The previous article in our series on picky eaters discussed why kids eat the way they do. Now it’s time to step back and consider how the way we feed children impacts their eating habits and food preferences over time.

One quick caveat. This article is not to meant to add to the already overwhelming guilt parents face when it comes to feeding their kids. Instead, the goal of this post is to help parents understand why certain feeding strategies fail and others flourish. When you understand the why behind feeding, it’s easier to make a change.

So with that in mind, let’s review the 10 common mistakes parents make when feeding picky eaters:

1. Catering to kids: Board Certified pediatric dietitian Angela Lemond, RD who blogs over at Mommy Dietitian, said the common feeding mistake she sees in her practice is short-order cooking. These are parents who make another meal when their kids say they don’t like what’s being served.

“Parents are so concerned kids won’t get the nutrition they need that they operate out of fear,” she says. “They don’t realize that letting their kids decide what to eat exacerbates the issue.”

In Child of Mine, Ellyn Satter’s explains it clearly: Making an alternative food so readily available tells your child louder than words can say, “I don’t expect you to learn to eat your meals.” Remember that your child wants to grow up with respect to eating, but she will take the easy way out if it is offered.

2. Not considering children’s food preferences: In our last article we talked about how truly scared kids can be when it comes to trying new foods. So while you don’t want kids to dictate the menu, you also want them to look down at their plate and see something that is familiar.

Christina over at Spoonfed blog said it perfectly in one of her comments: I’m not a fan of “eat-this-or-eat-nothing. So by offering the new items in addition to items you know the kids like (as part of the family meal, not by special order), you avoid that ultimatum while still exposing them to new foods.

3. Asking kids what they want: Does this sound familiar?
Parent: Do you want a turkey sandwich for lunch?
Child: No
Parent: Do you want a quesadilla?
Child: No
Parent: What do you want?
child: The same Chicken sandwich we have at grandmas.
Parent: We don’t have time for that. What do you want???

Young kids exert their independence whenever they can which may be why they tend to reply “no” to food offerings when asked. It’s much better for parents to decide what’s for lunch. Giving picky eaters the choice between two items works well.

4. Feeding on demand:Feeding babies on demand makes sense but it doesn’t work for older children. First off, toddlers don’t always know how to communicate hunger until a meltdown implodes and older kids can use pretend hunger to get what they want (my daughter is always conveniently hungry when we go to Vons where they have free cookies). This type of feeding can also lead to grazing and poor behavior at mealtime.

Jennifer from The Mommy Archives implemented planned meals and snacks with great results: One of my biggest issues with my little guy is that he would literally get up from the kitchen table and exclaim ‘I’m still hungry, can I have a snack?’ The first time I explained to him that I had a snack planned for him later he said ‘OK’ and walked out of the kitchen. It was literally that easy. Planning the snacks has set his expectation that next meal would indeed come and that he couldn’t just snack when he wants to.

5. Over praising healthy eating: If you’ve been following the parenting literature, you’ve probably heard that over-praising kids can have negative effects on their motivation.

An article in Parenting Science does an excellent job of summarizing the research in this area. In the article, Gwen Dewar, PhD, makes this interesting point about praising kids for doing what they love to do anyway.

…suppose that Adam loves to eat broccoli. But every time he eats broccoli, his mom praises him for it. Consciously or unconsciously, Adam starts to question his motivation. Is he eating broccoli only for the praise? Adam changes his attitude toward broccoli-eating. It’s a chore, not a pleasure. If the praise ends, Adam loses interest in eating broccoli.

6. Pushing veggies: When I asked Jennifer Orlet Fisher, PhD, Associate Professor in the Department of Public Health at Temple University, the one thing she wants parents to know about feeding, she said: “The goal should not be to get kids to eat vegetables, it should be to make sure they like them.”

As she discussed in the last article, vegetables are not naturally preferred by kids and take time to be accepted. Instead of pushing the veggies, parents can focus on making them attractive and available to kids.

After all, studies show pressuring kids to eat healthy foods decreases their preference for such items. And which salesman are you more likely to buy from? The one who is in your face, pushing his product or one that sits back with an attractive looking product enjoying it himself?

7. Using food as a reward: A while ago I was reading a blog where the writer admitted to making her kids eat more food, like veggies, in order to get dessert. She said she knew “the experts” say not do this but she does it because it works. Her kids eat their vegetables and that makes her happy.

The question this mom needs to ask herself is will her kids eat vegetables when she is not around? Will they grow up liking vegetables or viewing them as obligation foods, like so many Americans do? 

Research shows that this feeding strategy not only decreases kids’ preferences for the food they are made to eat (usually healthy fare) but it increases their fondness for the “reward” food.

8. Keeping children on separate meals too long: When I recently told a room full of parents that by one year of age babies can eat meals with the family most of the parents looked at me like I had two heads. I told them that the kitchen table is where children learn to eat and the sooner kids can get there the better.

One of the moms from the class sent me an email after making the switch: My daughter is 13 months old and I was shocked to hear she should be eating with us, since she was still eating completely separate meals, very bland, usually pureed. I thought about what you told us and one night figured “what the heck” and gave her a chopped version of our adult food- she ate every single bite and loved it! Now we eat the same food every night, from curry to talapia to tacos.

9. Serving food naked: A reader wrote to me about making meals for her, her husband and her toddler: I need to realize though that a two year old probably will not be interested in plain, broiled fish fillets with steamed, unadorned broccoli.

You may like your food cooked with little fat and sauces, but your child probably doesn’t. Remember, kids prefer energy-rich food so adding dips and sauces (even butter) can aid their acceptance of such foods. We’ll save specific strategies for our next post.

10. Labeling kids as “picky eaters:” The other day the grocery store and I saw a young girl pick up raspberries asking her mom to buy them.

“Why do you want these? You NEVER eat raspberries when I buy them,” the mom replied in a stern tone.

What the mom didn’t understand was that this is how children learn to like different foods. They see it several times, they show interest, they don’t eat if for a while, they try a bite, they don’t eat it for a while, they try it again and so on. She was telling her daughter she didn’t like raspberries but that wasn’t true. Her daughter was going through the process of learning, the same way kids learn to do other things like read and write.

Lemond recently relished watching her picky-eating son take the last step in learning to like a food. Her daughter was eating carrots with dip and her son dug right in. “The process works but it takes time and patience,” she said.

This is why I like the Ellyn Satter Division of Responsibility so much. It keeps things simple — parents decide the what, when and where of feeding and kids decide the whether and how much of eating. Feeding problems typically occur when parents try to take over the kids job or children are allowed to take over the parents’ job.

Don’t miss our next — and final — post in our picky eating series where we’ll go beyond the Division of Responsibility and discuss specific, proven ways parents can help their kids grow into good eaters.

Previous: 8 Things Picky Eaters Wish Their Parents Knew

References/Resources:

Tanofsky-Kraff M, Haynos AF, Kottler LA, Yanovski SZ, Yanovski JA. Laboratory-based studies of eating among children and adolescents. Curr Nutr Food Sci. 2007;3(1):55-74

Picky Eaters — Ellyn Satter, MS, RD

Expert Profile: Diane Keddy, MS, RD, FAED is a Nutrition Therapist and a Fellow of the Academy for Eating Disorders. She has treated men, women and children with eating disorders, including selective eating, for the past 25 years. Currently she is in private practice in Newport Beach, CA.

If all children accepted the food parents gave them, feeding kids would be easy. In fact, this is usually what happens the first 18 months to 2 years of a child’s life.

But then one day the same child who ate almost everything starts to say “no” and reject foods. In the eyes of a child, new foods can be scary and intimidating. And parents are left unsure what to do, afraid their little one will become deficient in key nutrients.

Welcome to Raise Healthy Eaters’ picky eating series. Here we’ll talk about why kids eat the way they do and what parents can do about it. I believe what happens during this lengthy stage of development can have a big impact on a child’s future eating.

But before we get into what is normal for most kids in terms of food choice and eating habits, it’s vital to discuss what isn’t normal. There are times when kids may require professional help if they are to become normal eaters.

Selective eating
Selective eating is picky eating that persists into middle childhood and beyond with an extreme reluctance to try new foods. Unlike eating disorders, there are no body shape issues and weight of the child can vary, with many children being underweight.

“Most pediatricians are missing it,” says Diane Keddy, MS, RD , FAED, a nutrition therapist who has worked with selective eaters for 10 years. “The longer parents wait to get help, the harder it is to treat.”

Now this doesn’t mean that any 10-year old picky eater has selective eating. Keddy says these kids only accept a very narrow range of (usually white) food. The typical list includes pasta, macaroni and cheese and gold fish and some will drink milk.

Selective eaters tend to only eat their accepted foods at home even if someone else is making it the exact same way. When they try a new food it’s common for them to choke, gag or even vomit which leads to their anxiety about eating. Keddy explains that this is neurological because the part of their brain that recognizes food as pleasure is underdeveloped.

Typically by age 6 kids really start expanding their palate but with selective eating this doesn’t happen, making social activities anxiety-ridden for the child. They often fall off the growth charts and can experience slow bone growth if left untreated.

Who gets it?
“Children with a family history of autism, eating disorders, OCD and severe picky eating are at greater risk for developing selective eating,” says Keddy. “With autism spectrum disorders (ASD) on the rise, selective eating is becoming more common.”

A recent study published in the Journal of Pediatrics, showed that while both ASD and non ASD children had picky eating, the ASD group refused more foods and had a smaller repertoire of foods they would eat. As a result, these children had insufficient intakes of vitamins A, C, D, zinc and calcium.

This doesn’t mean non ASD children can’t become selective eaters, but it appears to be more common in children with ASD.

The treatment
Keddy says that the treatment for selective eating is very different than what she recommends for normal picky-eating kids. The division of responsibility of feeding does not work with selective eaters. She utilizes a treatment called “systematic desensitization.”

Children are first put on medication to treat their anxiety. Once their anxiety is reduced and they are better able to relax, she works with them on trying different foods. For each new food they try, the parents give them some kind of non-food reward.

She describes it as a negotiation, where kids are allowed so many “pass” foods. She says the treatment takes a lot of energy and commitment from parents, but it’s worth it. Based on her own experience, she estimates that about 80% of selective eaters eventually become normal eaters.

What worried parents should do
“Parents know their kids best,” Keddy says. “If they sense something is wrong, they should seek professional help.”

Keddy says to start with the pediatrician and if they can’t refer you to anyone, find a dietitian that works with eating disorders. She says that even if the pediatrician says your child’s eating behavior is not worrisome, it’s worth it to get them evaluated. “It can’t hurt,” she adds.

The sooner kids get treated for selective eating, the better off they’ll be. Keddy says the average age she sees kids are 10. But children often display signs at much younger ages, typically starting around ages 3 to 4.

And if left untreated, kids who are selective eaters will grow into adults who can only eat a short list of foods. This not only negatively impacts health but hampers social activities where food is often the central part of gatherings.

So when in doubt, get your child evaluated. If this isn’t an issue for you, stay tuned for our next post in this series about the kind of little eater you have at home (and why it matters!).

Next: How to Pinpoint Your Child’s Eating Personality (and Why it Helps)

References

Bandini LG, Anderson SE, Curtin C, Cermak S, Evans EW, Scampini R, Maslin M, Must A. Food Selectivity in Children with Autism Spectrum Disorders and Typically Developing Children. J Pediatr. 2010 Mar 31.

Every mom is looking for kid-friendly meals to help improve their children’s eating habits.  Yet in last week’s expert interview, Ellyn Satter emphasized the importance of families eating together over what to feed.  That’s because family dinners are the place where children learn to eat.

I’ve incorporated family dinners at my house for over a year now.  Before that I would feed my daughter, put her to bed and then prepare dinner for me and my husband.  I’m exhausted just reading that last sentence.

So here are some tricks I’ve learned for making children – and parents –happy at the dinner table:

Don’t make it about them:  Focusing all the attention on children during meals teaches them to be self-centered about eating.  The goal is for kids to learn how to be a part of family meals.  That means no catering and no special meals.  They are expected to come to the table and decide for themselves how much to eat.

That doesn’t mean you don’t consider their likes, dislikes and ability to chew when deciding what to serve.  My daughter doesn’t eat much at dinnertime but there are a handful of meals I know show likes or is likely to eat (nothing is guaranteed).  So I make sure to include her favorite entrees about 2-3 times a week.  The other meals are items either my husband or I like and we eat out once a week. This way, everyone is a winner.

Make sure there’s something they’ll eat:  When I serve a new meal or something my daughter hasn’t eaten in the past, I make sure there are two things at the table that she likes.  Below is a before and after picture of a typical meal at our house.  I made lamb and lentil stew and served it with carrots (likes), bread (likes) and salad.  I make sure that the items she likes are not “special” items on her plate – they are for the whole family.   

As you can see, she ate most of the carrots, some of the bread and moved the stew around with her spoon.  I see that as progress…at least her utensils are touching the stew!

Serve dinner family style:  As children get a bit older, try letting them serve themselves.  This can really empower children and you might be surprised how much more willing they are to try new foods.  The first time my daughter tried asparagus was when I placed it on a serving dish instead of her plate.  There was such pride on her face when she grabbed it herself. 

Below is an example of a casual family style dinner I served – Rotisserie chicken (likes), strawberries (likes) and butternut squash.  I even made a meal for my littlest one from the butternut squash.  He’s coming to the dinner table early.

Learn from – and accept – dinner failures: I absolutely hate when I go to all the trouble of preparing a new meal only to find it tastes bland.  But I’m learning from those failures and realizing they are a natural part of figuring out what dinners work best for my family. 

The meals that taste good and are nutritious and easy to prepare go straight into my recipe book.  The ones that are complicated and don’t satisfy get thrown out.  Sometimes there’s a complicated meal that tastes great which makes it worth the effort, so it stays.

Because my children are young, I consider my meal-making practice for when they get a little older.  By then, I should have it mastered.  Am I fooling myself?

What are your experiences with family dinners?

Like what you see? Subscribe to Raise Healthy Eaters to be alerted of new posts.

Welcome to Raise Healthy Eater’s first expert interview. Ellyn Satter, MS, RD, LCSW is an internationally recognized authority on eating and feeding. Satter integrates her 40 years of experience in helping adults be more positive, organized and nurturing in caring for themselves and their children. She is also the author of several books including Child of Mine: Feeding with Love and Good Sense and Your Child’s Weight: Helping without Harming.

“Not knowing how important they [parents] are,” Ellyn Satter says after being asked what she believes is biggest feeding mistake parents make. “Children have a drive to grow up to be just like their parents.”

But she doesn’t push parents to eat or prepare ultra healthy meals. Instead, she emphasizes family dinners as the holy grail of raising good eaters. “There’s too much guilt and anxiety with the virtue of meals” she says. “Parents get caught up in the what of feeding when they really need to pay attention to the how.”

Satter asks busy parents to make only one change at first: eat together as a family. So whether they’re eating fast food or frozen meals, all they need to do initially is gather at the table. On her website she has a step-by-step guide for mastering family meals. And she makes the focus pleasure, not nutrition.

So her first piece of advice: start with the foods your family enjoys and build on from there. This doesn’t mean pleasure and nutrition can’t coexist, they definitely can. But Satter points out that if the meals you prepare aren’t rewarding, they won’t seem worth the effort.

This is the perfect segue into my next question: “How can moms get their kids to eat vegetables?”

In addition to being an internationally recognized feeding expert, Satter is also a mom of three (now grown) kids. When her daughter was little she wouldn’t touch a vegetable but Satter took it in stride. When she brought the topic up with other moms she found them in hysterics about their non-vegetable-eating kids.

“Don’t let vegetables be the deal breaker,” Satter says, leading to her second piece of advice for families. “Once family meals become a habit, naturally find ways to add more variety to meals, including vegetables.”

Satter says the best way to get kids to eat vegetables, or any food for that matter, is for parents to eat it and enjoy it themselves. Of course she talks about the division of responsibility – parents decide the what, when and where of feeding and children decide the whether and how much of eating. She also explains the importance of “neutral,” repeated food exposure. The bottom line: kids do best when exposed to a variety of foods with absolutely no pressure to eat.

When Satter’s daughter hit early adolescence she took up a new hobby: devouring vegetables. She noticed everyone else in her family enjoying them and realized she was missing out. She is an avid-vegetable eater today not because her parents tricked her into eating greens, but because she got to the point where she wanted to eat them.

The next question for Satter is about sweet foods: how often should parents serve dessert? She says frequency isn’t as important as how it is served. Too often, she explains, dessert is the unspoken reward that kids’ can fixate on at mealtime.

To solve this age-old dessert problem, Satter advises parents to serve a single serving of dessert with the meal. “Some kids will save it, others will eat it first and some will eat it right along with the other food,” she says. She points out that this is the one time she deviates from the division of responsibility because she advises parents to only allow their kids a single serving of dessert.

“To avoid scarcity with sweet foods,” she adds, “Make sure there’s another time (snack time for example) when they can eat all they want of the item.”

Who eats dessert with dinner? Isn’t that crazy? Not really. What this feeding strategy shows children is that sweet foods, already palatable and easy to like, are not such a big deal. They are just part of the meal like the vegetables and meat.

If you think about the nature of nutrition and behavior you can see how her approach makes perfect sense. We live in a culture where the “shoulds” of eating are all around us. Eat more fruits and vegetables. Watch the fat. And make sure you skip the tasty dessert at after dinner.

Yet despite all of this scolding, recent studies show only about 3 percent of Americans lead a healthy lifestyle. Let’s face it, it’s human nature to rebel against what you should be doing (kind of like cleaning out the sock drawer). If parents can learn to feed in a positive way, their children will grow into adults who eat nutritious foods not because they feel obligated, but because they enjoy eating them.

“The data is clear – pressure children to eat, and they’ll lose interest in food; restrict their access to palatable foods and they’ll become preoccupied with them,” Satter explains. “Just provide a variety of foods with structure, eat with your kids and trust that they know exactly how much to eat.”

Watch for part two of my interview with Ellyn Satter, where she explains the surprising benefits of raising a competent eater.

Subscribe to Raise Healthy Eaters to get alerted of future expert interviews.

I spoke with a woman recently who told me that she was a skinny, picky-eating kid. Food was always an issue at her home and her concerned parent constantly brought her to the doctor (who had her take a slew of vitamins). Now, many years later, she’s battling her weight right along with her siblings.

Lately I’ve been talking to a lot of moms about picky eating. While some toddlers are more prone to being finicky, most children will go through this stage to some degree. It’s a very normal part of development. Luckily, there’s a book to help moms deal with this challenging stage of development.

Child of Mine: Feeding with Love and Good Sense is the last of the Ellyn Satter books I plan to review. And it happens to be my favorite. Satter explains each stage of development as it relates to eating starting at infancy and moving through the preschool age. Unfortunately she stops at age five so moms of older children miss out.

In addition to being a dietitian, Satter is a Licensed Clinical Social Worker (LCSW). Her real-life accounts of families struggling with a variety of eating problems help the reader immensely. While most of her advice comes down to the Division of Responsibility of feeding (parents decide the what, when and where of feeding and children decide the how much of eating), understanding the big picture of childhood eating will certainly enlighten any mom.

This book taught me that how I feed my kids is as important as what I feed them. While following her advice has not been easy, I’ve already seen it pay off. I have to admit there have been times when I’ve wanted to tell my daughter “come here and finish your dinner missy!” But if I did that enough, she’d learn to eat for the wrong reasons.

The downside to Child of Mine is that some of the nutrition information isn’t up-to-date because it was published in 2000. But the advice on how to feed is right on.

Have any picky-eating stories to share? We want to hear from you!

Subscribe to Raise Healthy Eaters (or tell a friend) for more product and book reviews.

Dealing with a picky eater can be challenging for parents. Instead of getting lured into a no-win power struggle, here are seven effective ways to help your fussy eater become less fussy.

1. Change your mindset: Does your picky eater drive you completely insane at mealtime? Try not to dwell on the frustration of it all. Instead, think of it as a normal part of their development (which it is!). Young children learn to like a variety of foods the same way they learn how to dress themselves, tie their shoes and read and write – in due time.

2. Focus on the family: Instead of focusing all of your meal-planning efforts around your fussy eater (it will only frustrate and exhaust you!), prepare and plan meals with the whole family in mind. If you haven’t invited your little one to join the family table for meals, then do so. This is where they learn the most – by watching their family eat.

3. Provide consistent meals & snacks: It’s tempting to give picky eaters the foods they want, when they want them, but this can lead to all-day grazing. Studies show kids who eat planned meals and snacks have more nutritious diets then those who eat fewer meals. When you provide your child with 3 regular meals and 2-3 snacks, without food in between, they have more opportunities to eat and be exposed to different foods. Make sure to include their favorites along with other nutritious items they may not like so much.

4. Check liquid calories: Kids have the uncanny ability to self-regulate food intake which means they can fill up on any calorie-containing item including drinks. So watch how much juice and milk they are consuming to make sure these beverages aren’t displacing other nutritious foods in their diet. Keep juice to 4-6 ounces per day for 1-6 year olds and 8-12 ounces for older kids. Kids over 2 only need 2 cups of milk per day and when they turn 8 it goes up to 3 cups.

5. Don’t leave it all for dinner: Many parents wait for dinner to try new foods or serve certain items like vegetables. But kids are least likely to eat at dinner because hunger tends to wane as the day progresses. So serve veggies and other new foods earlier in the day when you child is likely to be more receptive.

6. Don’t say a word: Believe it or not, you are not responsible for what your child eats. Your only responsibility is to provide balanced meals and snacks. Leading childhood nutrition expert Ellyn Satter, MS, RD, LCSW encourages parents to employ a Division of Responsibility – parents decide the “what” and “when” and “where” of feeding and children decide “how much” and “whether” to eat. So resist the urge to say anything to your child about how much or what they are eating – leave them to do their job.

7. Include little ones in meal planning: Ask for older kids input when planning weekly meals, make little ones helpers in the kitchen and ask for help when picking out produce. Even though you are in charge when it comes to meal planning, making children part of the process will help pique their interest.

There are no secrets or tricks to get a picky eater to eat a variety of foods. They simply need time, no pressure and repeated exposure to nutritious foods. As a parent you are their teacher. And the best way to teach is to show.

Subscribe to Raise Healthy Eaters to get more childhood feeding tips.