When Your Child Won’t Eat

By Amy L. Zuraski, MOT, OTR/L

“Help! My child won’t eat ANYTHING!” is a statement

that, unfortunately, is commonly heard in parent circles and pediatric offices alike. Recent studies indicate that 18-50% of typically developing children will present with feeding difficulties at some point during development. While most of us adults can eat mindlessly and without thought to the process, eating is one of the most challenging sensory motor tasks in which a young child will engage. Feeding difficulties can be rooted in several different causes, but if you find yourself with a picky eater, try these strategies:

Provide structured meals and snacks: It is tempting with picky eaters to allow them to graze on snacks and beverages throughout the day, especially if you are concerned with weight gain or growth. Unfortunately, snacking can actually have the opposite effect. Children can fill up very quickly and “take the edge off” hunger, ultimately leading to overall decreased intake. Try presenting three designated meals plus 1-2 snacks per day.

Eat together as a family: As much as possible, try to eat meals together at the table with your child. Ideally, meals should be conducted in an environment free from distractions such as television and tablets. Use this time to model appropriate meal time behaviors and to engage in conversation with your child.

Play with food: While this may not be considered proper table etiquette for adults, children learn by interacting with their environment, and this includes food! Allow your child to engage in messy play with new and novel foods (i.e. finger paint with yogurt, build a face with vegetables, etc.). Repeated and playful exposure to the feeling and smell of foods will increase the likelihood that your child will be willing to taste something new. Engage your child in the process: Take your child to the grocery store and allow him or her to select a food to try. Make grocery shopping a game (i.e. “Can you find a vegetable that is purple? Can you find a fruit that is round?”). Encourage your child to interact with foods by assisting with simple meal preparation as developmentally appropriated or by serving foods to family members. Children are more interested in trying a new food if they have some ownership in the process.

Make small changes with food: Children generally like familiarity and routine, so use this principle with food as well! Make small changes with the foods your child is already comfortable eating. For instance, if your child eats Honey Nut Cheerios, try a different flavor such as Apple Cinnamon Cheerios. Present a favorite condiment like peanut butter with a new “dipper” such as apple slices, pretzels or graham cracker sticks. If your child likes French fries, offer sweet potato fries or tater tots.

Reframe the way you talk about food: Avoid labeling foods as “good foods” or “bad foods,” as all foods provide some type of nutrient to our bodies. When presenting a new food, talk about the characteristics of the food such as the color, shape or texture. Try to link these characteristics to foods your child currently likes (i.e. “Look! This raspberry is red just like the strawberries you eat!”). Avoid telling your child that he or she will not like a food. Restructure your language to remind your child that he or she is still learning about that new food. Praise any interaction with a new or nonpreferred food such as touching, smelling or licking.

While frustrating, some amount of picky eating is expected during development, especially during the toddler years as children begin to develop autonomy and personal preferences. Picky eating becomes more concerning and may warrant the need for intervention if your child is avoiding an entire food group or food texture, losing or not gaining weight as expected for his or her age, gagging or choking on foods or drinks, eating less than 20 foods, or consistently eliminating and not re-introducing foods he or she once ate. Fortunately, there are trained specialists such as occupational therapists, speech therapists, and dieticians who can help your picky eater. A feeding specialist can thoroughly evaluate your child’s skills to determine the underlying cause or causes of picky eating. Talk with your pediatrician regarding appropriate services to address your feeding concerns.

*AHN Pediatrics now provides Occupational Therapy services two days a week in our Greentree offices. If your child is in need of these services, talk to your pediatrician. **Amy L. Zuraski, MOT, OTR/L is an occupational therapist and the Regional Manager of Pediatric Therapy Services for Allegheny Health Network.