Looking after a picky child

  • Nutrition
  • Sunday, 31 Jul 2011

Taking care of a picky child can be difficult. Find out how you can cope with this problem.

GETTING your child to follow your lead is, for most parents, a difficult and sometimes even frustrating task. When has your child immediately put away his toys when you asked him to? Or stopped watching television the moment you told him to?

Similarly, getting your child to eat a balanced meal and finishing it can sometimes be so exasperating that you wished there was a cookie with all the essential nutrients for him to eat!

Almost every child goes through a phase in their life where they refuse to eat certain foods, sometimes refusing to eat or drink anything at all. While some may just quietly refuse to eat their meals, others may throw tantrums or cry when forced to eat something that they do not want to.

“Mild” picky eating is often stressful for parents, but is usually a phase that children grow out of without any serious nutritional, health or growth problems. In some cases, however, extreme picky eating often leads to a very restricted diet, which can cause malnutrition and other problems related to it.

Is your child a picky eater?

There are various factors which determine whether your child is a picky eater or otherwise. These include nutrient intake composition, the child’s weight, amount of food eaten and duration of food refusal. Children who are picky eaters are more likely to eat in small amounts, favour certain kinds of food, or avoid trying out new foods.

There are a few different types of eating issues that most children face. Some of them are listed below:

The one who accepts very few foods

? Eats only a few types of food (eg only white foods such as rice, noodles and bread); refuses to eat foods that have a particular taste, texture, smell, temperature or appearance.

? Show signs of nervousness when asked to eat foods with characteristics that they dislike.

? Could be due to choking, gagging, vomiting during introduction to food at a younger age.

The active one who is rarely hungry

? Constantly runs around, is curious about many things, and can hardly sit still for proper meals.

? Much more likely to show very little appetite; feels full after only two to three bites.

? Is easily distracted from meals, preferring to play with toys or siblings.       

The one who is afraid of eating

? Shows a strong resistance to any attempts made to get him/her to eat.

? Cries, pushes away food and refuses to open their mouth when offered food.

? May even cry at the mere sight of feeding/eating items such as the bottle, spoon or bowl.

? Could be due to a past traumatic event, including choking, gagging or vomiting.

? May also be due to a medical condition that involves the insertion of tubes through the mouth and throat.

Relevant issues

Parents with picky eaters are frequently worried that their children are not getting the proper nutrition that they need. Picky eating is actually a very common phase in the development of young children, and usually does not cause significant health, developmental, or social problems.

However, it is possible for extremely picky eaters to have negative consequences later on in life. In extreme selective/picky eaters, many of them lack the important vitamins and minerals crucial for development. For example, toddlers aged one to three years require 30% to 40% of their energy from fats, and more than 10% of these fats should be essential polyunsaturated fatty acids. Without a well-balanced diet, your child will not be able to obtain the necessary nutrient requirements for his age.

Insufficient nutrient intake may eventually lead to malnutrition, which can further result in loss of energy, loss of muscle mass, weakening of the immune system (increasing chances of infection), growth and development failure (stunting), as well as poor cell renewal and tissue conditioning (longer wound healing).

Examples of nutrient deficiencies include:

  • Vitamin A – Night blindness, eye dryness, dullness, or clouding of the cornea.
  • Vitamin B6 – Poor immune function, skin problems, hormonal imbalance, muscle spasms.
  • Vitamin B12 – Anaemia, sore mouth and tongue, nerve problems (severe cases).
  • Calcium/phosphorus – Rickets, which results in softening and weakening of the bones.
  • Iron – Anaemia, which can manifest as tiredness, headaches, breathlessness.
  • Zinc – Stunted growth, immune disorders, more susceptible to infections.

Nutrient deficiencies can also lead to other health problems such as severe dental decay, dehydration, or even constipation.

Ensuring that your child gets all the nutritional benefits from his diet may prove to be stressful.

In order to avoid any future medical problems, it can help to provide your child with some nutritional support. This will help ensure your child gets all the nutrients he/she needs for growth and development despite having a very restricted diet.

Play your role

Although this may be one of the most challenging times in parenting, it could also be a good time to get your child started on healthy eating habits.

? Keep offering him new foods. If your child is afraid to try new foods, or may just be reluctant to eat what’s on his plate, don’t give up. Research has shown that it can take up to 15 tries before a toddler accepts a new food. Serving a wide range of food options increases the chances of your toddler eating different types of foods.

? Don’t take “special orders”. You may want to make meals that your child likes to eat, but this would make catering for the whole family difficult as well. Include something he may like in the meal, but also encourage him to try whatever you are having.

? Have meals together. This way, you can eat “new foods” without actually offering your child any. When you eat, mention that the food is really tasty. Over time, he will understand that he is not being forced to eat and may get curious and try out the food as well.

In rare cases of extremely picky eating, providing additional nutritional support may be a choice. There are two types of supplementation:

Vitamin/mineral supplementation

Focuses on certain nutrients at a time, eg vitamin A, vitamin C, zinc, or iron.

This type of supplementation is good for children who refuse to eat certain types of food, such as red meat or spinach – therefore they lack iron.

Complete nutritional supplementation

This type of supplementation contains all macro- and micronutrients such as calcium, iron, protein, as well as other vitamins and minerals needed in the correct amounts for children.

It is beneficial for extremely picky eaters who often refuse to eat most types of food, and therefore, miss out on a lot of the essential nutrients.

Keep it up even when the going gets tough

Children often look up to parents as their main role models, and thus, parents can play a huge role in a child’s well-being and health. It may be trying times when your child refuses to eat, and it can get frustrating.

But the key is patience, and to never give up on your children. If you fail once, try and try again. Persistence will eventually pay off, and the best you can do is getting your child to eat enough for good growth and health.

Prof Dr Norimah A.Karim is a nutritionist. This article is courtesy of the Positive Parenting Programme by the Malaysian Paediatric Association (MPA) and supported by an educational grant from Abbott Nutrition International. For more information, please visit www.mypositiveparenting.org

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