Picky eater: What to do when a child won’t eat?

What is a picky eater and why does it occur?

A picky eater is a child who refuses a wide variety of foods, is reluctant to try new things and tends to prefer a narrow group of foods. This behavior may be due to several reasons:

• Normal developmental stage: It is common for children between 2 and 6 years of age to want to exercise autonomy, which includes making decisions about their eating.
• Food neophobia: Some children are afraid of trying new foods, especially if they have a different texture, color or aroma.
• Previous negative experiences: Choking episodes, force-feeding or association of food with negative emotions can reinforce refusal.

According to the Spanish Association of Pediatrics, understanding these reasons allows us to address the situation more effectively, avoiding turning food into a source of conflict.

Signs that your child is a picky eater

Some signs include:

• Consistent refusal of certain foods or food groups.
• Sensitivity to specific textures, smells or colors.
• Preference for the same foods over and over again.
• Decreased appetite with no obvious medical cause.

It is important to differentiate between a passing phase and a severe feeding problem. If the child presents weight loss, nutritional deficiencies or extreme anxiety around food, it is advisable to consult a specialist.

Strategies to improve the feeding of a picky eater

There are several strategies to encourage a more varied diet without generating rejection. But based on my experience as a nutritionist, these are the most effective strategies:

• Remain calm and avoid pressure: It is normal for children to go through these phases. Patience and perseverance are key to avoid reinforcing rejection.
• Respect their need for autonomy: Many children use food as a form of self-affirmation. Offering them healthy choices within a margin of decision can help (example: “Do you prefer carrot or broccoli?”). Also, including them in food shopping and preparation can pique their interest.
• Don’t stop offering rejected foods: To prevent permanent food rejection, it is essential to keep exposing the child to these foods at least 10-15 times in different preparations and forms. This helps to familiarize them and increase the likelihood of acceptance.
• Take advantage of the moments when he/she accepts food: When the child shows willingness to eat, you can prioritize more energy-dense foods or enrich those that he/she already consumes frequently.
• Avoid making the moment of eating traumatic: It is essential that the child relates eating with a positive, social and familiar environment. Punishing, forcing or scolding during mealtimes can generate aversion in the long term.
• Set healthy limits: Mealtimes should not be longer than 30 minutes. It is best to offer structured mealtimes and avoid distractions such as screens so that the child pays attention to his or her hunger and fullness cues.

Opt for energy-dense preparations

If the child consumes a small amount of food, it is key to increase the caloric density to prevent weight loss or aid in recovery. Some strategies include: adding 1 teaspoon of olive oil to purees or meals, sprinkling ground oatmeal on fruit or yogurt, including egg or avocado in various preparations.

Also, in severe cases, where intake is insufficient and growth may be compromised, supplementation with caloric modules may be considered, under the advice of a nutritionist.

Meal ideas for picky eaters

• Nutritional smoothies: Blend milk, fruit, almond butter or yogurt for a high-energy option.
• Pancakes with oatmeal and eggs: A nutritious and easy-to-consume option.
• Enriched puree: Add olive oil, grated cheese or avocado to increase energy density.
• Yogurt with fruit, sprinkled oatmeal and crushed nuts: Ideal for a nutritious and well-accepted snack.
• Toast with peanut butter or avocado: A breakfast or snack with healthy fats.

When to seek professional help

However, if the child continues to show very restricted feeding despite these strategies, it is important to consult a nutritionist or pediatrician in order to evaluate their development and nutritional status.
Some warning signs are:

• Weight loss or inadequate growth.
• Lack of energy or weakness.
• Extreme anxiety or stressful behaviors around food.

If you need more information you can contact me through my social networks.

Written by: Nutritionist Andrés Izurieta

Bibliographic citations:

Manual de Nutrición | Asociación Española de Pediatría [Internet]. 2021. Disponible en: https://www.aeped.es/comite-nutricion-y-lactancia-materna/nutricion-infantil/documentos/manual-nutricion-aep-2021