Raising a Healthy Eater: Expert Advice and Tools for Parents Dealing with Picky Eating

A common experience parents may face in the early years is their child becoming a picky eater.

While there is no universal definition for picky eaters, Leanne Elliston, Accredited Practising Dietitian at Nutrition Australia ACT , suggests that the term refers to someone who exhibits restrictive or selective behaviour around certain foods.

She also explains neophobia, which is a fear and refusal of unfamiliar or new foods.

Picky eating  increases significantly from 18 months to almost five years old and, in comforting news to all parents, nearly half of children were picky eaters at some point during early childhood.

What causes picky eating?

It turns out there are a number of reasons kids become picky eaters, from a child’s personality, to parental control at the dinner table (the more parental pressure to eat, the more likely picky eating would get worse), to social influences.

Other causes could be early feeding difficulties, late introduction of lumpy foods at weaning and early choosiness.

In good news, making fresh food available, eating the same meal as the child, and parents modelling health eating , all could prevent pickiness later on.

The consequences of long-term picking eating

Elliston stresses that parents shouldn’t worry about their child’s day-to-day diet.

“A child’s appetite will be influenced by growth spurts, how active they are on a particular day or whether they are feeling unwell,” she says.

For parents with picky eaters avoiding entire food groups for weeks, Elliston recommends monitoring their height and not just their weight.

“Weight can fluctuate day-to-day, however, growth in terms of their height should be monitored and plotted against their growth chart,” she explains.

The World Health Organisation (WHO) have height-for-age charts for both boys and girls.

“If a child’s growth falters, or even plateaus, that is the biggest physical indicator that their nutrition isn’t allowing them to thrive and grow,” Elliston adds.

Other symptoms can include persistent tiredness, always grumpy and regularly contracting viruses and colds.

“For iron deficiency, one of the most common deficiencies, children can present as pale, have an affected immune system, be lethargic and their picky eating habits can get worse,” Elliston says. 

The Mayo Clinic adds the following symptoms of iron deficiencies:

• Cold hands and feet
• Slowed growth and development
• Poor appetite
• Abnormally rapid breathing
• Behavioural problems
• Unusual cravings for non-nutritive substances, such as ice, dirt, paint or starch

Parents can include the following iron-rich foods in their child’s diet to help increase their iron intake: red meat, fish like salmon and sardines, poultry, legumes, tofu, leafy green vegetables and nuts and seeds.

She cautions parents against using an iron supplement without first seeking medical advice as having excess iron can have adverse effects.

Calcium is another deficiency to be mindful of.

“If children avoid dairy, either due to allergies, tolerance or vegan lifestyles, parents need to be conscious of their calcium levels, particularly in those early years as it can significantly reduce their bone quality,” Elliston describes.

Parents can include the following iron-rich foods in their child’s diet to help increase their iron intake: dairy products, leafy green vegetables, fortified foods, calcium fortified beverages, legumes and nuts and seeds.

While most parents might reach for a multi-vitamin, Elliston cautions against it.

“Multivitamins are a band aid solution and shouldn’t be permanent,” she says.

“Always aim for a varied diet that meets a child’s recommended nutritional intake.”

ARFID and when parents need to seek support

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder which usually starts at a much younger age than other eating disorders and is more common in boys.

Many children with ARFID are underweight and their condition can lead to problems from poor nutrition, such as, dizziness and fainting, slow pulse, dehydration and weakened bones and muscles.

If parents are concerned their child may have ARFID, they should speak to their GP for an assessment.

Early childhood services can support parents

In early childhood services that provide food for children, their menu is required to meet nutritional standards. They also often display the daily menu, as well as, record how much each child ate.

“Often children may eat better at childcare compared to home,” Elliston says.

“Childcare provides an opportunity for children to be exposed to a range of foods and nutrients that might not be offered in the home environment.”

Children may be less picky with their food when in a childcare environment due to a range of factors: social interaction with peers encourages trying new foods, peer influence positively impacts eating behaviours, routine and structure in childcare settings promote better eating habits, exposure to different foods at childcare broadens a child’s palate, and, positive role modelling by childcare providers can influence picky eaters to eat better.

If parents have any concerns regarding their child’s eating habits while in care, open communication between parents and educators is essential. Through discussion, parents are able to gain a better understanding of their child’s experiences with food at childcare and work together with educators to support healthy eating habits.  

Where to find support

For concerned parents, Elliston recommends a meeting with their family health practitioner.

A GP can assess the child and, if they are concerned, provide a care plan which will include up to five Medicare subsidised visits with an Accredited Practising Dietitian.

“Publicly funded dietitians are available through the local community health system, and parents can also search for privately funded dietitians through Dietitians Australia ,” she adds.

“Every case is individual and there could be underlying factors, like allergies and intolerances or gastrointestinal disturbances, feeding into a child’s picky eating behaviours, so it’s always best to seek medical advice if parents are concerned.”