Mealtimes with toddlers can be challenging to say the least.
Toddlers go through a phase of neophobia, or fear of new foods, that can last a few years, which makes them much more hesitant to explore new foods than they were in infancy. They also have a slowing growth rate compared to infancy (and therefore less hunger) and a strong drive to practice new skills of moving around, testing boundaries, and being in control. All these things can contribute to a phase of less-than-ideal eating and new refusals at the table that look a lot like picky eating. This is considered toddler selectivity, and caution parents from treating this like true picky eating, as strategies used for treating true picky eating can often prolong and worsen toddler selectivity.
Picky eating, which takes toddler selectivity to a new level, tends to be related to underlying issues like anxiety or fear around food and/or meals, sensory processing, or developmental delay. Children who exhibit true picky eating behaviors need slow, consistent change and challenges, balanced with love, some additional accommodation, and support scaffolding to learn to tolerate a typical mealtime environment and explore new foods. This level of support tends to be too much for typically developing selective toddlers and may worsen behavior and rigidity, preventing them from making progress.
It's likely true picky eating if your toddler…
Is willing to starve themselves rather than eat a non-favorite food
Exhibits specific sensory sensitivities and/or challenges such as refusing to have messy hands, won’t touch wet or messy textures, or hates having hands washed, face washed, teeth brushed, etc.
Shows signs of severe anxiety at the table (meltdowns/tantrums are different from the meltdowns/tantrums that occur during other times like bedtime, transitions, etc).
Behavior and refusals are consistent; they don’t come and go meal to meal, day to day, week to week, or from one caregiver to another.
Will not touch or interact with food at all even though pressure has been low and you’ve given them ample opportunities to go at their own pace *throwing counts as interacting*
Has been showing refusal behaviors and/or eating issues for 4-6mo+
Yes. Kids are quite capable of learning new skills and improving their behaviors at the table and the variety in their diet. It’s essential to use a consistent approach that balances connection, support, exposure, modeling, and tolerable challenges. Remember that reversing picky eating is all about laying down foundational skills and taking small, gradual steps in the right direction to learn about and tolerate new foods. This takes time upfront and years of ongoing work to grow skills and learn new ways of interacting with foods. Also, much of the work is done by the parent and revolves around steps to set loving and healthy boundaries, stay consistent even in the face of pushback from your child, and think carefully about how to balance support and comfort with challenge and learning.
We’ve got some good news and some bad news…The bad news is that we know certain parenting practices and styles do contribute to picky eating. The good news is that our extensive experience working with infants and families has shown us that parents don’t typically cause their child’s picky eating.
Research shows that picky eaters are more likely to have certain temperaments, which probably leads them to be picky and also likely leads parents to make choices that reinforce pickiness. Babies and kids who are fussier, more sensitive, and emotionally labile (lots of tantrums and meltdowns) are more likely to be picky. Additionally, children who have developmental differences, sensory processing challenges, sensory sensitivities, oral-motor challenges, and medical considerations are all at increased risk for picky eating, no matter what the parent does or does not do to avoid it.
Research also shows that a smaller but growing number of infants seem to struggle more than others to learn to eat a wide variety of real foods. Depending on the study, anywhere from 6-50% of toddlers are described by parents as “picky eaters.” Many toddlers will outgrow their picky eating by the time they hit 4 or 5 years old, but those who don’t outgrow it are often picky throughout much of childhood.
Yes, there are different frameworks and approaches to reversing picky eating. Our approach is a relational-developmental approach that relies heavily on connection, modeling, and encouraging exploration and discovery while fostering independence. Our approach also relies on using a small amount of hunger motivation. However, other approaches rely heavily on hunger manipulation to drive exploration and improved eating, and still, others encourage the use of pressure and even force-feeding to increase consumption. These approaches do not align with our core values of connection and respect, so you will not find strategies like these in our courses or guides.
See our Reverse Picky Eating guides for more information.
The short answer is yes. Participating in family mealtimes, handling the frustration of being offered food you don’t want, and managing fear or uncertainty to explore new foods are all part of practicing essential life skills. These life skills—flexibility, self-regulation, frustration tolerance, resiliency, and bravery—are important throughout your child’s life. Practicing these skills daily, at the table, in a safe, supportive environment, is incredibly important for helping a child build their sense of competence and self-efficacy.
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.
For more information, see our article Causes of Picky Eating.
While there are some kids who will be picky no matter what their parents do and no matter how hard you try to prevent it, there are also many children who have the potential to be picky but can be gently guided towards better eating through early, consistent parenting actions.
Building foundational skills early—when first starting solids—is an important first step. As the child hits toddlerhood, set clear boundaries around what food is served, when it’s available, and how you interact at mealtimes. All are essential for progressing a child’s skills and flavor palate.
The following can help establish strong foundational skills and prevent picky eating from taking hold:
Use responsive feeding techniques from the start.
Offer a wide variety of foods and flavors.
Model how to eat the foods you serve.
Give a child time and space to learn chewing skills.
Set loving mealtime boundaries.
Consider how often you eat out and what the environment will be like. If meals out are a rare family treat and you are going to socialize with family or friends, consider throwing out most of your rules and just focus on keeping the peace and enjoying yourself. Often, the stress and sensory overwhelm of a restaurant, practicing good manners, and interacting with family and friends is just too much, and your child’s worst behaviors come out.
Try shifting your definition of success from eating new foods to staying calm and enjoying the social event. For example, this might be a reasonable time to bring special food items that you know your child loves, or consider bringing along a tablet that your child can use to watch a show while you enjoy the company of your friends. This is perfectly reasonable to decide it isn’t the time or place for the child to expand their palate.
You might be surprised! Sometimes, adopting this very low-pressure, no-expectations attitude can lead to some surprising steps forward for a child who is usually hesitant. The low-pressure environment and social reward of being with loved ones and watching them eat can occasionally trigger a child to try a new food or eat better than they would at home.
Addressing picky eating often takes a team of medical professionals. Often, families will work with:
Primary medical provider
Feeding and swallowing specialist, usually a pediatric occupational therapist or a speech-language pathologist
Possibly a psychologist or a family counselor.
Here are some steps you can take to find local experts to help address picky eating:
Talk to your child’s primary healthcare provider. Bring your list of concerns.
If your doctor does not seem concerned and/or does not offer you a referral to a feeding therapist, ask for one! You have every right to tell your child’s healthcare provider that you want and need more help with this. Make it clear that you’d like a referral for a feeding therapy evaluation from a licensed pediatric occupational therapist or speech therapist.
Ask the child’s healthcare provider for recommendations on therapists to see or where to go. Often the physician will have a few local resources, which can be an excellent starting point. If your child’s primary care provider has no recommendations, or if you start at the recommended resources but would like other options, you can do your own research to find local support.
Start with a Google search to find your local children’s hospital, regional center, or early intervention services, as well as any private pediatric occupational therapist or speech-language pathologist clinics in your area.
Contact each of these with a brief description of what you need—a feeding therapy evaluation and possibly intervention for your baby or toddler to help with [x, y, z] issue.
Interview each clinic or therapist. Ask questions and search for the right fit for you and your child. In particular, you want to make sure you find someone who:
Has pediatric feeding experience
Has advanced practice and training in the area of feeding issues or works closely with a mentor
Uses a variety of respectful approaches in their feeding therapy
Picky eating has a wide range of severity. Some picky eating cases are relatively harmless and bothersome and resolve with time, while others are severe and persistent with significant negative health and wellness repercussions.
It should be noted that our professional team has a low threshold for advocating for additional support and feeding therapy services. If mealtimes are stressful for your child and/or your family, even if your child is gaining weight appropriately without any nutritional concerns, please alert your child’s primary medical provider. They should be able to help you problem-solve and decide if feeding therapy or any other referral may be helpful.
Often unhappy around mealtimes: fighting, yelling, crying, or just generally stressed or anxious at most meals
Refuses to eat what is served, demands preferred foods
Will not taste or explore new foods
Will not eat a certain category of food (i.e., vegetables or proteins) or even certain textures or colors.
Eats only a few foods
Insists on eating things in a very specific way (i.e., only specific brands; only if the food is served in the original bag/box; only when food is cut exactly so; only if food is not touching)
Difficulty gaining weight or gaining weight rapidly
Gagging on food occasionally at meals
With the above signs, there is usually no need to seek professional help immediately. Many of these challenges can be addressed with extra support from parents and caregivers at home. (See our Picky Eating Bundle for guidance.) Expect significant progress after a few weeks to several months; however, you should see *signs* of improvement within a month.
*If you see zero progress or worsening behavior after strategy implementation, strongly consider contacting your child’s primary healthcare provider. Following a detailed history and physical exam, individualized support from a feeding specialist and/or referrals to other specialists may be warranted.
Complete refusal to eat or drink anything
Dehydration: not producing tears or saliva; concentrated (dark yellow) and infrequent passage of urine
Constipation: passing fewer than two stools per week; passing hard, painful stools; blood in or around stool; significant abdominal pain
Significant weight loss
Choking and/or gagging on solid foods or liquids frequently at meals
Extremely low energy or overly sleepy
Child is feeling extremely overwhelmed or experiencing a significant decrease in quality of life
If your child is experiencing any of the above signs, seek care immediately. This may be an urgent care visit with your child’s primary care provider, another provider, or a trip to the emergency department.
For more on when to seek professional support, see When to Seek Help for Picky Eating
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