What is a picky eater?

The peak time for picky eating is the toddler or preschool years. A picky eater:

• may complain or whine about what is served
• refuses certain foods, especially vegetables and meats
• pushes foods around the plate
• hides foods or gives them to a pet under the table
• eats enough total foods and calories per day for normal growth.

What causes it?

Children of all ages (and adults) commonly have a few food dislikes. A picky eater is a child with many food dislikes. At age 2 or 3, up to 20 percent of children are picky eaters. It is normal for most young children to dislike foods with a bitter or spicy taste. Sometimes children dislike foods because of their color, but more often it's because they are difficult to chew. Children accept tender meats better than tough ones, and well-cooked vegetables better than raw. Occasionally a child who gags on large pieces of all foods has large tonsils that make it difficult to swallow.

How long does it last?

Most children who are picky eaters will grow out of it. They start trying new foods during the early school years because of peer pressure. The voracious appetite during the teen years also increases the willingness to experiment. If you try to force your child to eat a food he doesn't like, he may gag or even vomit. Forced feedings always interfere with the normal pleasure of eating and eventually decreases the appetite. Learning to accept new foods should not be expected before the teenage years.

How can I help my child?

• Try to prepare a main dish that everyone likes. Try to avoid any unusual main dish that your child strongly dislikes. Some children don't like foods that are mixed together, such as casseroles. Try reintroducing such dishes when your child is older.
• Allow occasional substitutes for the main dish. If your child refuses to eat the main dish and this is an unusual request, you may allow a substitute dish. Acceptable substitutes would be breakfast cereal, yogurt, or a simple sandwich the child prepares for himself. If the only meat your child will eat is chicken, keep a supply in the refrigerator for when you need a protein source. Never become a short-order cook and prepare any extra foods for mealtime. The child should know that you expect him to learn to eat the main dish that has been prepared for the family.
• Respect any strong food dislikes. If your child has a few strong food dislikes (especially any food that makes her gag), do not serve that food to her when it's prepared as part of the family meal.
• Don't worry about vegetables, just encourage more fruits. Because vegetables tend to be hard to chew and some of them are bitter, they are commonly rejected by children and even by many adults. Keep in mind that fruits and vegetables are from the same food group. There are no essential vegetables. Vegetables can be largely replaced by fruits without any nutritional harm to your child. This is not a health issue. Don't make your child feel guilty about avoiding some vegetables.
• Don't allow complaining about food at mealtimes. Have a rule that it's okay to decline a serving of a particular food or to push it to the side of the plate. But complaining or whining about it is unacceptable. For whining about food, give 1 warning. If it happens again, send your child away from the eating area for 5 minutes. If he gets disruptive again, send your child to his room and put his food in the refrigerator. After 1 hour, he can again have his food if he requests it.
• Encourage your child to taste new foods. Many tastes are acquired. Your child may eventually learn that she likes a food she initially refuses. Research shows, it may take seeing other people eat a new food 10 times before they're even willing to taste it, and another 10 times of tasting it before they develop a liking for it. Don't try to rush this normal process of adapting to new foods. Don't talk about bites because trying to force a child to eat one bite of a food per year of age is not helpful with most picky eaters. Instead, it's better to simply serve it repeatedly, ask your child to taste it, then trust him when he says that he did.
• Avoid pressure or punishment at mealtime. Never pressure, beg, or bribe your child to eat all foods. Never punish your child for refusing to take one bite of a new food. It will only lead to liking that food less over time, gagging, or even vomiting. If your child has a stubborn, strong-willed nature, pressure around eating can progress to a power struggle which in turn prolongs the picky eating.
• Don't argue about dessert. An unnecessary area of friction for picky eaters is a rule that if you don't clean your plate, you can't have any dessert. Since desserts are not necessarily harmful, a better approach is to allow your child one small portion of desert no matter what she eats. However, there are no seconds on dessert for children who don't eat an adequate amount of the main course. Desserts don't have to be sweets, they can be nutritious desserts such as fruit.
• Don't argue about a bedtime snack. If your child complains about bedtime hunger, avoid a long discussion. Give him a small, plain snack (such as cereal) before it is time to brush his teeth.
• Don't extend mealtime. Don't keep your child sitting at the dinner table after the rest of the family is done. This will only cause your child to develop unpleasant associations with mealtime. If he suddenly wants to eat, give him 5 extra minutes.
• Keep the mealtime atmosphere pleasant. Make it an important family event. Draw your children into friendly conversation. Tell them what's happened to you today and ask about their day. Talk about fun subjects unrelated to food. Avoid making it a time for criticism or struggle over control.
• Avoid conversation about eating at any time. Don't discuss what your child eats in your child's presence. Trust your child's appetite to look after your child's caloric needs. Also don't give praise for appropriate eating. Don't give bribes or rewards for meeting your eating expectations. Children should eat to satisfy their appetite, not to please the parent. Occasionally you might praise your child for trying a new food that he does not like the taste or texture of.
• Give your child a daily vitamin-mineral supplement. If your child is not eating at least 1 serving or meat per day, give a multivitamin with iron to prevent iron deficiency anemia. Although vitamins are probably unnecessary for most of us, they are not harmful in normal amounts and may allow you to be less concerned about your child's nutrition and health.

When should I call my child's health care provider?

Call during office hours if:

• Your child is losing weight.
• Your child gags on or vomits certain foods.
• Your child has heartburn.
• You have other questions or concerns.