TME 211 - How To Help A Picky Eater

0:06Have you ever wondered why offering a little kid a new food can lead to a tantrum? Or why asking your child to take one more bite can end up with them actually eating less? Or maybe mealtimes just aren't the fun and loving moments you imagined. Maybe they feel more like a battlefield. Well, if your child is a picky eater, you may constantly worry about whether your child is getting enough. So let's look at some of the ways you can help a picky eater without turning every meal into a battle. Welcome to Toddlers Made Easy. I'm Dr. Catherine, your host. And for those of you who don't know me, I'm a recently retired pediatrician, mum of four, adult kids, amazing kids, and I've got an 82-pound golden doodle who thinks he's a lapdog.

0:51During my 40 years of pediatric practice, I saw just how stressful picky eating battles can be for families. Take Leonard and his family, for example. Leonard wouldn't eat any foods that were touching, and the only vegetables he would reliably eat were potatoes. Offer him anything else, and he'd say, no thank you broccoli, or no thank you corn. His mom tried everything she could think of to get him to eat vegetables, and eventually meals started to sound like this. If you don't eat any vegetables, I'm going to send you to your room. Most meals ended up with his mom taking him upstairs and saying, when you're ready to eat a few carrots, come back downstairs.

1:30Finally, his mom called me. She was at her wits end. In fact, the younger sibling was starting to follow his older brother's lead, and that was the final straw. There are several things you can do to help a picky eater, and the first may feel a little counterintuitive. Start by taking off the pressure. Many parents will crank up the pressure when they're worried their child isn't eating enough, but adding more pressure can actually make things worse. And pressure doesn't always sound like

1:58Dr Cathryn:eat your broccoli or else. It can also sound like this. You can go and play if you take one more bite of broccoli or like this. You don't need to eat all the corn, but you do need to take three more bites. And sometimes it comes as pleading. Just take one more bite, sweetheart, please, for mummy. Do any of these sound familiar? Bargaining, bribing, and pleading are all forms of pressure. And while they come from a really loving place, they can have the opposite effect from what you've intended. Research has shown that when kids feel pressured to eat, they often eat less. We want kids to eat because they're listening to their body signals or because they're interested in the food, not because they'll get a prize, earn your approval, or avoid a punishment.

2:44So what can you do instead? The next suggestion may feel really hard, even scary, but you want to stop pressuring your child to eat more. Now, based on feeding expert Ellen Satter's Division of Responsibility in Feeding, you and your child each have different jobs at mealtime. Your job is to decide what food is offered, when meals and snacks happen, and where your child eats. But your child's job is to decide whether to eat, what to eat from what's offered, and how much to eat. In other words, you decide what, when, and where meals happen, and your child decides whether and how much to eat. And that's the hardest part.

3:25You're giving up the job of nudging your child to eat and letting them decide how much their body needs. Well, you're probably thinking, but if I leave it up to my child, he won't eat anything. I heard this all the time in my office and it's really an understandable worry. But once your child realizes you're not going to argue, bargain or pressure them to eat, mealtimes start to feel safer. And this gives your child more room to explore food and pay attention to their own hunger and fullness signals. Now, this doesn't happen overnight. It takes time for both you and your child to adjust to a different way of doing meals.

4:01And here's something that can help you during this transition. Rather than worrying about what your child is eating at one meal, zoom out and instead look at what your child eats over the course of a week. Now, this may sound great in theory, but what does it look like in real life? Well, you put the dinner on the table and your child says, gross. Well, instead of trying to convince them otherwise, you can simply say, you don't have to eat it, sweetheart. Or your child says, I hate broccoli. Well, you can say, we all like different things. You don't need to convince them to take a bite. Your job isn't to get broccoli into their mouth.

4:37Your focus is on creating a relaxed, healthy mealtime. Now, when my granddaughter was younger, her parents gave her a no thank you bowl. If there was something on her plate she didn't want to eat, she could put it in the bowl. She didn't have to eat it or leave it sitting on her plate. There was a lot less fighting and playing with food after the no thank you bowl was introduced. I've suggested this to many families in my practice and they found it helpful too. So the first step to help a picky eater is to take off the pressure. The next thing you can do is to take the focus off what your child is eating.

5:12Dr Cathryn:So when you can, eat meals together as a family. And rather than making the conversation about what your child is or isn't eating, talk about your day. Or ask your kids something like, what was the best part of the day? The idea is to make dinner about being together, having fun, and sharing, instead of monitoring every bite. When my kids were little, we couldn't always sit down together every night. But Friday night was family night. And 36 years later, my kids still come home on Friday nights, now with their partners and kids of their own. Kids also learn about eating just by watching you. There's no lectures needed or finger wagging.

5:48Dr Cathryn:They're learning from watching what you eat and how you eat it. Another way to help is to let your child spend time around food without asking them to eat it. Young children can toss the salad, tear the lettuce, paint on cooking oil, or stir the sauce. They can put napkins on the table and even clear their plate as they get older. The goal isn't to get them to taste something while they're helping. It's to let them get comfortable handling food without the pressure to eat it. Now, there's other ways you can make eating easier for your child. And the first one is to make sure they're physically comfortable at the table.

6:25An uncomfortable child is less likely to enjoy or explore new foods at mealtime. Now, I know this sounds trivial, but take a moment and consider what it feels like when you're sitting on a stool. Think of how uncomfortable you quickly feel without the back support or somewhere to put your feet. The same is true when your child's seating doesn't make them feel safe and secure. If they don't feel comfortable in their chair, they won't last long. They may be busy fidgeting and repositioning themselves instead of exploring the food on their plate. So what helps? A child's feet should be firmly supported and their ankles, knees and hips should be at about 90 degrees.

7:02When the chair fits, there's less fidgeting and constant repositioning. Fewer falls as well. In my ER shifts, I saw many kids who hit their head when they unintentionally push their chair over backwards. So far, we've taken off the pressure, we've taken the focus off of how much your child eats, and we've made sure they're comfortable at the table. Now let's look at the skills your child needs to eat. A few years ago, I was visiting one of my kids who was living in Grenada. At many meals, we were served foods I just didn't recognize, and I wasn't sure what part was edible or even how to approach eating it.

7:38So I watched the people around me. Now, imagine you've been on this planet for less than 800 days. There are going to be plenty of foods you have no idea yet how to eat. Sometimes kids need to be shown how to eat a new food. A few days ago, my granddaughter was over for lunch and we served tacos. She was confused by the hard shell and she wasn't really sure how to hold it or how to eat it. So I showed her and I explained that the shell would be crunchy and the softer food would be inside. She had been about to give up, but after some explanation, she gave it a try and she enjoyed it. And there's something else to keep in mind.

8:13Toddlers are fiercely independent and food is one place where they can exert control. So whenever you can, offer two good choices. You might ask, do you want strawberries or blueberries? This gives them some control without turning the meal into a power struggle. It's also normal for kids to be more selective about food during the toddler years. That can make it hard to know whether you're dealing with typical food selectivity or something more persistent. We've covered some of the most common ways to help a picky eater. But of course, every child is different. Remember Leonard, whose mom was sending him upstairs when he wouldn't eat his vegetables?

8:49Well, she made a few changes that made a big difference. She stopped punishing him when he didn't eat. She started using a no-thank-you bowl, and she brought him into my office regularly so we could keep an eye on his growth. Seeing that Leonard was growing gave his mom something she really needed, and that was reassurance. She didn't have to watch every bite or push him to eat more. She could relax a little and let him decide how much to eat. And that's a big part of helping a picky eater. Your job isn't really to make your child eat. Your job is to offer the food, give them the opportunities to explore it, and make mealtimes feel as relaxed as you can.

9:27Their job is to decide whether to eat and how much. Now, I know that can feel really scary, especially when you're worried your child isn't eating enough, but more pressure usually isn't the answer. So start by taking some of that pressure off. Give your child time to get comfortable with unfamiliar foods. Show them how to eat something when they're not sure. And when you can, give them a little control without turning dinner into a negotiation. Helping a picky eater takes time. You're not looking for one perfect dinner. You're helping your child become more comfortable with food over many, many meals.

10:06If you're worried about what your child is eating, their growth, or whether the picky eating is more than the typical toddler food selectivity,

10:14Dr Cathryn:please have a chat with your health care provider. That's what they're there for. Sometimes, like Leonard's mom, having someone keep an eye on your child's growth can give you the reassurance you need to really take off the pressure. I know this is a really hard topic, but I want to encourage you, you're doing better than you think. Keep up the good work, and I'll see you next week. Thank you.