Dear Northern Arizona Healthcare,
I am the mother of an eight-year-old and he is an extremely picky eater. Everyone has said that all kids are picky and he will just outgrow it, but he hasn’t yet. I’m getting concerned as he is getting older because I know how important it is to have balanced diet. Do you have any tips on how to help our child incorporate more foods into his diet?
Signed,
Concerned Mom
Flagstaff, AZ
Answer:
Dear Concerned Mom,
This is a great question, especially as we are coming up on National Nutrition Month. National Nutrition Month focuses attention on the importance of making informed food choices and developing sound eating and physical activity habits. Your child’s ‘picky eating habits’ are something that many children deal with, 25-35% of children will struggle with some type of feeding or growth issue at some time during the first ten years of life. Research shows only one-third to one-half of children will “outgrow” their selective eating within a two-to-three-year timespan. This means that a majority of kids will not outgrow their pickiness, and research shows these kids are often fussy for a good reason. Some of the reasons could include:
- They may be lacking oral motor skills – how the lips, teeth, tongue and cheeks work together to help us chew our foods.
- They may have difficulties swallowing liquids, which is known as dysphagia.
- They may have sensory challenges that can trigger them when eating certain foods.
- They may have other symptoms or conditions that make eating uncomfortable or something they want to avoid.
You may want to seek out a professional if your child struggles with aversion to food or food textures and groups, transitioning from pureed to table foods or mealtime challenges. Northern Arizona Healthcare’s Children’s Health Center has a network of providers who enable patients to receive multiple specialized services. From our therapy providers to our specialty clinics, the Children’s Health Center is able to coordinate comprehensive care for most specialty needs in our pediatric population. These services include a feeding team of trained professionals who can evaluate your child’s eating and make a plan to help them broaden their preferred foods. Some of our providers that could help devise a plan for your child include:
- Speech Language Pathologists to work on the oral motor skills
- Occupational Therapists to work on any sensory issues
- Registered Dietitians to ensure adequate nutrition to support healthy growth
- Social Workers to address any mental health pieces that may also be affecting the broad picture of eating/feeding
We like to refer to the Sequential Oral Sensory (SOS) Approach to Feeding, which is based in systematic desensitization, when looking at children who are finicky eaters. Children who appear to us as “picky eaters” often have a stress response when offered new foods. This feeding therapy approach encourages them to explore at smaller levels of interaction, first tolerating it on their plate (or on the table), then interacting with it with a utensil or helping prepare the food. We will then progress to smelling the food, then touching it, then tasting it, then fully eating it. We follow cues from the child in order to set the pace of this progression, and different foods often follow different progressions, because we all have our own preferences.
We also like to educate families about the Division of Responsibility (DOR) in Feeding. The DOR framework was developed by Ellyn Satter, a registered dietitian and family therapist. It has been in use for nearly 50 years and is recognized worldwide by dietitians, pediatricians and therapists as a powerful tool for promoting healthy relationships with food. The approach is based on the idea that children are naturally intuitive eaters with an inborn ability to regulate their own food intake. When children eat within a structured and supportive environment, they will grow into the bodies that are right for them. Some benefits of using DOR include, children developing lifelong healthy eating behaviors; children exploring foods on their own terms and in a positive way; and children being allowed to make their own decisions which can help build a sense of control.
If you are interested in booking an appointment with our specialists at Children’s Health Center, your health care provider can provide a referral to our services.
Thank you for your question about a prevalent topic, helping children and adolescents develop healthy eating habits and lifestyle choices will bring long term health benefits to them.
Kirstin Nelson, MS, RDN, CSP
Pediatric Dietitian
Northern Arizona Healthcare
Children’s Health Center
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