Picky Eaters
Brought to you by: Childcare Network
What we will cover
Eating issues
Jags
Picky eaters
Problem eaters
Factors
Temperament
Genetics
Parenting style
Stage of development
Goals based on the childs needs and our capabilities
Quality of diet
Quality of mealtime
Aiding proper development
Carrying out an action plan
Methods
What is a picky eater?
picky eater:
child who has begun to eat limited number of food choices for several weeks
to months
made distinct by the length of time
food demanded to be prepared one way i.e. must be fried, a certain color,
accompanied by a certain condiment etc.
Becomes upset and or does not eat if meal contains other foods alongside preferred
food
Eats the desired food when available then refuse to eat when other meals are
served.
Food Jag
will usually last about 3 weeks at most
Category
Picky Eater
Types of food child eats
30 or more
Food Jags
Foods not eaten for a
period of time are usually
re-adopted
Acceptance to new foods
Will touch or taste it.
Allows it on their plate
Categories of food texture
Eats at least 1 food from
different texture category
Family/group Meals
Eats different food but
alongside family food
Steps to new food
15-25 steps to eat new
food
Parent report
Sometimes reported as
picky eater
Combination of Factors
Genetics
of taste
1. Genetics of Taste
Sensitivity to certain flavors that each
person is born with
These taste sensitivities change very
slowly through training
Genetics of taste
Overall, humans prefer sweet & slightly salty
reject sour & bitter foods, especially children.
Genetic taste preference vs learned preference
Genetic sensitivity can be overridden through
Alteration of food to neutralize or mask disliked flavors
Aside from these points, there is no evidence that a child cannot learn to like
a new food
they are not inborn with preference
shaped by the environment in which they learn about new food
2. Temperament
The behavioral style of
the child to given
circumstances
Temperament
You will already be familiar with most of your childrens temperaments and actions
Easy - 40%
adapts to regular schedules & accepts new foods
Difficult - 10%
slow to adapt and definitely negative to new foods
Slow to warm up - 15%
slow adaptability, negative to new foods but can learn to accept new foods
Intermediate low or high (mixed behaviors) 35%
Slow to Warm Up and Difficult children may need 810 exposures to new foods before
acceptance
If the food is not offered they will never learn to accept a new food
3. Parenting style
Methods and attitudes
towards the child that
influence their behavior
Parenting style
Parents and caretakers have tremendous influence on childrens development of
appropriate eating, physical activity, and other health behaviors and habits formed
during the toddler and preschool years.
Lessons transferred by example and attitude conveyed from parent or caretaker
Both positive and negative aspect
Food intake related to parents or caretakers preferences
Feeding and growth concerns for infants and toddlers
are common in all cultures
families will respond to this in various ways (parents telling childcare providers which way
to feed)
Style should be the same for all children
High
Respons
ive
ness
Behavioral control,
Low
warmth
, suppor
tiveness
Demandingness
High
Low
Qualities valued and methods used
Authoritarian
Qualities Obedience, Structure, Rules
Methods Punishment, Demands, All or nothing Expectations
Authoritative
Qualities Standards, Self-regulation, Flexible but Assertive
Methods Guidance, Support, Enable
Uninvolved
Qualities Distance, Disinterest,
Methods passive neglect, absence, Unaware
Permissive
Qualities Lack of structure, guidelines, roles, or goals
Methods Appeasement, over-involved, avoids direction, indulges
4. Stage of Development
Physical, mental, and emotional
development of the child that varies
for each child
Toddlers and Preschoolers
Picky eating begins in these age ranges but does not cease once the child grows
Toddlers (1-3 years old)
Remember that with toddlers, growth may plateau while eating patterns are changing
As a toddlers growth rate slows, their appetite decreases. Usually after 2 years old, they will gain ~5 lb and 2 inches
per year
Around 2-3 years old the child needs to develop a sense of personal control
Preschoolers ( 3 or 4-5 years old)
Child begins to assert control over their environment
Toddlers
Feeding skills:
Gross & fine motor development improved
12 - 24 monthsweaning from breast/bottle to cup
12 monthsrefined pincer
18-24 monthsable to use tongue to clean lips & has developed rotary chewing
2-3 years- feeds self using fingers, spoon, and cup. Spills a lot. Have a favorite food
Adult supervision vital to prevent choking
Feeding rituals of toddlers
Rituals in feeding are common
Likes the food in a certain bowl and or during a tv show
May have strong preferences & dislikes
Food jags common - can occur when growth is not occurring due to decreased
caloric needs
How to provide:
Serve new foods with familiar foods & when child is hungry
Have the child watch you eating the food or others
Appetite and Food Intake of Toddlers
Nutrient-dense snacks needed (animal crackers, salted crackers will not fill
up)
Provide new snacks, kids will become bored
To ensure hunger for meals:
Avoid grazing including with juices, not allowing kids to eat alone, provide water
Having snacks too close to meal time (within 2 hours)
Toddler Portions:~ 1Tablespoonfor
each year of age from each food group.
Ex., 2 y.o. is offered
2 Tbsp of starch
2 Tbsp of protein
2 Tbsp of vegetable
Minimum amount for each type of food
(rice)
(beans)
(Tomatoes)
Preschoolers
Growth increases to 4-6 lb per year and 2-3 inches
Feeding Skills
Able to feed self and drink from cups neatly
Eventually moves to knife and fork by grade school age
Feeding Rituals include:
Hunger related to growth
Hunger increases prior to the spurts of growth
Some kids will go through growth earlier or later than other children
How to provide:
Can include child in meal selection & meal preparation; at home and at day care
help add and stir ingredients
give 2 appropriate choices (i.e., what vegetable to add to salad or what cereal
for breakfast)
Growth - continued
Five to six years
same rate of growth
Six-year permanent molars appear
Begin to lose front baby teeth
Prefer plain, bland, unmixed foods
Six to Nine Years
Further teeth development
Nine to Twelve Years
Appetite is increased
Girls growth spurt begins
Irritable when hungry
How does picky eating affect the child?
Emotional, Behavioral, and Physical
Self expression the need to develop a sense of self
Sense of control and independence leads to feelings of autonomy
They need support in transitioning from toddlerhood to pre-schooler
Avoid power struggles will make meal time a negative experience
Why picky eating is an important issue to overcome
Learning to enjoy new foods and developing feeding skills are important components of this period of
increasing independence and exploration.
It is one of the main concerns parents bring to their pediatricians
During toddler and preschool years, adequate nutrition is required to support cognitive and physical
development
Prevention and treatment of overweight and obesity
Of
children ages 2-5:
10.4% are overweight (BMI/age >95%)
20.6% are at risk for overweight (BMI/age 85%-95%)
BMI
is lowest from ages 4-6 years
Adiposity
declines
reboundnormal increase in BMI that occurs after BMI
When is picky eating
confused with or
evolved into Problem
eating?
Goodness of
fit
Sensory
based
eating issue
Genetics of
taste
Picky eaters vs Problem eaters
Behavioral
Category
Picky Eater
Problem Eater
Range of food
30 or more
20 or less
Food Jags
Foods not eaten for a period of
time are usually regained
Food lost is not regained
Acceptance to new foods
Can touch or taste. Allows it on
their plate
falls apart with new food
Categories of food texture
Eats at least 1 food from different
texture category
Refuses entire categories
Family/group Meals
Eats different food but alongside
family food
Always different food than family
Steps to new food
15-25 steps to eat new food
More than 25 steps
Parent report
Sometimes reported as picky
eater
Always reported
Identifying Problem eaters
As we saw from the chart
Have similar issues with picky eaters
Aversion or avoidance of all foods in a specific texture or nutrition group
Delay in transition from soft to solids by 1 year
Less than 20 foods, losing foods, not picking up new ones
Cries during meal
Problem eating be a difficult issue to overcome and can continue into later
life leading to health issues or poor quality of life for the person and those
who care for them
Causes of eating problems Being aware of
issues a child may have, communicate with
parents
Oral motor feeding problems
Difficulty with mixed textured foods, preferring only crunchy or soft
Oral motor weaknesses with chewing, sucking, tongue movements
Choking/gagging with trying non-preferred textures
Tongue thrust
Other medical issue causing stomach discomfort
GERD (gastro-esophageal reflux disorder), delayed stomach emptying, chronic
constipation
Sensory-Based Feeding disorders
Dental Issues
Swallowing issues
food sensitivity -such as dairy or gluten
Being aware of physical symptoms that
may be displayed
You may see these traits that help you identify problem eating that now has
caused issues with the child
Some issues will not be obvious, like deficiency, until they are advanced
When the child is underweight/not following growth curve
Concerns about micronutrient deficiency (Fe, Ca, vitamin D)
When extreme or prolonged
Overweight obesity
Iron-deficiency
anemia
May cause delays in cognitive development and behavioral disturbances
Child seems tired
Being aware of physical symptoms that
may be displayed - continued
Constipation
Causes of constipation: Stool holding, inadequate fiber and fluid in diet and inadequate activity
Adequate fiber
1 and older
Use the childs age then add 5 grams of fiber OR 14g/1000kcal
Ex. Age=5; 5 years old+5 gram of fiber = 10 grams/day
Ex. 1300kcal needs = 14 +~5 grams = 19gms/day
Dental Carries
Children who do not want to drink water during the day, only juices or milk
Prevalence:
1 in 5 children ages 2 to 4
Causes:
Drinking juice from a bottle
Bedtime bottle with juice or milk
Carbohydrate foods in mouth for >30 minutes
How does picky eating affect you
as a childcare provider?
Increases your work by:
Cooking personalized meals for a child (Short-order-cook)
Puts you off schedule for meals
Requires you to chase after/entertain picky eating children
Wastes food if the child is not eating
TIP:
Cater to the childs
imagination.
Giving a name creates
ownership and pride
Introduce new items one at
a time
i.e.
1. Broccoli
2. Broccoli w/ butter
3. Broccoli w/ cheese
4. Broccoli w/ cheese and
chicken
5. Broccoli w/ cheese and
chicken and rice
Show the child that the
source of these flavors can
be just as delicious.
1. Strawberry Ice cream
with small bites of
strawberry mixed in
2. Strawberry Yogurt with
strawberries mixed in
3. Plain yogurt with
strawberries mixed in
4. Strawberries
Make kids more aware of
the variety of good tasting
vegetables available.
Use what they like to
expand what they eat.
What can salsa be paired
with that this child might
not like if it was not
seasoned?
Be aware of strong
dislikes.
These foods can be
introduced later on or in a
different form rather than
throwing them into the
meal hoping the child will
not notice.
Methods
Psychological stages 8 to 14 months
CHILDS TASK = learn to explore their world and manage separation anxiety at
the same time. The child controls HOW MUCH and WHETHER to eat.
However, children are not born with the knowledge of what they should eat
PROVIDERS TASK = encourage new initiative in self feeding and allow
exploration of foods WHILE providing structure, routines and safe boundaries.
The care giver controls WHAT and WHERE to eat.
Division of Responsibility
Ellyn Satters DOR (Division of Responsibility in Eating)
Provider is responsible for WHAT, WHEN and WHERE
Child is responsible for WHETHER and HOW MUCH
Children have an innate ability to self-regulate food
intake.
BUT
Children are egocentric
Cannot understand that something is good for
them if it tastes bad or does not appeal to their
senses (texture, sight, sound, smell).
Psychological stages 18 to 30 months
CHILDS TASK = to undertake body management more
independently.
May express dislike for foods
Assertion of self by doing things differently and by self
Provider's TASK = maintaining a positive relationship and
teaching the concrete components of learning to eat and
social interaction at meal time VERSUS on how much food
gets into the child.
Mealtime
Mealtime structure maintaining the mealtimes that you set for children
Even though a child may not be hungry, keep them seated with the rest of the
children during the meal keep them involved with the meal
They may not want to listen/become confrontational
Allow the child to self feed if able provide proper utensils
Dont worry about the mess
Be a model for the child
Sit with the children
Eat the same food
Avoid distractions - no TV/phones/toys/books
Avoid Distractions for yourself too!
Ask parents not interrupt mealtime
Foods to provide
Foods that are easily chewed for those under 4
Steamed carrots vs raw
Tough foods can present a choking hazard
Provide new foods with known foods (foods they will eat)
Continue to expose the child to new foods several times, through each meal
of the day once, and in different forms
Be aware of the childrens culture- try culturally diverse food
Vegetables on the plate vs vegetables in a stew vs vegetables in rice
(Examples)
Variety
Offer new foods with a different
dressings/condiments/toppings/colors/texture/temperature/utensils
It is more likely they will find a pairing they like
Avoid these choking hazards
Raw carrots
Large sections of hot dogs
Raw celery
Raw cherries with pits
Whole grapes
Round, hard candy
Peanuts and other nuts
Amount
Appropriate portion sizes are important, but when it comes to new foods,
having the child try even a bite is a success
Serve sampler platters different fruits and vegetables
just like at a normal party or family style
This practices self-service
Avoid encouraging child to clean your plate
Children adjust caloric intake to meet caloric needs naturally
Time
As
we said before, offer new foods when the
child is hungriest, at the beginning of the meal.
Offer
food at intervals not less than 2 hours &
no more 3 hours, However, DO NOT BE AFRAID
IF THE CHILD DOES NOT EAT
hungry child will eventually eat
Continue
to offer the foods over time, dont
become discouraged after a few failed
attempts
Dont
force the child to sit and eat everything
or beyond the time when everyone else has
finished the meal
Teaching
Healthful
WHAT
eating habits must be learned
IS THIS STUFF? Proper table manners
Gradual
desensitization what is it?
introducing
new foods to the senses
Visual
Smell
Touch (temperatures, textures)
Lips, teeth, tongue, bite
Dont write off a child as someone who doesnt eat i.e. Broccoli
My Pyramid for Kids
Teaching the children about my plate will help them visualize their meal in a different
way
Teaching yourself about the needs of the child
- Malnutrition can occur at low levels for long periods of time (reference the copies you
made)
Most toddlers and preschool-age children have adequate vitamin & mineral
consumption except for
iron
calcium
zinc
http://www.cnpp.usda.gov/FGP4Children
Development of the child
Working with the child on meeting the expectations of growth
Being able to use utensils and cups
Sitting for the meal
Not playing with food
Reference the sheet
Working with Parents
Making parents aware of your efforts and childs progress
Alert the parents of any concerns you have, perhaps it is something they knew
about but did not mention
Encouraging the parents to work with the child at home
Creating a nutrition Board
Create a bulletin board for the kids to see when they come into the day care
Post menu items you will be providing and include pictures so that they can
see what to expect
Post the food art that the children have colored
Create activities for children to decorate the board
For example: if you are serving broccoli for dinner, make the afternoon activity to cut out
little broccoli men to post on the board
Have the kids try to wear the color of the food that will be introduced to
For example: if they are eating carrots, wear orange
Being creative with food
Exposing a child to a new food in a different way just a few times can
condition them to request these items instead of dreading them.
Begin by introducing
the food in a playful
way
And then work your
way up to simpler
presentations
Showing Kids How They Are
Growing
Posting the growth chart can teach kids the importance of
eating healthily in order to grow big & strong to motive them
Creates a positive connection between their nutrition and
growth
Visual progress is easiest for them to understand
Have the kids see you mark their growth on a piece of paper
for them to take home
Skills the children can and want to use
SEE KITCHEN ACTIVITIES SHEET
2 years old
4 years old
Peel eggs and some fruits
Set table
Wipe tables
Measure dry ingredients
Throw things into the trash
Assemble sandwich
Tear lettuce
3 years old
5 years old
Measure liquids
Add ingredients
Cut soft fruits with a knife (dull)
Scoop, stir, squeeze, knead
Name and count food
Use egg beater (with assistance and
monitoring)
Expecting Results
Sample Meal/ Practice
11:45am
Tell the children it is time to eat
Child stop playing and wash hands in preparation for the meal
11:50am
Table is set
Everyone is seated
11:55am
Food is served
12:00 pm
Meal Begins
Behaviors and Responses
The child may display a range of temperaments from easy to difficult
Different children will take up new foods more easily than others
When a child is refusing to eat, it may seem impossible to coerce, force, or
charm them into consuming what you are putting on the table especially
when the child or children behave by:
Crying
Hiding
Wasting time playing
Recruiting other children
What are some of the behaviors you have seen?
HOW DO WE DEAL WITH THESE ISSUES
Review and Summary
Review and Summary
So
what is a picky eater?
What
are causes of picky eating?
How
do we know a food jag from a picky eater
from a problem eater?
What
are the problems we can see arise from
picky eating?
What
can I do about picky eating?
Toddlers
Serve new foods with familiar foods & when child is hungry
Toddlers imitate parents & older siblings
Preschoolers
Creating new ideas
The double-edged sword of milk
Limit milk consumption to 24 oz./d (3 cups) since milk is a
poor source of iron
Why?
Child fills up on milk, no long has an appetite for other
foods
May be being provided too much too soon child is not ready
for so much food which doesnt leave space to create a
balanced diet
Offer heme iron food sources (beef, chicken, fish) and nonheme iron containing food sources (grains, legumes)
References
Nutrition Now Judith E. Brown Nutrition for the Growing Years: Childhood through
adolescence
Nutrition for the Toddler and Preschooler (2014) -Patricia Miner PhD. RD.
The Science and Culture of Picky Eating When to Worry and What to Do (2012) Dr. Ruby Roy
Addressing Picky Eating: Strategies for Success (2013) Molly Holland, RD, MPH, CD American Dairy Association and Dairy Council, Inc. & New York State Dietetics Association
My pyramid posters http://
www.cnpp.usda.gov/food-guide-pyramid-young-children-graphic-resources
My Plate Coloring - http://www.foodpyramid.com/myplate/for-kids/
Maze Sheet - http://www.choosemyplate.gov/kids-activity-sheets
Behavioral Milestones sheet - http://
www.choosemyplate.gov/health-and-nutrition-information
Picky Eaters Sheet, Picky Eaters Tips, Kitchen Activities. http://www.choosemyplate.gov/preschoolers-picky-eating
