More than picky eating

Most parents know the struggle of trying to get their kids to eat new foods or finish their broccoli. Some might turn spoons into helicopters or cook side dishes of chicken nuggets. Picky eating strikes many children during their toddler years, but are there times when it’s more than just a childhood phase?

Parents can, for the most part, breathe a sigh of relief. When picky eating is caused by a physical problem, the symptoms are usually obvious, said Kerry Glidewell, a speech-language pathologist with Wolfson Children’s Rehabilitation.

Sometimes, a problem with motor skills makes it difficult for a young child to chew, she said. That may lead the little one to consume only liquids rather than solids. Or, the child may have a food allergy that makes it difficult to digest certain foods, causing vomiting after meals.

“Normally, it’s not the feeding problem that appears first,” Glidewell said. “A lot of times it's secondary to other medical conditions.”

When it’s only pickiness

Normal picky eating looks more like a behavior issue, Glidewell said. For example, some children are just more sensitive to new textures and tastes, or wary of all things unfamiliar and “icky.” Other children are picky eaters because they have discovered the power of saying “no,” and mealtime is one more way to test the boundaries of what they control. Still others learned their picky eating habits by taking unconscious cues from their parents.

“We see a lot of families eating separate foods,” said Glidewell. “Kids learn that this is mom’s food and this is my food, and they’re not the same. And that can start a pattern of being really picky.”

Most of the time, picky eating isn’t so extreme as to cause poor nutrition. The problem is more a quality-of-life issue.

“You want to go to grandma’s house, but worry little Jimmy won’t eat when you get there,” Glidewell said. “Or parents come home already stressed from work and they’re having to be short-order cooks.”

When is it something more serious?

Still, parents worry when little ones don’t eat and they may want to know, when is picky eating more than just behavior? Talk to your pediatrician if your young child:

• Eats fewer than 20 different foods.
• Has frequent bouts of vomiting or constipation.
• Is not progressing from a bottle or pureed foods after 12 months.
• Has a physical reaction to food, like gagging or holding food at the front of the mouth rather than chewing.
• Is outside the recommended weight for his or her age, not simply at the low end.
• Stops growing for six months to a year.

An otolaryngologist, gastroenterologist, speech therapist, occupational therapist, or other specialist may be able to help.

The path to healthy eating

Whether the cause is medical or emotional, there are many ways parents can help their child move past picky eating habits. Glidewell's tips are to:

• Establish regular mealtimes.
• Sit at the table with family members, not in front of a TV or with an iPad.
• Let children eat just a few bites of food if they're not hungry.
• Encourage children to try new foods. Instead of ordering them to simply eat it, let them get used to it slowly by touching it or by tasting a small bite.
• Talk about enjoying the way food tastes. Say things like, “Ooh, this apple is sweet. These nuts are crunchy.”
• Make gradual changes to your child’s diet. If a child likes pancakes, try waffles. If a child likes strawberries, tell him or her that raspberries taste similar.

Finally, said Glidewell, don’t make the rules too rigid. Some children may not like vegetables, but that’s not an eating disorder. Parents should never force-feed a child.

“Remember the days when you had to sit at the dinner table all night until you ate your green beans?” she said. “Did you walk away thinking, ‘Now I like green beans?’ No, you just remember the pain of having to sit there and your dad being mad at you.”

Are you worried about your child’s eating habits? Therapists at Wolfson Children’s Rehabilitation and its Feeding Program help children develop feeding experiences that are safe, nutritious and nurturing. To learn more, call 904.202.4200.