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Picky Eaters: Pathological or Just Particular?
Filed under: Nutrition: Health, Behavior, Nutrition: Toddlers & Preschoolers, Nutrition: Big Kids, Nutrition: Tweens
For picky eaters, there can be no food substitutions. Illustration by Dori Hartley
Harrison Bloom, age 5, will eat macaroni and cheese only if it's Kraft brand. A friend's mom once resorted to pulling the iconic blue and orange box out of the garbage as proof. Relieved, he tucked into the day-glow orange heap with gusto.
"Harrison's a typical picky eater in that the foods he will eat are starch foods [and dairy]," says his mother, Californian Toni Bloom, a registered dietitian (and no, the irony is not lost on her). "So we do lots of grilled cheese, cheese toast, bagels and cream cheese, cheese quesadillas," she says in a phone interview with ParentDish. She also has 3-and-a-half-year-old twin boys.
The morning of the interview Bloom served a new food to her sons: mini bagels from Trader Joe's. This was a departure from the regular-sized bagels she usually serves. Harrison refused to eat one, "because it was a differently shaped bagel," says Bloom.
She admits she bought the mini bagels knowing he'd have an issue with them. Through her own research, she came upon a treatment philosophy that made sense: offer variations of foods the child already eats. "One small tweak," she explains. "A slightly different colored cheese than the Havarti white cheese. It's this painful, thoughtful [process]. You have to think this through. 'Let's see. What's one degree different than that?' And who likes to do this? I'd rather short-order cook."
Bloom is on to something. According to Dr. Brad Riemann, Clinical Director of the Obsessive Compulsive Disorder Center and Cognitive Behavioral Therapy Services at Rogers Hospital in Wisconsin, one of his center's most successful treatments, mirrors Bloom's approach. "We apply strict, graduated exposure therapy to this problem. We spend a lot of time with the child and sometimes their family developing a food hierarchy. We get an idea of what they can eat and then we develop these hypothetical challenges -- exposures -- to try to spread their wings a little bit."
There's no official diagnosis called "picky eating," as it's often a symptom of a larger problem, says Riemann in a phone interview with ParentDish. "Some picky eaters we see in our facility have Obsessive Compulsive Disorder (OCD), meaning they may be concerned for example, about contamination -- who touched my food, who prepared it, what germs might be in it ... Another child may significantly reduce his or her food intake and what they eat, just like this person with OCD, but they don't care about germs at all. They're concerned, say, about the fear of choking. Their fear is so intense they only drink soup broth and malts."
Another cause is Sensory Processing Disorder, which involves sensitivities to texture, smell and sight.
When dealing with a finicky eater, "It's a matter of being flexible," says Long Island mom Cristina O'Keeffe in a phone interview with ParentDish, although she admits to having good days and bad days when dealing with her elder daughter, age 4-and-a-half: "I have times when I'm open and creative ... and there are days when I'm rushing and I'm frustrated and I'm chasing her around and I'm like, 'I'm only asking you to eat three pieces of an apple.'"
How can a parent tell the difference between generic picky eating and something more serious? According to Riemann, "When it interferes with the child's life: Children going over to other people's houses, friends' houses, sleepovers, and they can't eat anything."
"There seems to be a sincere, true, anxiety fear-based problem about how parents" try to address picky eating in the child's early years, says Riemann. "I'm clearly not saying it's the parents' fault by any stretch, but when [picky eating behaviors] start popping up they don't seem to be very significant [so] parents say, 'Well, OK, if Johnny doesn't like that food let's not go there. We'll pick and choose our battles.' So they give up a little bit of ground ... Johnny pushes back a little bit further and they give up a little bit more ground and the next thing you know, you may have a problem on your hand."
Riemann explains why this happens: "Part of it is because we care about our kids, we want our kids to be happy. Part of it is, do we really want to be going to war again at the dinner table? And part of it is that preparing food these days is so much easier."
Yes, convenience foods have made things a lot harder -- for parents of picky eaters that is. Once upon a time parents told their children to eat what's being served or else go to bed hungry. This was before microwaves and two-minute enchiladas made it easy to cater to individual tastes.
O'Keeffe tries not to fall into the trap of preparing separate meals for her two daughters, but does take advantage of prepackaged foods: "I will offer them an easy thing I can grab out of the pantry," she says, listing items like fruit, yogurt, cereal and cheese sticks. "But I won't make them another meal. That's not going to happen."
Riemann's suggestion to parents who suspect their child is a picky eater but without pathology is to be firm but reasonable. He also recommends using rewards when necessary. And no, he doesn't consider that a bribe. "There's a big difference between bribes and reinforcement," he says. "Reinforcing your children and providing rewards can be a key role in this. For example, you can tell your son if he tries a little bit of this cutlet he can have extra time playing video games or an extra book at bedtime. Those kinds of things can be powerful for children and can sway their decision."
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ReaderComments (Page 3 of 3)
1-08-2011 @ 11:35PM
Niki said...I'm 39. I was a picky eater. Nicknamed "Picky Niki." My mom made one meal for dinner. I was not given a choice of other items. I was also told that I had to try all foods. And yes, I was forced to eat things I didn't like. The result? I vomitted up the stuff I didn't like: bananas, peas, milk on my cereal, green peppers, onions, fruit, etc. To this day I still hate bananas, green peppers, fish, all fruit, milk on my cereal, etc. But I also eat things that I didn't like as a kid, such as green peas, onions, some shrimp. And I also still try new items and then form my opinion. Some things are a texture issue, some things are simply a taste issue. People often have a hard time comprehending my disdain for fruit. To me, all fruit has a bitter taste and I can't eat anything bitter. With fish, it's the taste and texture. Did I starve as a kid? No. Am I malnourished? No. Am I psychologically messed up as an adult? Not that I'm aware of. Do I like a lot more than I did as a kid? Absolutely. Am I still Picky Niki? You betcha.
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1-08-2011 @ 11:44PM
Laura said...Wow, my children will eat what I cook. Period. I make good, well balanced meals but we don't have a lot of money and I refuse to cater to a picky eater. I refused to allow the 'I don't like this' garbage in my house.
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1-08-2011 @ 11:57PM
Tina Volpe said...Kids like to be in control and so I allowed them to make choices. I always made TWO vegetables with every meal and told them they were allowed to hate one vegetable for that one day only. The hated vegetable landed in the next morning’s egg omelet. On the third day – you guessed it – the two previously hated vegetables were served and remember they were allowed to hate ONLY one vegetable per day. Worked like a charm!
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1-08-2011 @ 11:53PM
Gina said...My kids weren't picky eaters but my grandchildren are. My oldest grand daughter will say, "I don't like that". I said." Have you tasted this before"? She'll say no so then I ask her why she says she doesn't like it if she's never had it before? So after about 10 minutes of it being on her plate she took a bite and LOVED IT! She was surprised and ate the whole thing. It was TROPICAL FRUIT. lol I figure as long as she eats a few decent things and I'm giving her a vitamin she should be Ok. It's not good to force a kid to eat anything! Besides, some picky eaters turn out to be just fine AND at a correct weight. I was NEVER a picky eater and neither was anyone else in my family and because we love everything, we eat everything! I almost feel it's better to be picky!
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1-09-2011 @ 12:19AM
CrazieGurl said...I'm a picky eater, and I always have been. But my idea of picky means "preference," and not necessarily "requirement." I guess I took for granted my ability to suck it up and eat things I didn't like when the time came (at sleepovers, dinners, lunches, business occasions, school dorms, etc.) I met someone my first year in graduate school who could probably count the things she would eat on two hands tops - - and an entire family that would refuse to eat my "picky eater meals" if they contained even a teaspoon of something they didn't THINK they liked.
Growing up as a picky eater and liking certain foods (it's alarming to see how many picky eaters like the same things - starches, cheese, sweet dairy in general) I learned to cook for other picky eaters. But I had never encountered anyone who wouldn't eat my food until I met these people.
My mom was a self-proclaimed "picky eater" as well, which might have contributed to my small preference palate. But I learned as I got older that being too picky with food meant I was left out of a lot - potlucks became a search for familiar looking dishes and making excuses for why I wasn't eating more. I was ofter accused of being anorexic in college because I wouldn't eat much at the dining halls - - mostly because the food looked gross, and partially because what was being served didn't fit into my niche of "edible food." The first night my now-husband cooked for me? He made a very oily, French cuisine - - I ate the ladylike 60% minimum and put it down.
Picky eaters will eventually have to learn what I did - suck it up, pretend not to taste it, or eat at least 60% to be polite. Life will not be easy if you limit your internal menu to only a few items.
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1-09-2011 @ 12:55AM
Cosmic Energy said...I was born a picky eater. I'm 52 years old, and I am still a picky eater. However, when I work on a tv set, movie set, or am in a commercial, the food they serve at lunch time is indescribably delicious. The actors are fed yummy food, all kinds of delicious foods. It is total child abuse to force a kid to eat what they are served. As a child I had to sit at the table for several hours until I ate everything on my plate. Total torture. It made me wish I was born in an orphanage where they don't care if you eat or not.
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1-09-2011 @ 1:10AM
Brandi said..."Sensory Disorder"? Really?? More like an illconceived excuse for childhood obesity and lazy parents that don't want to actually parent their child(ren).
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1-09-2011 @ 1:26AM
60's rule said...I have to agree that unless there is an actual alergy to certain foods a child should eat what is prepared for the family. I have nieces 3 and 5 who often say I don't like this or that but I insist that they taste whatever it is. We also introduced them to ethnic restaurant foods at an early age...Mexican, Japanese, Chinese, Thai plus seafoods of all sorts and things like avacado, broccoli, mushrooms, they even like lemons and sour pickles (from 1 year). I believe that the wide variety of food being introduced at an early age trained them to be more open minded. I have often seen parents refuse to offer foods that they didn't like themselves...why? I make it a clear that we only feed them good food and let them know what the food does for their body...egg=protein=muscle/toast=carbs=energy and so on. It's cute to hear the 5 year old tell the 3 year old to drink her milk so she'll get calcium and have strong bones. Children learn to make good choices when you respect them enough to give them the opportunity and the knowledge required to do so.
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1-09-2011 @ 2:00AM
Cazbotch said...There is no such thing as a "picky eater." Kids will be as picky as you let them be. If you only give them healthy food, that's what they'll eat. They won't starve themselves. If they miss a meal or two, they won't pass away and once they're hungry enough, they'll eat. I'm not saying to give them liver and onions... you can give them healthy food that tastes good.
If someone only allowed their child to eat mac & cheese, fries and chicken nuggets and refused to give them anything nutritious, they would be accused of child abuse. Why would anyone allow a small child to decide to do this to themselves? I don't get it. You're the parent. No need to make a fuss. Offer good food and if they don't eat it, fine. They don't get anything else. It's pretty simple.
And yes, I have three children. All of them tried to be "picky" at one time or another. I just gave them a choice of eating or not. End of story. Funny thing - two of the three won't eat fast food to this day.
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1-09-2011 @ 1:47AM
Augusta said...Every person on this earth has foods they don't like, wether it's a fairly universally hated food like liver, or something most people enjoy like pizza. Kids are no different than adults in that they will have their own tastes, and their own opinions and ideas. As long as what they do eat is healthy, and you aren't letting them chow down on junk all day, no one should worry about it but their parents. I have one child that will at least try whatever you put in front of him, (and at times has eaten things that made him want to puke just so he wouldn't hurt my feelings by saying he didn't like it) and my youngest used to eat whatever I gave him. When he turned about 18 months old, he just up and decided he didn't like much of anything anymore. All the doctors say is "kids are picky" and "he'll grow out of it." I have tried making him go hungry, he starved himself for 4 days. I've tried forcing it in his mouth, he sat with the same bite in his mouth for 3 hours before I let him spit it out and go to bed. I tried bribing him, and he'd rather get no dessert or game time than eat the food. Even when he says it tastes good, he looks like he'll be sick from trying to chew it, so I really believe he has a texture issue. I just make sure he gets fruits, grains, and drinks V8 for veggies. He may end up a vegetarian since meat seems to be the biggest problem, but I have learned it's not worth the fight. It has nothing to do with being lazy, as I have tried everything I can think of. I just don't want to be the screaming crazy woman shoving meatloaf down her child's throat, it is NOT that necessary, and I would rather enjoy my time with my kids than spend it fighting over food. I hated being forced to eat things I didn't like, and I don't want to do it to my kids. Eating something you don't like won't kill you, but don't you prefer food that tastes good to you?
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1-09-2011 @ 2:27AM
Jen said...I have four children, the older three all went through their "picky-eater" phases so I know the difference between a picky-eater and a child with a real problem. My 4th has been diagnosed with mild autism but we cannot find a link between that and his eating problems. His menu is limited to less than ten foods in total and will not stray from his routine no matter what I do. And yes, I've tried the don't eat, eventually they get hungry...doesn't work in his case. It's not a texture issue in general because he does do different textures. He's five and has altered very slightly but in a negative way...he's actually getting pickier. He's very healthy, rarely sick, active, happy and intelligent. Bottom line, he eats horrible. He won't even drink anything other than water (rarely some milk). I'm not looking for criticism but would appreciate some helpful comments. His pediatrician, therapist, teachers or myself can't figure out his reasoning so constructive help would be appreciated.
This is what he eats (and yes I have tried to vary) Chocolate Chip poptarts (only choc chip, nothing else), almost any kind of chicken nugget or tender as long as its not cut up, bread rolls, applesauce (any flavor), yogurt (thick & creamy only - nothing chunky), entemann's chocolate chip cookies (no other brand), chocolate chip waffles or muffins (sensing a chocolate chip theme), tons of water, occasionally milk, rarely cinnamon toast crunch cereal, occasionally rippled potato chips, saltine crackers, chocolate graham crackers and goldfish crackers...that's it, no matter what I try. I'm just looking for answers because it's not healthy for him physically and socially and it's an inconvienence on the family.
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1-09-2011 @ 2:37AM
Ashley said...For me, it's always a big thing on whether or not a child can articulate WHY they don't like something. A lot of times, it can be something very easy to fix. When I was growing up, I lived on peanut butter and jelly on crackers (I hated, and still hate bread) and breakfast cereal. I hated the food my mother put in front of me. Why? Because my mother had never learned to cook. She over-salted everything and cooked vegetables until they were limp and soggy. When my dad, the trained chef, cooked, I ate everything. If I told my mother something was too salty, she insisted it wasn't. If I told her I didn't like the soggy vegetables and please serve them to me raw, she insisted that adults ate them cooked. My dad understood that if I didn't like salt, he wouldn't add salt and if I wanted veggies to be raw, he didn't care, as long as I ate them.
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1-09-2011 @ 2:53AM
Rich said...My kids learned to eat all different types of foods from day one. As they got older, each of them found a few things they really didn't care for, but I never ever had a problem with them refusing to eat. In fact, by the time they were five, they were eating crab legs, fish, lobster, just about any meat, vegetable, and fruit. The rule from day one was that they had to eat at least half of anything put on their plate, even if they didn't like it. I think it was easier because both my wife and I ate just about anything. As they saw us eating different things, they naturally just ate as we did.
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1-09-2011 @ 3:33AM
kathie said...My first born was not picky, my second born started to act so when he was 2 or 3. In my house, if you don't like it, you wait til you want to eat something else that is available, not something I will do special, but something available, like leftovers from the night before after the rest of us enjoyed our meal. If that is not good enough, don't eat. My son who was picky didn't last long acting that way. For snacks they had to have something healthy, not sugary crap and then when it was time for the crap food, they enjoyed it even more. Though neither were considered skinny, neither were overweight at any point in their childhood as an added benefit, as 90% of their friends were. It is a control issue no matter how you want to color it. I am amazed at the dancing around parents will do by saying "I pick my own battles" That is one helluva battle to pick because it leads into all kind of other control issues. I've seen it time and time again.
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1-09-2011 @ 5:21AM
Chowhound said...My father had a real easy method for dealing with me if I tried to get picky. He'd simply state: "This ain't no cafe. You can either eat what your mother fixed or go hungry." After finding out the hard way that the threat was serious, I ate what was offered from then on.
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1-09-2011 @ 6:39AM
shellyafinney said...When I was a child I was an incredibly picky eater and I can tell you it is at least 90% the parents fault.
Apparently from when I was newborn I was a slow feeder and not particularly interested in food after I was weaned but unfortunately my parents made the classic mistake.
Instead of remembering the mantra 'they'll eat when they're hungry' they panicked that I was not eating enough and started 'supplementing' my diet with treats and alternatives so by the time I started school to even look at a vegetable on my plate would genuinely make me retch.
Now I am a parent myself and I have learned from their mistakes. We sit around the table together, we all have more or less the same meal and no alternative is offered. Voila, none of them are in the least picky (and gradually I have got much better too as a result, although I still have issues with certain food types).
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1-09-2011 @ 7:55PM
Melissa said...I was a very picky eater as a child, or so I thought. After growing up and having my own children I see that I may have had the Sensory Processing Disorder. However, I am now 31 and eat more things then I ever have but I still stay away from things that I had texture or smell issues with b4. My oldest has the same problems as mine but worse. He doesn't use the same utensil for different foods and if a food he has always liked tastes a little different then it may turn him off it for a while. I have tried introducing him to the same foods with different variations but its not doing any good. He is pure sight, smell, habit, and texture. I have learned to incorporate healthy things into the foods he likes. He loves pasta so I make home made pasta sauce with different vegetables pureed into it and he would eat this any time of the day every day. I fugure that as long as he is healthy and growing (he is one of the tallest & strongest in his grade) I will continue to feed him the foods that work for him as long as he tries at least a bite of something that is new when I make it. I know I should make new stuff more but there is a lot you can do with pasta sauce. He is a lot like me so I am not worried for him too much. I am confident he will eat more when he is older and wiser.
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1-11-2011 @ 5:21PM
Shelley said...First of all, for those you who actually posted "helpful hints", thank you!!! For others of you who seem more interested in "you created your picky eaters, so there!" SHAME ON YOU! For arguments sake, let's say it's 100% my fault I have a picky 6 year old. What then? You're right, I'm wrong? What has that accomplished? I can't go back in time and change whatever it was I did. What now? These kinds of articles are best used if we are trying to help each other overcome and fix problems. My picky eater started as a toddler right after nursing ended. My three older kids aren't picky like she is. The "rule" has always been you try everything. She went to bed hungry day after day, then week after week. EVERY doctors appointment she was taken to, the doctors reassured me that she was able to find nutrition in the very few foods she would eat, and to BACK OFF! Still after all these years, my instinct is to say eat this or go hungry! But it has done NO good for my daughter. The few occassions when she has tried a new food is when I've gotten off my high horse, relaxed and realized that the world wasn't ending, and taken the focus off "the picky eater". I've prepared something slightly different than her normal and given it to her as she comes in very hungry from Kindergarten.
My point is simple, let's put suggestions on here and help each other and stop pointing fingers.
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3-20-2011 @ 9:01PM
JE said...When I was a child, my parents made me sit at the table until I ate. It wasn't pleasant and I didn't always eat but they didn't "molly coddle" me either. They didn't give in one inch. Today, I eat just about everything except for insects, crabs and sushi. I love fruits (all kinds) and veggies (all kinds). Later in life before they passed, I thanked them many times for "making me eat" and setting the rules without going back on their word. They let their "yes" mean "yes" and their "no" meant "no". Consistency prevailed. I'm especially grateful to them because I have a wonderful assortment of food to enjoy. When God put us here, there wasn't factory mac and cheese so I would say our creator knew what we needed.
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3-23-2011 @ 1:10PM
stufry1 said...My son won a contest in the Tribune for the pickiest eater in the Chicago area. He ate apples, peanut butter, bread, milk, cheerios, some crackers and a little cheese. And french fries. He was extremely picky from the beginning; it wasn't a learned or rebellious thing. I had a great pediatrician who looked at the list and said, "He eats better than many kids in the third world. Never fight about food."
So that's what he did. We took apples and peanut butter with us. He went through a gallon of milk every two days. He was healthy and very tall and thin; an excellent athlete and student.
His friends accepted him. He is very accepting of people who are "different," always thought for himself and did not give in to peer pressure. I think it made him strong.
We had and have a great relationship because we let him be who he was. I read about super tasters, and believe that things just tasted too strong for him.
When he went away to college we helped him set up his room with a little fridge and he figured out where the nearest grocery story was. He fed himself, but discovered cheese pizza. Then one of his friends took him to In and Out and he had a cheeseburger. Add that to the list.
He's now an employed 25 year old with a great job and a great life. When he called last night he said he and his girlfriend were heading out for corn and crab soup. He is over the moon about LA food trucks.
Some kids just taste things differently. You have the choice of accepting them or making food an issue they (and you) will remember as a big awful part of their childhood.
Relax. They grow up and leave home and you'll miss them. Enjoy them while you have them.
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