So You Have a Picky Eater

Picky eating is one of the more frustrating aspects of parenting. This is partly because it can sneak up on us — many babies are wide consumers of food, and most toddlers are not. This happens for evolutionary reasons (once children are walking around out of your sight, you want them to be more discerning about what they put in their mouth), but knowing that doesn’t make it less frustrating when your asparagus-loving baby turns into a pizza-only toddler. 

The truth is that some picky eating is almost universal, and it’s a rare child who doesn’t go through some form of this phase. But some are worse than others, and this post will dive into what the data says about how worried you should be and what you might do to combat this. 

I will say at the outset: This is a piece focused largely on what we’d see as standard, I-only-want-pasta-and-carbs-and-white-food picky eating. I will not focus on eating patterns that truly put kids at risk of undernourishment. That is a problem for a pediatrician; and for children who are malnourished, there is a whole other set of guidelines, most of which are more intense and involved, for increasing eating.

Here, I’ll really dig into the basic, everyday world of my-kid-wants-nuggets-for-all-meals.

Do you care about this?

Before we dive into the data, you should start by asking whether this is important to you — whether you care about it. The vast majority of kids, even if they eat a very, very limited set of foods, will get enough calories and vitamins. 

For some people, picky eating feels like a problem. But getting their kid to not be a picky eater may not be important to everyone. You may care that your child is willing to eat some vegetables, but you may not particularly care if they eat different ones. There is nothing wrong with a child who eats only broccoli and pasta, as long as that works for your family.

Going further, you may not care if the child eats only pasta, figuring they’ll get into broccoli when they grow up. If the diet is extremely limited, you might need a multivitamin. But otherwise, this is not obviously a problem. So ask yourself first: Is this a problem you want to engage with now? If yes, read on.

What makes a healthy diet?

Let’s imagine that you do care about promoting a particular diet. Usually people try to promote what is seen as a “healthy diet” — one with lots of fruit and vegetables. Question: How can you get your kid to eat like this? The good news is that there is plenty of research on this question. The bad news is that a lot of it is not very good.

Consider a paper from 2017 that got a lot of media attention. The authors followed 911 children from the age of nine months to 6 years and related their early diet to their later diet. They found that children who ate a varied diet at nine months — and in particular those who consumed a wide variety of fruits and vegetables — were also more likely to eat a varied diet with vegetables at age 6.

The researchers concluded that tastes are formed early, and that it is therefore important to expose children to a variety of foods early in life.

This is certainly one possible explanation for the results. But it is by no means the most likely one. A much more plausible explanation is that the kind of people who feed their children vegetables at age 1 are also likely to feed them vegetables at age 6. This is just a very basic causality problem, and it is difficult to learn anything here.

However, we can get some clues about the true underlying relationships from smaller, more indirect studies.

Consider the following quite neat example. Researchers recruited a group of mothers and randomized them into a “high-carrot” or “low-carrot” diet during pregnancy and lactation. The high-carrot moms were drinking a lot of carrot juice.

When their children were ready for rice cereal, the researchers offered the babies a cereal made with water or one flavored with carrots. The kids whose moms had eaten more carrots were more likely to prefer the carrot cereal (as evidenced by their consumption and their facial expressions, and presumably also whether they picked up the dish and threw it on the floor). This suggests that flavor exposure — in this case, through the placenta and through breast milk — affects whether children are receptive to new flavors.

Related to this, once children are starting to eat solid foods, there is randomized evidence that repeated exposure to a food — say, giving kids pears every day for a week — increases their liking of it. This works for fruits but also for vegetables, even bitter ones. It reinforces the idea that children can get used to different flavors and that they like familiar ones.

This shouldn’t be too surprising. People eat differently in different cultures, and we know people continue to express preferences for the foods they ate as a child, even if they move to another location.

So, on one hand, from a global public health perspective, I would be extremely hesitant to conclude that lack of exposure to vegetables at age 1 was the problem with older children’s diets. The problem was much more likely to be with the foods kids were offered at both ages. On the other hand, from the standpoint of an individual parent, if you want your child to eat a variety of foods, this suggests it is beneficial to expose them — repeatedly — to these flavors.

My kid is picky: Now what?

However, even if you eat all kinds of weird stuff while breastfeeding, and carefully expose your child to brussels sprouts for weeks on end, they may still end up being somewhat picky about their food. Researchers classify this pickiness into two groups: food neophobia (fear of new foods) and picky/fussy eating, in which the child just doesn’t like a lot of different foods.

As I mentioned at the top: nearly all kids become more picky around 18 months or 2 years, and then grow out of it later. This is often a surprise to parents, and this change can lead to unrealistic expectations from parents about how much their toddler and young child will eat. As a review article from 2012 notes, “The majority of children between one and five years of age who are brought in by their parents for refusing to eat are healthy and have an appetite that is appropriate for their age and growth rate.” The article goes on to note that the most useful treatment for this problem is parental counseling, not anything to do with the child. Thanks for the judgment, researchers.

This suggests that even if your child doesn’t eat that much some of the time, you probably shouldn’t be overly concerned, but it doesn’t answer the question of how you can treat or avoid general pickiness. This is a topic of some research interest. One study I like a lot followed 60 families of kids ages 12 to 36 months as they tried introducing a new food. The families videotaped their dinner interactions for a night so researchers could study what seemed to influence the new food adoption.

This study reported what parents actually do rather than what they say they do. This is good, since none of us are especially good at reporting our actual behavior. The primary finding relates to how parents talk about the new food. Kids are more likely to try and eat a food with what researchers call “autonomy-supportive prompts” — things like “Try your hot dog” or “Prunes are like big raisins, so you might like them.” In contrast, they are less likely to try things if parents use “coercive-controlling prompts” — things like “If you finish your pasta, you can have ice cream” or “If you won’t eat, I’m taking away your iPad!”

Other studies show that parental pressure to try new foods or to eat in general is associated with more food refusal, not less. The study also shows that food refusals are more common in families where parents offer an alternative. That is, if your kid doesn’t eat broccoli and then you offer him chicken nuggets instead, he may learn that this is always the reward for not eating new foods. This problem is exacerbated by parents’ concern that their child isn’t eating enough (which, see above, is probably not true).

Putting this together leads to some general advice: Offer your very young child a wide variety of foods, and keep offering them even if the child rejects them at first. As they get a little older, do not freak out if they don’t eat as much as you expect, and keep offering them new and varied foods. If they won’t eat the new foods, don’t replace the foods with something else that they do like or will eat. And don’t use threats or rewards to coerce them to eat.

This advice is easy to give, but it can be hard to take. It is frustrating to sit at a meal that you know to be delicious with a 4-year-old who screams that they hate it and will not eat anything. I don’t have a great solution for this, other than earplugs. Oh, or try this: When my younger child was 4, I trained him to say, “I don’t care for pot roast” rather than “I hate pot roast,” since it at least sounds more polite, even if still combined with pushing the plate away and putting on an angry pouty face. (Parenting: It’s a long game.)

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