What to do when your child is a picky eater

As hard as it can be, practise the policy that parents get to decide what to serve and children get to choose what or whether to eat. — Positive Parenting

Picky eating is a common predicament with children.

One review article estimated that it affects between 6% to 50% of children across the globe.

Also known as fussy eating, picky eating can be defined as refusing to try new foods or having strong food preferences.

Even though the majority of picky eaters will grow out of this behaviour, if left unaddressed, this problem may affect their dietary intake, which can in turn lead to growth and developmental problems.

Let’s take a look at some common parental concerns:

Why is my child picky with food?

It is not easy to pinpoint a single cause, as the problem stems from an interaction of multiple factors.

These can include food neophobia (fear of new food), history of food trauma (e.g. choking), parental dietary habits, feeding styles and control (either too strict or too lenient) and higher taste sensitivity, among others.

Picky eating has also been linked to improper complementary feeding, e.g. early introduction of complementary foods prior to six months of age.

Underlying medical issues, like oral motor difficulty, gastroesophageal reflux disease (GERD) and allergies could also be the cause.

How does it affect my child’s dietary intake and growth?

Picky eating may result in a lack of food variety in the daily diet, as the child tends to eat only the same type of food most of the time.

Low consumption of vegetables, fruits or meats due to picky eating can lead to an imbalanced diet and insufficient intake of certain nutrients, such as protein, dietary fibre, and micronutrients like iron and zinc, which are necessary for growth and development.

Hence, growth and weight problems, such as underweight, stunting and overweight, may arise.

There is also the risk of developing other problems, like constipation, dental problems, or even eating disorders in the future.

What can I do then?

Here are some suggestions to help your child try more varieties of food:

> Prepare meals together

Let him pick the veggies to cook for dinner and give him simple kitchen tasks suitable for his age and motor skills.

Exposure to various ingredients may encourage him to try new foods.

> Be creative with recipes

Mix familiar foods or favourite flavours with new foods or less favoured flavours.

Try serving new foods that have similar colours, flavours or textures with her favourite dish.

> Have the same meals together as a family

Your child does not need a “special” meal, but do include food that he eats at the table.

This is an opportunity to demonstrate healthy eating.

> Limit snacks and have meals on time

Don’t give beverages or snacks too close to meal times as this can reduce her appetite.

> Praise your child for trying new food

But don’t reward or bribe him for his attempts.

And do continue to include the food regularly or in different ways during meals.

> Offer small portions in fun ways

Decorate the dishes in fun, colourful ways to make food look more appetising and tasty (e.g. bento boxes).

Kids also love bite-sized finger foods.

It’s frustrating when my child throws tantrums during meal times. Should I let her have whatever she wants?

Offer her two healthy options and let her decide which one to eat.

However, avoid forcing her to eat or punishing her for her refusal.

Remember this simple rule: parents decide what to serve and kids get to choose what or whether to eat.

Continue to offer her a variety of new food choices.

It may take up to 20 repeated exposures before a child accepts a new food.

Be consistent, but it’s okay to have short breaks between tries.

How can I be sure that my picky eater is still growing well?

One simple way is to consistently monitor his height and weight to detect any sudden changes to his growth.

The World Health Organization (WHO) weight-for-age and height-for-age growth charts are available online.

Do not panic when his height or weight seems to fall outside of the recommended growth curve.

As long as he has a progressive growth pattern over time, he is growing well.

Food diaries may be used to check if he is consuming enough food and nutrients.

Early detection is the key to manage any growth issue and prevent it from becoming a lifetime problem.

Do seek advice if your child fails to gain weight (poor/no weight gain) or loses weight over time.

What else can I include in her daily diet?

Milk should be a part of the daily diet of a growing child, to contribute to meeting her energy and nutrient needs.

As fussy eaters are likely to be deficient in crucial nutrients, formulated milk powder for children, fortified with various nutrients and other food components, can be considered for inclusion in her daily diet.

It is however important to note that milk is not meant to be a replacement of her regular meals.

Continue to follow the tips above to help improve the diet of a picky eater.

A healthy diet that is balanced and varied is essential for your child’s growth.

It is also important to monitor her weight and height regularly, and track her eating behaviour.

Picky eating can be resolved if you take the time and effort to address the issue.

Do seek the advice of a healthcare professional if you have problems tackling her picky eating habits or have concerns about her growth.

Dr Roseline Yap is a nutritionist and honorary treasurer of the Nutrition Society of Malaysia. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.