Did you know that your child’s stomach is as big as their fist? Over the years many parents of toddlers have asked me “Why isn’t my child eating all the food I bring at lunch time”. “My child is so picky”. The children’s lunch box is filled with a cup of sliced fruit, a cup of pasta with meat sauce and a cup of broccoli. You have just packed enough food for a ten year old! I hope you will find this article written by Dr. Howard Bennett helpful as he discusses picky eaters and how much food is enough.
“I talk to parents about “picky eaters” every day. Although some infants are less adventurous than others, “picky eating” typically starts around age 1 to 5. In most cases, this is normal and will lessen as a child reaches middle school. Nevertheless, it’s worth exploring why this develops, and what parents can do to minimize mealtime struggles.
Caloric needs change in early childhood
Babies gain more weight in the first year of life than the next two years combined. Infants need more calories than toddlers relative to their size. As a parent, your job is to prepare meals for your child and make sure he eats in a safe environment. It is your child’s job to determine how much he eats at any particular meal. (Research shows that healthy children know how much to eat to stay healthy.)
Here’s additional insight into why toddlers often eat less than babies:
Because jarred foods are watered down, they contain fewer calories per volume than table foods. Toddlers don’t need to eat as much table food to get the same calories they did from baby food.
Some children prefer to graze rather than eat big meals. From a caloric perspective, it’s acceptable to have five small meals per day rather than three large meals.
Milk contains lots of calories. Sometimes children will not eat because they drink too much milk. In general, children should drink between 16 and 24 ounces of milk per day. Most doctors recommend switching to low-fat milk at age 2.
Juice fills children up and contains little nutritional value, even 100% natural fruit juice. Children do not need juice, but if you use it, dilute it with lots of water.
Portion sizes in young children
It’s normal for children to vary how much they eat. One day they may eat three big meals while the next they barely eat at all. When you consider your child’s eating habits, look at what he consumes over the entire week.
One rule of thumb is that for each meal, children need one tablespoon per year of age for each food group. This means a 2-year-old needs two tablespoons of meat, vegetables, grains and fruits at a meal. To put this into context, four green beans are about two tablespoons.
Parents often serve larger portions hoping their children will eat more even if they don’t finish what’s on their plate. This approach can work against you if a child is at an age where he’s asserting his independence. It’s usually more effective to give smaller portions thereby allowing him to ask for more.
Why children resist new foods
Infants develop a preference for sweet foods. Still, most of them eat a variety of foods once spoon-feeding begins. However, some infants are more tentative about adding new items to their diet. This can occur because they don’t like how a food tastes or because it’s harder for them to make transitions.
Many parents find toddlers enjoy a “white diet” that consists of milk products, pasta and other carbohydrates. There are two reasons for this. First, these foods are bland like the pureed foods they were given as infants. Second, these foods are sweet. Milk contains lactose (milk sugar), and saliva contains chemicals that begin to digest starches when they are chewed. That’s why a cracker tastes slightly sweet before it’s swallowed.
As children get older, they may resist new foods because they prefer to eat the same things over and over. The concept of eating something because it is good for you does not resonate with most children.
Sensory food aversions
Children often complain that eating certain foods makes them sick. This happens because some foods have a smell, taste or consistency that bothers them. Research has found that some people have more taste buds than others. Children with food aversions are more sensitive to the physical and sensory properties of what they eat. As a result, certain foods not only taste bad, but can also be unpleasant to chew and may even gag the child. Children commonly generalize about food, so if one green vegetable leads to a negative reaction, they may reject all green vegetables.
Sensory food aversions run in families. If a child has this issue, there’s a good chance one or both of his parents had the same problem growing up.
Avoid eating struggles with your child
Children are sensitive to their parents’ emotions, but they don’t always react the way you’d expect. If you offer your child dessert as a reward for eating certain foods, he may be less inclined to eat those foods. If you get upset when your child does not eat, his eating behavior may get worse.
It’s natural for parents to talk and interact with their children during mealtime. This is what makes family meals a warm, bonding experience. However, if you sing, dance or use the TV to get your child to eat, he will learn that you are willing to go to any length to get him to finish a meal. In time, he will become more resistant to your efforts.
The best way to reassure yourself that your child is healthy and growing well is to ask your doctor. Doctors keep growth charts on patients that show if they are growing normally. It helps to remember that some children are genetically destined to be shorter and leaner than others.
Why it’s hard to be relaxed if you have a “picky eater”
Whether infants are bottle or breastfed, there is a special closeness that develops during feeding. These feelings continue as babies start solid foods. However, after months of interacting with a baby who eagerly awaits spoonfuls of pureed food, it can be disconcerting to have a toddler on your hands who has his own opinions about what he wants to eat.
When a child rejects food, parents may feel like they are being rejected. You may not be aware of this on a conscious level, but feeling rejected can make it harder to deal with a picky eater. It can also bring up feelings from your own childhood, especially if you had eating issues with your parents.
There is one additional factor to keep in mind if you have a selective eater. When your child was a newborn, there’s a good chance the doctor asked you to wake him every few hours to feed. This was recommended because newborns sometimes sleep through feedings if they haven’t learned to respond to their hunger signals. Doctors discontinue this recommendation once babies are gaining weight; however, this early experience often “sticks” with parents. If a parent doesn’t realize that young children will eat when they’re hungry, this early feeding experience may foster an eating problem in the other child.
Techniques that encourage children to try new foods
Because I’ve been a pediatrician for a long time, I’ve heard lots of tips on ways to get children to eat. Here are some of the strategies parents employ:
Employ the two-bite rule. This means a child must take two bites of a new food before saying he doesn’t like it.
Force a child to stay at the dinner table until he finishes his meal. (This rarely works.)
Encourage children to go to the grocery store and help with meal preparation.
Make eating an adventure. Mashed potatoes can be formed into mountains. Broccoli can become magic trees in the forest. Sandwiches can be cut into funny shapes. (A number of books have been written using this approach.)
Add fruit and yogurt to smoothies. (Avocado and cooked baby spinach can also be used because they have a bland flavor.)
Hide small amounts of vegetables in soup, sauces, and burgers, etc. (Cooked carrots, cauliflower and baby spinach are the easiest to hide.)
In my experience, some techniques work better than others. In addition, while some children will respond to just about any intervention others resist everything a parent tries.
Medical conditions that cause feeding problems
The majority of selective eaters are healthy children who grow well and do not need dietary supplements. However, there are medical conditions that may be associated with feeding problems.
You should seek professional help if your child’s feeding struggles are taking a big toll on the family or he has any of the following symptoms:
pain with swallowing
food gets stuck on the way down
food rejection that began after a frightening episode of choking
losing or not gaining weight
coughing, choking or wheezing after eating or drinking
extreme sensory food aversions .”
Dr. Bennett is a Washington pediatrician and author of Max Archer, Kid Detective: The Case of the Recurring Stomachaches and other books for children. His website is www.howardjbennett.com