Maggie Baumann, MA: Several posts ago, I wrote about whether or not there was a link between finicky eating early on and the development of eating disorders such as anorexia and bulimia. My overall message was, "Yes, children who have certain food-avoidant issues have a higher risk of developing an eating disorder later on in life."
A couple of readers wanted to know what to do when you have a child who is a finicky eater. So I interviewed Michele Manarino, MS, RD, a registered dietitian and mom of a 2 1/2-year-old daughter, Sierra. Michele has a private practice and sees adolescents and adults with a variety of nutritional issues, including eating disorders. She also teaches nutrition at several colleges in Orange County, California. As a mom, she "walks the talk": Her toddler is "a healthy, normal eater," she says, "and that makes me a happy mom!"
Here's Michele's advice as to what moms can do if they're struggling with a child who is a finicky eater:
Maggie Baumann: Is picky eating hereditary?
Michele Manarino: I do not have any research to back that up. But what I do know is if parents are picky eaters, kids pick up on that and will often follow what is modeled to them. For instance, if mom never eats broccoli, but puts broccoli on her child's plate, the child will probably not want to eat it. Children model parents' behaviors as to how and what they eat.
MB: I know moms who try to get their kids to eat a variety of foods, but whenever a new food is introduced, the child pushes it away and won't eat it. Then mom gives up. What's your advice?
MM: What I've learned from the parents I've worked with is, they give up too soon. I suggest this rule: Practice exposure. You need to expose your child to new foods more than once before you give up. In fact, I stress to parents to expose the child up to 20 times before giving up on a certain type of food. Kids learn to eat what's familiar. If the food is brand new to them, picky eaters will push it away. The trick is to try to get the child a little more interested in the food each time you prepare it for them. For example, maybe the third time you expose your child to a new food, you ask the child to smell it, but don't demand that he/she eats it. Maybe the sixth time, you ask the child to put his or her tongue on the food. Maybe the eighth time, you ask the child to help you prepare the food. Also, let the child see you eating it. Again, the modeling behavior is important. Eventually, most children will take a bite -- and hopefully like what they are tasting. Obviously, there will be certain foods kids won't like, and you never want to push them to eat it if they truly dislike the taste.
MB: What is "normal" eating for a child?
MM: Well, there really isn't a "normal." Kids eat all different kinds of ways. They have their own distinct tastes they prefer. Some kids will go through food phases wherein they want to eat the same food over and over again. This is normal and nothing to worry about. Eventually, they will switch to other foods as a natural course of action. Sometimes kids go through a phase where they are so hungry, they eat everything and want more. And some kids may go through a phase of not being that hungry and not wanting to eat much. All these phases are normal.
Our children are born being natural, intuitive eaters. They know how much to eat, and they stop when they are full -- that is what intuitiveness is. Look at breastfed babies: We really don't know exactly how much breast milk they are ingesting, but they will cry when they are hungry and push the breast away when they are full. And they develop and grow on target.
MB: "Intuitive eating" is a common phrase today -- and most adults who diet are not intuitive eaters. They're following a program that takes them away from their natural hunger and fullness cues. As children age, do they lose their natural tendencies to eat intuitively?
MM: They don't have to, but many kids will if they're exposed to dieting at an early age, or if they reach their teens and start to experiment with different eating patterns or diets in a quest to lose weight or change their body size. It's a sad statement on our culture that our children are exposed to the unhealthful eating and dieting patterns that are splashed across many of the popular women's magazines today.
The good news is that, no matter what age you are, if you've lost your ability to be an intuitive eater, you can get it back. It means trusting that your body will eat what it needs and that it will stop when it's full. And it means no more dieting. I help many patients, from adolescents to adults, learn how to regain their intuitive eating patterns. This is one way to avoid the development of eating disorders -- most people who develop eating disorders usually start the process by going on a diet to lose a few pounds.
MB: What do you do if your kid only eats snacks all day?
MM: It's the parent's job to offer a selection of foods at structured times in the day. Offering three meals and three snacks to your kids at specific times will keep them on track. And if the child chooses not to eat a meal, you can let them make that choice. The consequence is that the child will need to wait to eat until the next structured time, be it a snack or another meal. If you get into the groove of giving your kid snacks all day, you are going to end up putting yourself at risk for living with a fussy eater.
MB: What are your thoughts on desserts and sweets?
MM: All foods are equal, and we should relay that message to our kids. When we say that chocolate cake is bad or that an apple is good, we set up a system where kids see foods in a nonintuitive way. Desserts and sweets are part of the foods available to us, and in moderation, they are healthy to eat -- just like a bowl of carrots. The message to the children should be "balance and eating intuitively." I promise you they will be nourished and healthy kids. Restricting certain foods sets up the feeling of deprivation, and all dieters know what that feels like. When you feel deprived, all you want is the food you won't allow yourself. It's the same for kids.
MB: When should a mom worry about a finicky eater?
MM: If a child is not getting enough nutrients to grow and develop at the rate he or she should be, you should consult your doctor. Luckily, most kids are seen by their pediatricians at set intervals, so the doctors can monitor the growth and development and catch anything that's medically or emotionally off-balance quickly.
MB: Any last tips?
MM: When you present your child with a balanced meal that you are also eating, don't succumb to the child's whining or fussiness about eating the food. If, to avoid the complaints, you end up making a new dinner you know they will eat, yes, it might be faster and less confrontational, but in the long run, your kids will know they have the power to use their fussiness to be picky eaters.
Another good tip: Get the kids involved in the cooking process -- when they are, the likelihood of them wanting to eat the food they helped cook is much higher. Of course, you'll need to give age-appropriate cooking duties that match the child's ability and safety. A 2-year-old can certainly stir a bowl of eggs with your supervision. At my house, my husband and toddler took time together to grow a garden of different kinds of foods. Sierra takes pride in harvesting the vegetables, and now she is a lover of tomatoes -- and I am not sure she would have been had she not been so invested in growing and watering the plants.
So, in summary, moms and dads: Model healthy eating, expose your child to all kinds of foods, don't give up too early if they seem not to like a certain food and involve them in the cooking process as much as possible. Happy eating!