is to remember the “Division of Responsibility in Feeding”. Ellyn Satter, a world renowned authority on eating and feeding, came up with the "Division of Responsibility in Feeding" idea many years ago. From her practice as a registered dietitian and a psychotherapist for eating disorders, she has come up with a lot of great information that helps frame the idea of how to work through children who are picky eaters. I would encourage everybody who reads this blog and/or has a picky eater at home to go to her website or get her book as both have fantastic insight into picky eating. Today, I wanted to share a few thoughts that I have taken away from her research to help my patients and their families work through the picky eating stage of life.
Division of Responsibility
The idea of division of responsibility at mealtime is very easy in theory but tough to work through. We have to remember that eating is a learning process for our children. From infancy to adulthood, there are many things we have to learn to master eating. Starting in infancy, learning how to suckle and latch to a bottle or breast can take some doing. As infants grow and start to take in solid foods, learning how to handle the textures and tastes can take some time. But as we work through all of these different phases of growth and development with eating, both the parent and child need to understand their role at mealtimes.
To break this down a little bit, let us think of what the parent’s responsibility is for mealtimes through different stages of growth and development. In infancy the parents decide the "what". It is then the child's responsibility for the "how much". Parents will decide if they are going to breast-feed or bottle feed and to make sure that the child has their feedings on a daily basis. The child will then take in as much as they need at each feed. That is pretty simple, infancy is easy. We decide what they are going to eat and they decide how much to eat. It is when we introduce solid foods that things become a little bit more difficult.
Starting around 6 months, most parents will introduce solid foods. Whether they make them at home or get them store-bought, the principal is the same. The parents at this stage of life then decide the "what", "when", and "where". It is then the child's responsibility to decide how much they are going to eat and whether they are going to eat it. Again, this can be a little tricky in the late infancy and early toddler years as we are just introducing foods. Sometimes the textures and other things make it a little bit more difficult for children to eat, but once they master the technique of eating something that has more of a consistency than liquid, generally it becomes a taste preference after that. Parents offer the baby foods during the day and the child will eat it. Most infants are not too picky with foods so, again, this stage is generally pretty easy to work through.
What age is picky eating the most common?
The most common time in a child life to become picky is in those toddler years and beyond. This is where the division of responsibility at mealtimes becomes the most important and when parents need be able to hold strong to this and work through this picky time of life. For toddler years and beyond, the parent’s responsibility is to provide a well-balanced, healthy meal option for breakfast, lunch, and dinner. The child responsibility at this time becomes whether or not they are going to eat the meal and, if so, how much they are going to eat.
How to handle picky eating
Generally, for my patients, I recommend parents offering 3 meals a day and 2-3 snack options per day. Especially for those that are picky, this can become a difficult thing. What happens if the parent offers a breakfast option that the child does not like? What do they do? More often than not parents will make a second option that the child does like. Once lunch comes around, they make a meal for the child. If the child does not like the meal, what happens most often? We make them a different meal. This becomes such a fight and a hassle that many parents end up just making the child either a separate meal or making them something that they know that the child would eat at every meal. This is where we have to break this cycle and remember that, as parents, our job is to provide our children with a healthy, well-balanced meal and let them choose to eat.
They will not go hungry
For my most picky eaters and parents that struggle the most, I like to remind them that their child will not go hungry. I promise you they will not! Picky eaters learn that they can almost dictate what they get to eat based on how they act. There will be a lot of temper tantrums, a lot of fights, and a lot of frustration on both you and the child. But what we have to do is offer that one meal to the child, and if they choose not to eat that meal or to only eat certain parts of it, but we do not make them a separate meal or offer them something else. They eat what they want at mealtime and then wait until the next opportunity to eat. For example, you make a well-balanced lunch and your child elects to eat one item or none of the food on the plate. We allow them the opportunities to eat; we do not make them anything different. If they elect not to eat very much for lunch, they wait until the next eating opportunity, such as the afternoon snack. Again we offer a snack and let the child decide whether or not to eat it. If they elect not to eat that, their next opportunity is the evening meal.
Kids can be stubborn, but just remember that they will not go hungry! Eventually their bodies will tell them that they need to eat something and they will start to eat. They will end up eating more of what you offered during the mealtimes if you stay consistent. The first couple of days are going to be the most difficult but everyone will make it through. I would encourage you to speak with our child’s pediatrician if you have a picky eater at home for any additional tricks or thoughts they may have. Additionally, visit https://www.ellynsatterinstitute.org/ where they break this down even further.