It’s not uncommon for children to have difficulties with mealtime! This is true for many different reasons, but when should we be concerned about our children’s eating behaviors? This resource is to help differentiate between “picky” eaters and “problem” eaters.

Picky Eaters

Picky eaters are more commonly known to parents. We often believe our children will not eat because they are “picky.” Often, picky eaters are generally selective about what foods they are willing to eat. Picky eaters will accept at least 30 or more types of food. The rate of acceptance varies, and for a certain amount of time, your child may want to eat (or not want to eat) certain foods. Commonly, as children begin to explore and age, they begin to express autonomy through pushing boundaries. This may include fluctuating compliance in the foods they choose to eat. This may explain why a child may suddenly refuse food they previously enjoyed. If you notice your child begins to refuse a specific type of food frequently, then take a break from presenting that food. Your child may accept that food again after a certain amount of time has passed from the last time they ate it.

Problem Eaters

Problem eaters are less common. Often problem eaters are severely restricted in the types of food they accept. Commonly, problem eaters will accept 20 or less types of food. When a problem eater is presented with new foods, they will often have a severely negative reaction. New foods may often cause problem eaters to cry, throw a tantrum, gag, or even vomit when presented. Common associated behaviors include possessing fear when seeing a new food and/or unwillingness to tolerate its presence. Problem eaters also often have difficulty with entire food groups rather than specific foods. For example, problem eaters may not tolerate any meat or will not eat anything crunchy.

What to do

If you have concerns about your child’s feeding or wonder what can be done to help, refer to a feeding specialist. This may be a speech therapist, occupational therapist, or dietician. Refer to your local provider to determine what resources your family may have near you!

Resources

Fraker, C., Fishbein, M., Cox, S., & Walbert, L. (2007). Food chaining: The proven 6-step plan to stop picky eating, solve feeding problems, and expand your child’s diet. Da Capo Press.

We’ve all done it before- we beg, we plead, we bargain, and we bribe- we would do anything to our picky eaters to eat! What is the caregiver’s role in prompting picky eaters and what effect do these prompts have during mealtime? While there are no “magic words” to get your child to eat a full serving of green beans during dinner, there is research behind different strategies and their effect on a child’s consumption that can be used both in the clinic and at home.  

The Research 

 Jordan et al. (2020) sat down to observe 199 children during mealtime with their primary caregiver to study the different types of prompting provided when a child was presented with a plate of green beans and how these prompts affected the child’s consumption. The children were sorted into 2 groups, picky eaters and non-picky eaters, based on a parent questionnaire. There were two categories of prompts studied, which included coercive control (i.e., when the caregiver used threats or bribes to try to get their child to eat) and autonomy promotion (i.e. when the caregiver gave the child more of a say in whether or not to try to food.  

The Results 

As you may have guessed, caregivers of picky eaters used more prompts and the picky eaters themselves consumed half the amount of green beans as their non-picky eater counterparts. In terms of promoting, coercive control was not effective when it was used on picky eaters and appeared to reduce the amount eaten by non-picky eaters. Praise, a subtype of autonomy promotion, was the only prompt that appeared to increase the number of green beans consumed for both picky and non-picky eaters. Overall, the more prompts the caregiver gave, the fewer green beans were consumed.

What does this mean? 

 You may be thinking “easier said than done.” You are not alone. Truth is, getting a picky eater to eat is no small task and every child is different. Getting a child to eat something they do not want to eat is a struggle that every parent, caregiver, and feeding therapist has and will continue to experience. Both caregivers and therapists are no stranger to a little bribe. Our parents said it to us, and we will likely continue to say it to our children: “If you eat your vegetables you can have ice cream for dessert!” However, if we can all take one thing away from this post is that praise is a wonderful thing for every child! Work up the SOS feeding hierarchy (explained below) to exploring food together and pair each small step with praise. Don’t forget to praise your efforts as well and seek comfort that you and your child’s therapist are in this together! 

Take home: Using the SOS Feeding Hierarchy 

The SOS feeding hierarchy is used to increase familiarity and build a tolerance to novel food with the goal of increasing a child’s repertoire of consumed foods through play and interaction. Start with the steps you know your child will be successful in and use praise and individual interests to progress up the latter. Take it one, small step at a time ensuring that the steps between levels are small enough for the child to tolerate. You can always scale back depending on your child’s response! Here is a quick outline of the hierarchy: 

• Tolerates – The child tolerates the physical presents/sight of food, whether it be tolerating having the food in the same room, at the table, or on their plate. 
• Interacts with – The child uses a utensil, napkin, or other food to touch the target food without directly touching the food to their skin.
• Smells – The child wafts the smell toward them or picks up the plate to smell the food.
• Touch – The child touches the food to their skin or body part including fingers, hands, or face. Keep in mind: the closer the food gets to the child’s mouth, the more threatening the food may appear.
• Taste – An action that results in the child tasting and processing the taste of the food. Can use small “snake tastes” with the tip of the tongue to assess response.
• Eating – The child chews and swallows the food or at least part of the food. It can start with first biting and spitting out and work up to chewing and swallowing.  

And remember- praise, praise, praise! 

References 

Jordan, A. A., Appugliese, D. P., Miller, A. L., Lumeng, J. C., Rosenblum, K. L., & Pesch, M. H. (2020). Maternal prompting types and child vegetable intake: Exploring the moderating role of picky eating. Appetite, 146