A Situation That’s Hard to Chew — How To Handle Picky Eaters

Demanding a limited diet of hotdogs and mac-n-cheese is practically a rite of passage for the preschool set, but how do you distinguish between a picky eater and a child who has a more serious problem such as a feeding disorder?

Cheri Fraker, a speech therapist with Memorial’s Center for Selective Eating and Pediatric Feeding Disorders, said many parents of picky eaters assume the child is simply in a stubborn phase. However, only 3 percent to 12 percent of children refuse to eat purely for behavioral reasons, such as seeking attention or being in control, said Fraker, who specializes in evaluating and treating pediatric feeding disorders.

Many reasons exist for children to be selective eaters. Some have acid reflux or other gastrointestinal disorders. Others have sensory difficulties and can’t stand the appearance or smell of food, while others have vitamin deficiencies that curb their appetites. Some children don’t develop good basic feeding skills. They refuse to eat new foods because they don’t know how to chew them and often will seek out foods with similar textures, such as crackers, French fries and chicken strips.

To ensure their child receives some nourishment, frustrated parents may encourage their children to drink milk or juice, but that’s not a good alternative, Fraker said. Too much milk can lead to anemia, and too much juice can cause diarrhea and will decrease their appetite.

If a parent suspects a child may have a feeding disorder, he or she should speak with the child’s pediatrician, who will make the decision to refer the child to a feeding specialist for an assessment. It’s important for children to be assessed and treated to put them on the road to healthy eating, Fraker said.

In general, some tips parents should consider to encourage good eating skills include:

• Ensure meals last about 20 minutes and do not exceed 30.
• Limit juice to 4-6 ounces daily. Juice and milk should be scheduled during meals, with water in between meals.
• Use divided plates. Offer new food in a designated “looking” section of the plate for items they aren’t required to eat; don’t pressure them to eat it. Always have something they will eat on the plate.
• Give child-size portions. From age 1 to 3, children only need one tablespoon each of meat, veggies and fruit for each year of their lives.

Additionally, a recent study published in the American Journal of Clinical Nutrition found that parents who offer small, non-food rewards — such as a sticker — for about 10 days have better luck getting young children to try a tiny bite of their vegetables. This study, however, has yet to be tested in a home setting.