Behind Their Bite: When is Picky Eating Something More? - Promise
Behind Their Bite: When is “Picky Eating” Something More?, Powered by Nemours Children's Health System

Behind Their Bite: When is Picky Eating Something More?

Everyone knows one, has one or was one – a picky eater.

The logic behind why a child does or does not eat something is difficult to understand. Sometimes picky eating is as simple as a food being too bitter or too bland. Other times, it can be more complex.

I like to remind parents that it can take anywhere from 10-15 tries before a taste becomes likable or even familiar. Coffee is a great example. The first time you tried it, I bet it wasn’t your favorite food. But over time — and early wake ups, dance recitals, baseball practice, carpool, swim lessons and potty training — it probably holds a pretty significant place in your heart (and your sanity).

Introducing new foods to picky eaters

  1. Introduce a new food with old foods and favorite foods (example: mac and cheese with broccoli)
  2. Consider “taste-ability.” Crunchy, sweet, good-looking foods will be preferred over soggy, bitter, ugly ones. So asparagus may not be high on the first try list…
  3. Plate a small portion. Don’t force your child to try it, just let it hang on the plate the first few times.
  4. When you feel ready, encourage your child to touch, lick or nibble the food. Try this a few times.
  5. Next, have your child plate their own food without saying anything and see what they do. Slowly, the food won’t be as new and they will be more inclined to try it on their own.

Expanding the diet of a picky eater can be a lengthy process, and there is always the chance that your kid just won’t like broccoli, but these are some great tips to help get that diet growing. And coming from a reformed picky eater, it really does work.

When is picky eating something else?

There are times, however, when picky eating is more than just a simple dislike of taste and/or texture. If your child is showing signs of picky eating alongside a series of additional, possibly non-food related symptoms, there may be more going on. Symptoms would include:

  • hypersensitivity to textures, like tags in clothing
  • delays in daily activities such as dressing, brushing teeth, sitting and standing
  • slow developmental skills in the classroom and with crafts
  • delayed or slurred speech
  • excessive drooling while eating
  • coughing while swallowing
  • difficulty chewing and swallowing

Ideally it is best to work with a team of health care professionals, who can help you assess if your child’s aversion to certain foods is more than picky eating. A team would consist of a pediatrician, a psychologist, a speech and language pathologist, an occupational therapist, a registered dietitian and, of course, the parents. In the perfect situation, the team would do the following:

Sample case: James, age 2, starts to gag each time he tastes, or even sees, certain table foods. He will try refusing, but if mom can get him to eat it, he will either spit it out or vomit it back up.  

  • Family notices the intensity of James’ reactions and symptoms. They addresses their concerns with their pediatrician.
  • Their doctor will make a plan with the family. They will work together to determine if it is behavioral or physiological in nature. They may do preliminary allergy testing.
  • A psychologist, if required, will consult with the doctor to see if there is any pattern of disordered eating or need for therapy services.
  • A registered dietitian will help assess which foods cause this reaction. If there is an allergy or behavioral food aversion, they can work with the family to help maintain adequate nutrition and growth for James by working to integrate different foods into James’ diet and help to find an alternative nutrient and/or food sources to maintain a healthy lifestyle.
  • A speech and language pathologist will assess his ability to swallow, chew, and move the food through his mouth and esophagus to make sure there are no issues or safety concerns with feeding and swallowing.
  • An occupational therapist, in this particular situation, will assess any physical barriers James may have that would be inhibiting his ability to move food from the plate to his mouth.

Realistically parents do not always have access to this kind of multidisciplinary team. Remember it that it takes roughly 10-15 tries before a child acclimates to a new food. If your parent’s intuition leads you to believe something else is getting in the way, talk to your pediatrician first. And remember, sometimes people just don’t like certain flavors or textures — and maybe that is what’s behind their bite.

Learn More

How to Deal with a Picky Eater (KidsHealth.org)

Lauren Cohen, MS, RD, LDN

About Lauren Cohen, MS, RD, LDN

Lauren Cohen, MS, RD, LDN is a registered dietitian at Nemours/Alfred I. duPont Hospital for Children, in Wilmington, Del.