March 18, 2009

In Search of the Picky Eater

Searching for food refusal in a 2-year-old's world.

Chances are good that your child is, was, or will be a picky eater. I'm confident about this because of how often I hear this concern and how intensely parents worry about it. It may be surprising to learn that there is no general agreement on what, exactly, defines a child as a picky eater.

Some researchers include kids who don’t have a problem eating--a long as it’s the same few foods. Others include kids who eat very slowly, are not taking in much volume of anything, and don’t gain weight well. There’s the kids who have a tantrum if the foods on their plate touch each other, and those who will only eat foods of one color (it’s usually not green). Some won’t try new foods, and some won’t eat foods of a certain texture or temperature or that look like some other foods.

I was very impressed by a research study from 2004. These scientists didn’t try to define picky eating. They let parents define it for themselves. They polled over 3000 parents and asked if their child was a picky eater. The age of the kids was limited from 4 to 24 months. They found that at 4 months, about 19% of the children were thought to be picky eaters, but at 24 months, it was 50%. So at 2 years old, half of all children are thought of as picky eaters by their parents.

Let’s take a step back here. What does normal mean? If half of all 2-year-olds are said to be picky, and I suppose the other half isn’t picky, which group represents normal 2-year-old eating?

The importance of this study is really a discovery about normal child development. As a result of this finding, the chances are that your picky-eating 2-year-old is normal.

Normal, for me, means that I don’t have to do a lot of tests, don’t have to worry about unusual food allergies, and can reassure the parents that their kid is just like half of all the other 2-year-olds out there.

So when would I be concerned? I ask the parents if there’s any sort of reaction which could be related to an allergy, such as a rash, breathing problems, or swelling. I look at the growth chart to see if the child is growing at the same rate as their peers. It’s OK if they’re a little skinnier than most, as long as their weight keeps rising along the same growth curve. Is their development normal? Are they doing all the typical things a 2-year-old does? Are they showing any signs of a nutritional deficiency of some sort?

Usually, when I get the answers to these basic questions, the parents need reassurance most of all. Normal doesn’t mean convenient. It also doesn't mean that we give in to the grandparents who insist that the child isn't getting enough.

Should we intervene with picky eaters? Maybe it's just a lifestyle choice. That's the next post.


  1. Eating is one of the few things small (and even big) children have control over. If you're a child, it's also a great way to get mom and dad's attention. The feeling that we have failed to nourish a child can feel like a major failure as a parent, and it's a "failure" that's readily visible to others.
    When I had my kids, I had very definite ideas about how they would eat healthy food, vegetables, etc., but they had other ideas. As they got older, they would even stop eating foods they happily ate as babies or toddlers.
    I remember that I was a "picky" eater as a kid, and managed to grow up and expand my repertoire; my kids will, too. Or not!
    I don't "push" healthy food any more, though I do talk about how the food I eat helps my skin, etc. Ultimately, it is their choice what they eat.


Please let me know what you think. Do you know a child or situation like this?