Addressing child picky eating

by Ellyn Satter, MS, MSSW, Dietitian and Family Therapist

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For children to do well with food acceptance, we need to see the issue from the child’s point of view – and the parents’.  All food is strange to the young child, even though the parents eat it and are thoroughly familiar with it. Children learn to eat what parents eat, but they need time and enough exposure to take the strangeness out. It is normal for children to be skeptical of new food: some are less skeptical, some are more. The way they react reflects their temperament: Some children are, for the most part, positive and receptive, some are slow to warm up, and some are downright negative. Children can be approaching their teens before they make strides with increasing their dietary variety, and they do it then only if they haven’t been pressured to eat in the meantime. Pressure and manipulation make children less likely to eat new food, not more.^{1, 2} Through no fault of their own, parents of unusually small children or those born prematurely, with medical problems, on the autism spectrum, or with developmental disabilities are at risk of raising picky eaters. Parents (and their health professionals) get scared and lose trust in the child to act on their own behalf. Instead of following the child’s cues with feeding, they pressure and manipulate the child to eat. Such children have more to learn, take longer to learn, and can be especially skeptical, slow to warm up, and negative about unfamiliar food. But they do learn. Those children need time and patience, not pressure, and their parents need the same.

It all depends on feeding

Children do well with learning to eat a variety of food when parents follow the Satter Division of Responsibility in Feeding (sDOR). Parents do the what, when, and where of feeding and let their child do the how much and whether of eating. Following sDOR means being considerate without catering in meal-planning and giving children repeated neutral exposure to unfamiliar food.³ Children even learn to eat fruits and vegetables (FV) when they see them at meals over and over and no one pressures them in any way to eat them.⁴ Children eat the way parents eat. Parents who enjoy vegetables have children who enjoy vegetables,¹ and the same holds true for parents, children, and milk-drinking.⁵ On the other hand, parents give up too soon on their child’s food acceptance. They tend to offer new food only three to five times before deciding their child dislikes it,⁶ Children need to see, smell, watch others eat, touch, and taste food, and take it out again, dozens of times to get comfortable with it.⁷ Then they eat it sometimes, not others.

Pressure on parents doesn’t work

To learn to do expert assessment and treatment so you can help, consider taking the Feeding with Love and Good Sense VISION workshop. 

  

Parents feel pressure, and they pass it right along to their children. Consider the warnings that a child’s lifelong nutritional and medical welfare depends on parents’ seeing to it that children eat the right food and avoid the wrong food. In the first place, there is no evidence that people who lock-step follow good-food-bad-food guidelines do any better nutritionally and/or medically than those who do not. Second, you can’t make a child eat anything they don’t want to. Third, it is neither kind nor effective to make parents feel bad about what they eat and what they feed their child. Parents who eat and enjoy more FV apply less feeding pressure,^{1, 2} and therein lies a clue: Parents who feel comfortable with their own eating, and therefore with the food they offer their child, are less likely to apply feeding pressure. Do parents have to eat FV in order to feel comfortable with their own eating? Not at all. Parents are entitled to eat what they eat, and they do better with feeding when they do. They are the experts in their own lives, and they know what food they can (and want to) plan, purchase, prepare, and eat.

Do we have to give up on parents’ good nutrition?

The idea that we “let” parents eat what they want is, of course, ludicrous. We can’t get parents to eat any differently than they do already. We can only make them feel bad about what they eat, and we do that with appalling regularity. However, if we endorse parents’ food choices, we support them in feeling good about their food and eating and make it possible for them to provide family meals. In short, we help them to be Eating Competent (EC), as defined by the Satter Eating Competence Model (ecSatter),⁸ and to raise children who are also EC. Parents’ EC correlates with their following sDOR and raising children with lower nutritional risk.⁹ The Satter Hierarchy of Food Needs explains how the security of getting enough to eat of food we prefer lets us learn and grow: We get around to planning, then with experimenting with novel food and therefore achieving variety-based nutritional excellence.¹⁰ Of course, parents who genuinely want to eat and enjoy a wider variety of food (and not just want to want to) can ever-so-gradually bring themselves along with repeated neutral exposure to new food, the same as their child does.

What about child nutrition?

It’s not about getting children to eat healthy food today. It’s about supporting children so they enjoy eating healthy food for a lifetime. There is a whole world of food out there, and children have many opportunities outside the home to learn to enjoy it. And they do, provided parents send them out, not having won the Formula 500 for eating healthy food, but feeling good about eating and taking an interest in food. In other words, it is critical to raise children to be Eating Competent. EC children feel positive about eating and food, are relaxed around unfamiliar food, gradually learn to eat the food parents and other adults eat, intuitively regulate their food intake and grow consistently, and participate comfortably in family meals.

Make yourself the feeding expert

There is a great need for knowledgeable, theoretically and practically expert professionals who can help parents resolve feeding problems and find well-deserved joy with feeding. Instead of being able to enjoy their child, many parents are miserable about feeding, endure struggles around feeding that may have gone on since the child’s earliest years, and continually worry about their child’s growth. To learn to do expert assessment and treatment so you can help, consider taking the Feeding with Love and Good Sense VISION workshop.

1. Fisher JO, Mitchell DC, Smiciklas-Wright H, et al. Parental influences on young girls’ fruit and vegetable, micronutrient, and fat intakes. J Am Diet Assoc. 2002;102:58-64.
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8. Satter E. The Satter Eating Competence Model: the Satter approach to eating Ellyn Satter Institute. Accessed February 2, 2022. https://www.ellynsatterinstitute.org/satter-eating-competence-model/
9. Lohse B, Mitchell DC. Valid and reliable measure of adherence to Satter Division of Responsibility in Feeding. J Nutr Educ Behav. 2021:211-222.
10. Satter E. Hierarchy of food needs. J Nutr Educ Behav. 2007;39:S187-S188.