Behavior

Picky Eater

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Picky Eater, Picky Eating

  • See Also
  1. Avoidant-Restrictive Food Intake Disorder
  • Epidemiology
  1. Incidence: Up to 50% of those under 2 years
  • Physiology
  1. Childhood eating behaviors are impacted by many factors
    1. Food choices (or lack thereof)
    2. Sensory impact (texture, taste, color)
    3. Parental response to a child's eating behaviors
  2. Aversion to trying new foods is part of normal development
    1. One of many signs that child is exercising their autonomy
  3. Significantly restricted diet (limited to a few foods) may however result in adverse effects
    1. High Carbohydrate, highly sweetened foods may replace a more nutritionally adequate diet
    2. Galloway (2003) J Am Diet Assoc 103(6): 692-8 [PubMed]
  • Risk Factors
  1. Autism Spectrum Disorders
  • Differential Diagnosis
  1. Avoidant-Restrictive Food Intake Disorder (previously Feeding Disorder of Infancy and Childhood)
  • Management
  1. Review growth charts to confirm no Growth Delay
    1. Typically the normal growth charts are reassuring to parents
    2. Supplements and Vitamins are not needed and risk Overdose
    3. Expect fluctuating eating behaviors throughout childhood
  2. Children are wary of new foods
    1. Promote calm and positive mealtime experiences
    2. Offer reassurance
      1. Picky Eating is very common in toddlers (up to 50%)
      2. Typically transient and resolves spontaneously
    3. May take exposure to a food up to 10-15 times before they accept it
    4. Avoid punishment or reward as this may exacerbate the problem
      1. Birch (2001) Pediatr Clin North Am 48(4): 893-907 [PubMed]
    5. Offer a wide variety of healthy foods at each meal
      1. Child decides which foods and how much to eat
      2. Those items not eaten may be re-served as leftovers
    6. Older siblings who eat a broader variety of foods may be a good influence (modeling)
    7. Combine foods in fun ways
    8. Limit milk to 24 ounces daily in toddlers
    9. Limit juice to 6 ounces per day
  • References
  1. Bryce (2025) Am Fam Physician 111(1): 31-6 [PubMed]
  2. Cathey (2004) Pediatr Nurs 30(2): 101-7 [PubMed]
  3. Nasir (2015) Am Fam Physician 92(4): 274-8 [PubMed]