Picky Eaters vs. Problem Feeders

In last week’s blog, I discussed some simple tips that my family has been using the last couple months to get us out of a boring dinner rut. But what if you really do have a picky eater? In the therapy world, there is the distinction between a “picky eater” and a “problem feeder.”

Picky eater: This is probably what many of us were like as kids. Picky eaters often reject vegetables and solid meats (ham, steak, chicken breasts). They also have a short list of preferred foods (pizza, hamburgers, PB & J, French fries, grilled cheese, chicken nuggets). Picky eaters, will often pout and complain if you put a new food on their plate. They will occasionally touch, smell, or tiny taste it, but generally don’t have a complete melt down when a new food is presented. And finally, picky eaters will eat 30 or more foods in their food range – which is the range of foods a child will eat when you add up all snacks, breakfast, lunch, and dinner combined.

Problem feeder:  This is a much trickier child. Problem feeders will not just reject meats and veggies, but much larger categories of food such as nothing sticky, no fruits or veggies of any kind, or nothing cold, and only eat crunchy. The foods that problem feeders WILL eat become tricky and very specific as well, such as only “Kraft Easy Mac” and not “Kraft Macaroni & Cheese” made from the box. Or only Aldi’s apple juice, and not Motts Apple juice. When a new food is presented, or a known food presented in a slightly different way, problem feeders often “fall apart” and begin to cry and tantrum at the sight of the new or altered food even being on the plate. In fact, some problem feeders will begin to gag at even the smell of a new food. And finally, problem feeders typically have less than 20 foods in their food range.

In general, “picky eating” is something that can be addressed at home, under the general guidance of your pediatrician. However, “problem feeding” is much more serious. Problem feeding requires a multidisciplinary approach between the family, the pediatrician, a feeding therapist (generally an OT or ST), and sometimes even a registered dietician.

However, whether you have a picky eater or a problem feeder, here are some tips that your family can try from a few of our TEAM Feeding experts, Connie Clark (ST), Allison Schmitz (OT), and Amy Love-Smith (ST).

1. Don’t give up. Keep presenting foods over and over again. Kids are finicky. Kids are temperamental. Don’t assume a child doesn’t like something just because it is rejected one time. You never know when a child will change his/her mind. It can take 30+ presentations of a new food for a child to become comfortable with it. (By the way – it took me 33 years of trying to learn to like oatmeal!)
2. Go small.Small portions, small bites, and only 3 different foods on the plate at a time. A couple tablespoons of a food is a big enough portion. The child can always ask for more. And in the principals of Food Chaining, there is value in the “mouse nibble” of trying a new food. Quite frankly, even kissing or licking a new food is a start.
3. Forget the veggies.We know grandmas everywhere will cringe at this one, but veggies are an acquired taste. Focus on adding variety to fruit choices and to the overall diet first. Then, tackle veggies once the overall diet has improved. Is the diet already good except for veggies? Congratulations! Your kiddo really isn’t that picky – just being a kid. Keep placing that tiny tablespoon of green stuff on the plate, and call it a truce.
4. Be a family.Study after study has shown us that family meal time is one of the biggest factors for raising healthy, happy, successful children. Focus on the child being at the table as a member of the family, and being exposed to the culture, values, and food of the family. And… the child needs to witness that other members of the family eat and enjoy a variety of foods. If the child routinely sees his brother eating veggies, and notices that brother doesn’t keel over and die, then the child is more likely to try veggies. However, if daddy picks all of the broccoli out of the pasta dish and refuses to eat it, you have a much smaller chance of the child trying broccoli. If you won’t/don’t eat it, neither will your child!
5. Play with your food.Pretend cook. Have tea parties. Use real food for art projects. Make food fun! All of this exposure to food when there is NO pressure to eat can make a child much more comfortable with an undesired food when it comes time for meals.
6. Use language.Help the child use describing words for food. This teaches him/her about the various tastes/textures and helps the child to draw similarities between foods they like and other foods by incorporating language. Example:  “Yum… cheese pizza! It has tomato sauce on it. What else is made from tomatoes? Salsa, ketchup, spaghetti sauce?”
7. Do not negotiate.Dinner time should not be a time for arguments. Go ahead, place a non-preferred food on the plate. If needed, and the child is ready for it, set a clear expectation of a REASONABLE about of smelling/tasting of the new food that is required of the child. And then stop the negotiations. Many children love the power battle back and forth at meal times. Disengage. Change the subject. Make polite dinner conversation.

Once again, these are simple tips to be tried at home, grandma’s house, school, etc. These are appropriate for “picky eaters.” If you feel that you have a “problem feeder,” and these tips are not working, get help! Talk to your child’s pediatrician, speech therapist, or occupational therapist and find out what can be done to make meal time more successful.

Resources:
The Star Institute for Sensory Processing Disorders: Picky Eaters vs Problem Feeders (Downloaded November 2016)
Children’s Therapy TEAM Blog, Melissa Foster, Dinner Diversity, November 28, 2016.