When it comes to preventing picky eating and what causes it, there are many opinions and no definitive answers. However, there is a large body of research examining risk factors for selective eating in childhood.
Note: Where the research is lacking, we offer guidance and understanding on this multi-faceted topic from 40+ years of combined experience as feeding therapists working directly with picky eaters and their families, as well as working with infants transitioning to solids who did not develop picky eating. This guidance combines information and strategies gleaned from clinical practice, literature, research, and practical experience to discuss some common, preventable causes of picky eating and what parents/caregivers can do with babies starting solids to prevent picky eating.
In our experience and based on the research, there are four primary causes of picky eating:
Certain child characteristics—including medical issues, neuro-developmental differences or disabilities, and temperaments put a child at higher risk
Anxious, controlling, and/or permissive parenting practices and styles
Negative mealtime experiences
Lack of exposure to textures, flavors, and chewing practice at key ages
Out of these four primary causes, three can be addressed to either prevent or improve picky eating. Some children will be picky eaters regardless, but many won’t if we take thoughtful steps when starting solids and feeding in toddlerhood.
Certain child characteristics that contribute to picky eating are among the causes of picky eating that parents have no control over. Even after employing the best strategies to prevent picky eating in the areas we can control, certain children with these traits will develop picky eating regardless.
Babies are born with unique temperaments and come into this world with their own personalities and sensitivity levels to experiences. One child will soothe easily, whereas another child needs a lot of support to calm down when upset. A child's temperament…
Describes how they approach and react to the world.
Influences a child’s behavior and the way they interact with others.
Is thought to be innate, with some kids more sensitive than others from the beginning.
Sensitivity
Research shows that picky eaters are more likely to have certain temperaments, which probably leads them to be picky—babies and kids who are fussier, more sensitive, and emotionally labile (i.e., lots of tantrums and meltdowns) are more likely to be picky eaters than mellow, go-with-the-flow kids.
Sensitive children are more prone to experiencing everyday life situations as stressful and scary, and operating in a fight/flight/freeze response throughout the day. Over time, these kids may be at higher risk of feeling that the world is overwhelming, which may be why research has identified that kids who have moderate to severe selective eating patterns are at higher risk of qualifying for a mental health diagnosis like ADHD, anxiety, or depression as they get older. Young children often cannot express their fears verbally; instead, they will express their fear through behavior, and parents/caregivers need to identify this behavior as a call for “help!”
Anxiety
Research also shows that picky children are more likely to have anxious temperaments. Anxiety can be incredibly powerful surrounding eating and mealtimes when the child has experienced something painful or negative at meals in the past. (See below for more on negative mealtime experiences.) A child’s anxiety surrounding mealtimes and eating might include:
Tasting something and not liking it
Fear that they will not feel good after eating
Fear of not being heard and being forced to eat or try something
Fear they won’t be able to chew the food well.
Example: A child may create a mental story that foods from a certain box from a certain store are “safe.” When a parent tries to introduce a similar food item from a different store, the child refuses—this stems from the fear of change, the fear that it’s different and potentially not safe.
Chronic stress and overwhelm in a child can be harmful to development; however, when these daily experiences are buffered by the presence of a loving caregiver, who supports the child and helps them cope and understand that these experiences are not harmful, each stressful experience becomes an opportunity to build resilience, flexibility, and capacity to cope.
Mealtimes for highly sensitive children, because they happen several times a day, become a small opportunity to practice self-regulation, cope with stress and upset, and build flexibility. Over time, sensitive children can learn that the world might be a bit intense or overwhelming at times, but they can handle it.
Sensitive children are often finely attuned to the environment and remarkably responsive to sensations, their bodies, and emotional cues. They can be empathetic, insightful, and wonderfully successful at tackling challenges with patience, consistency, and the right supports.
Keep in mind that certain medical needs, health conditions, and neuro-developmental differences inherent to a child can also significantly increase the risk of picky eating.
These include:
Sensory processing differences, including sensory modulation issues, sensory discrimination concerns, and sensory-based motor disorders
GI issues with pain and motility problems
Allergies
Cardiac or respiratory issues
Developmental delay (including oral motor delay)
Differences in muscle tone (hyper or hypotonicity)
Each of these conditions can:
Significantly impact a child’s comfort within their body and with eating,
Make self-feeding or learning to chew and swallow more challenging
Negatively impact hunger or satiety
Contribute to negative experiences at mealtime that quickly compound over time and reduce a child’s experience of joy when eating food
Even when an underlying issue is fixed or improved—such as GI motility issues, allergies, sensory processing disorders, or developmental delay—their effects may be seen in the child’s eating long after addressed, as the child relearns that food, eating, and digesting no longer hurts, or no longer feels challenging.
Kids who have consistently negative and uncomfortable experiences with food from infancy are more likely to develop picky eating, no matter what a parent does. In these situations, the parent may employ every strategy available to support great eating and positive relationships with food, yet the child’s overpowering internal experience can still lead to picky eating. However, remember that the parent’s effort and foundational work are vitally important and can enable a child to improve eating after a medical or developmental issue is addressed.
Certain parenting practices and styles tend to produce picky eaters more often than other parenting styles, even when the child has a low risk for picky eating based on their temperament or medical and neuro-developmental characteristics.
Some kids will be picky no matter what the parent does, and as noted above, certain medical or neuro-developmental issues will contribute to pickiness despite a parent’s best efforts. However, these child issues are rare.
Most healthy children can learn to eat a wide variety of foods when allowed to build a strong, positive foundation—meaning what we (as parents) do to support or hinder this development matters.
Additionally, sensitive children are especially impacted by parenting styles and choices at mealtimes, which can support or hinder food exploration. With sensitive kids, it’s important to acknowledge that parents likely won't cause the child’s picky eating—but more challenging child temperaments probably lead parents to make choices that reinforce and contribute to pickiness.
Here are common mistakes parents make that may cause or contribute to picky eating:
Limiting what you serve to an infant or child
Controlling how much your child eats
Not allowing the baby or child to feed themselves or explore food independently
Pressuring a child to eat more or less
Catering to a child’s flavor preferences at most meals
Insisting on keeping a child clean or avoiding mess
Allowing the child to dictate the foods you serve at most meals
High parent anxiety around meals and parenting styles that are either highly controlling or overly permissive also tend to contribute to feeding difficulties and picky eating. See below for more on how they impact eating, but the underlying theme within all these parenting types is control—either too much or too little control of feeding and mealtime.
A common confession we hear from parents is that they love their child so much, are terrified that something bad might happen to them, and they worry about all the inherent risks of learning to eat.
Parental worry about their child’s eating can include:
Worry the child isn’t eating enough
Anxious about eating the right things
Concern for choking
Concern for mess
Research shows parental worry can increase food fussiness and lower expectations of what the child might eat (“Oh, my child won’t like that!”). This anxiety limits what parents offer to the child, as well as what they will allow the child to do on their own. Ultimately, parental anxiety can cause parental control of the meal and limit exposure to the foods and chewing practice necessary to help the child learn to eat safely.
Parents who are concerned about their child eating enough may also fall into a cycle of pressuring their child to eat or trying to control the amount a child eats. This leads to mealtime battles and less meal enjoyment for the child. In this case, the child’s picky eating likely increased parental anxiety, but the subsequent parental control likely reinforces the picky eating behavior. While it’s challenging to let go of the worry about your child eating enough, eating the right type of nutrients, or liking certain types of foods, worrying about a child’s nutrition worsens eating behaviors and food refusals. Additionally, parents who approach their child’s eating with calm confidence end up with less fussy eaters over time.
The research on parenting styles and picky eating shows:
High levels of parental control led to worse eating in infants and children.
When parents attempt to control how much a child eats—through pressure, force-feeding, coaxing, or rewards for eating—children eat less and have more behavioral outbursts in relation to food and mealtimes.
When parents practice non-responsive feeding practices either with bottle feeding or spoon feeding—i.e., pushing a baby to finish a bottle even when they indicate they aren’t interested—picky eating is more likely after the transition to solids period.
Lack of trust in a child’s fullness response leads to more selective eating patterns.
Permissive parenting is the opposite of controlling parenting, with few guidelines and rules.
Permissive parents do not expect mature behavior from their children and focus more heavily on responsiveness and warmth.
With eating, permissive parents are more likely to give children exactly what they want, i.e., short-order cook.
Research shows that short-order cooking decreases the likelihood that a child will eat the family meal.
In contrast, research shows that fair, benevolent boundaries around mealtimes improve eating behaviors in children. Permissive parenting tends to be light on boundaries and rules.
Certain parental actions when feeding a child can inadvertently lead to and reinforce picky eating.
Serving separate meals and special foods for the child (rather than serving one family meal for everyone at the table) is linked to increased picky eating.
Replacing uneaten food with something new (i.e., short-order cooking) can send the message that there is no need for the child to taste or eat what you serve because there will always be a preferable option if they refuse to eat the first.
Children need to be hungry at mealtimes to eat; providing too much food throughout the day and not setting limits or schedules around mealtimes can prevent a child from feeling hunger motivation to engage with the meal. Over time, as the child receives less exposure to family meals, the child may experience true picky eating.
Offering accommodations and adaptations before the child has a chance to problem-solve or try on their own; sends the subconscious message to the child that they are incapable and need someone else to do things for them.
Parental actions that reinforce picky eating are often a result of parental fatigue. Give yourself some grace. Parenting is exhausting work. And many children have a temperament that makes them more fussy, sensitive, and emotionally labile, which can further wear down parental resolve over time. More sensitive children can cause parents to second-guess themselves, their rules, or their decisions. As a result, an exhausted parent may be more likely to make concessions that can, over time, further lead a child to be picky, including short-order cooking or serving the child a separate meal.
If you’re facing parental fatigue:
Go easy on yourself.
Solicit support from a partner or co-caregiver.
Keep in mind that you don’t need to get it “right” 100% of the time. Try to be consistent more often than you give in, and you’ll be on the right track.
Remember that setbacks are opportunities for learning.
You can always regroup and try again.
Babies have an inherent drive to eat and explore food. However, babies also quickly learn from negative experiences and avoid whatever causes that negative experience, which can extend to eating. The drive to avoid pain or stress is so strong that this can override the innate desire to seek food and explore items in the mouth. When this happens, the baby can become picky because eating is associated with pain, fear, or stress.
Our brain and nervous system are shaped through experiences, which create automatic reactions in our body and guide our behaviors. When a baby experiences pain repeatedly when they eat, their brain quickly learns, “Food hurts me, so I should not trust it.”
As we learn, especially as we develop language, we turn subconscious experiences into stories to make sense of them. If a child has a food allergy or frequently gets an upset stomach after eating, their nervous system learns that food can cause pain, and the story the child might tell themselves may be something like, “Food makes me feel bad. I shouldn't eat anything I'm not very familiar with."
Stress and frustration have a similar effect to pain when eating. When children feel pressured to do something they are not yet ready to do, they feel stressed. And when a child feels consistently stressed about food and eating, they make a brain connection between the two experiences. We are all driven to avoid stressful or painful experiences, so children begin to avoid eating or become very rigid in what they will accept. Some eating experiences that might register as negative and stressful:
Feeding a baby or child after they communicate they are full or want to stop
Parent/caregiver insisting on holding the utensil when the child communicates they want to hold it
Wiping baby’s hands and face throughout the meal when the baby is fighting it
Picky eaters have often felt ongoing stress, pain, or other negative experience in connection to eating between birth and 2 years old. However, plenty of children develop into picky eaters without any identifiable negative experience with food. At the same time, we also see many children who experience negative emotions or sensations in connection to eating and yet go on to develop healthy food relationships, so we know it’s variable.
Sometimes, anxiety is caused by life circumstances, especially stressful life events where a child might feel out of control. Because a child can control food and what goes in their mouth, picky and restrictive eating tendencies can develop. Additionally, when a child’s communication has been ignored—whether at mealtimes or in general throughout their day—they will grasp at opportunities to exert control where they can get it.
There is a strong connection between a delayed introduction of textured and chewy foods and an increased likelihood of a child being very picky. Researchers suggest that there is a critical window of feeding development between 6-9 months, where a baby is most ready and willing to accept and learn how to chew textured foods; if you miss this window, the baby will have a more challenging time learning these skills.
Additionally, clinical experience from our feeding specialists shows a possible correlation between the delayed introduction of chewable solids and parental anxiety.
The literature identifies several additional risk factors for developing picky eating, including feeding practices before 6 months of age and social determinants of health.
These factors alone do not cause picky eating; there is simply a correlation with an increased likelihood of picky eating.
These additional picky eating risk factors are complex and require a multitudinous analysis that is beyond the scope of this article.
For a simple question, the answer is not so simple. One theory says having food preferences may be a normal variation of the human condition, as all children and adults experience taste preferences. It can also be said that picky eating is just a “phase” that passes by adolescence or young adulthood. Although these things can be true for some young children who deal with picky eating, there is more to consider.
Health & Development
Research shows that children identified as picky eaters by their caregivers demonstrate overall poor dietary intake, specifically limited intake of micronutrients like zinc and iron, as well as fiber. Research also shows correlations between picky eating and unhealthy weight—both significantly low BMI as well as high BMI or obesity—as well as constipation and gastrointestinal issues, and acute infectious illness.
With reduced food intake and distorted nutrient intake due to poor dietary variety, picky eaters are shown to have both distorted growth and health outcomes compared to children with more varied diets. Additionally, picky eating is correlated with overall decreased physical activity and delayed gross and fine motor development due to reduced strength and endurance.
Behavior
Due to poor nutrition, there is a correlation between picky eating and adverse behavioral outcomes. The research draws connections between decreased attention span, mental flexibility, and overall learning ability in children with limited diets. Additionally, picky eating has been shown to cause increases in problematic social behaviors, including anxiety, depression, and withdrawal.
Stress
Picky eating can cause high levels of stress in families. Parents concerned about weight, health, and development feel responsible for a child’s eating and report feelings of depression, hopelessness, and overwhelm.Impact of Picky Eating on Level of Family Stress in Healthy Children between the Ages of 3 and 6 Years Families with a picky eater are shown to have negative emotional climates in the home that impact not only the parent and picky eater but also the other children or adults in the home.
There isn’t a good answer to this question, but studies are looking at selective and picky eating in adulthood. A growing body of literature suggests relationships between picky eating in childhood and disordered eating in adults, which have negative psychological correlations, including anxiety and stress. Additionally, research has identified that kids who have moderate to severe selective eating patterns are at higher risk at qualifying for a mental health diagnosis like ADHD, anxiety, or depression as they get older.
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