October 23, 2024

How to Tell if a Child’s Picky Eating Requires Intervention with a Pediatric Nutritionist

By Rebecca Appleman, RD

Many, if not most, children are picky eaters, or display some degree of pickiness at some point in their development. Not only have young palates not yet been exposed to certain spices and flavors, but children “like what they like” and may choose to eat or not eat foods based on seemingly arbitrary factors, like whether a food is dinosaur shaped or if it is soft to chew.

Picky eating is a common phase in many children’s development, but it can also go too far. Sometimes, the “picky eating” may actually be a more serious feeding issue, benefitting from intervention with a skilled registered dietitian nutritionist.

Signs of “Typical” Picky Eating

It can be difficult to tell when picky eating is a serious problem or a typical part of a child’s development, so we encourage you to consider reaching out to our nutritionists here at Appleman Nutrition, who can help distinguish between the two. We can talk to you about your child’s eating habits, behaviors around food, sensory sensitivities, food preferences, and any recent changes in their diet, in order to make sure that your child is getting the nutrients their growing bodies need.

With that in mind, there are some behaviors that can appear more typical of young eaters, especially during toddler years. These include:

• Refusing Certain Foods – It’s normal for children to have strong preferences or aversions to certain foods, like vegetables or unfamiliar textures. This can change over time, and you may even see your child temporarily lose interest in foods they used to enjoy.
• Limited Food Variety – Children often prefer familiar foods and may eat the same foods repeatedly for a period. They may also favor specific food groups or textures, such as eating mostly carbohydrates or mostly crunchy foods at times.
• Resistance to New Foods – Many kids are hesitant to try new foods, which is a common part of the learning process as they explore different tastes, sights, and textures. It often requires multiple steps and repeating the exposure to get a child to feel comfortable exploring a new food item.

While these behaviors can be frustrating, they are generally part of normal development. Most children with these types of “picky eating” behaviors will start to explore new textures, appearances, flavors, and food combinations with time, repetition, and patience.

When Picky Eating May Require Intervention

Sometimes, picky eating can signal a more serious issue, such as a feeding disorder, sensory disorder, or general anxiety around food, that might require professional intervention. Some signs that picky eating may benefit from further attention include:

• Severely Limited Food Choices – If your child consistently restricts their diet to only a handful of foods and refuses entire food groups (such as vegetables, fruits, or proteins), this could be a sign of more serious eating issues. A child nutritionist can help introduce new foods in a structured and supportive way to help ensure they are getting the nutrients needed for proper growth and development.
• Nutritional Concerns – If your child’s diet is leading to nutritional deficiencies, poor or inadequate weight gain, stunted growth, gastrointestinal complaints, delayed milestones of maturation, or frequent illnesses, consulting a registered dietitian nutritionist is critical. They can help assess how well your child is meeting their dietary needs, correct for relevant nutrient deficiencies, create a balanced and appropriate meal plan, and provide strategies to improve their overall nutrition as well as decrease the stress in the home around meal times.
• Sensory Sensitivities – Some children avoid foods based on texture, smell, or appearance, which may be due to sensory processing issues. A child nutritionist can work alongside other professionals (like occupational therapists) to develop a plan that gradually expands your child’s tolerance for different foods.
• Meal Anxiety or Emotional Distress – If mealtime is consistently stressful for your child, with meltdowns, anxiety, or avoidance, it may indicate that food-related issues are more than just picky eating. A nutritionist can offer techniques to make mealtimes less stressful and more enjoyable, while ensuring your child’s diet is still balanced and adequate.
• Inconsistent or Declining Growth – If your child is no longer gaining weight along their typical growth curve or is experiencing weight loss, it’s important to seek the expertise of a pediatric nutritionist to evaluate whether dietary restrictions are affecting their development. Achieving weight restoration and meeting needs for ongoing growth and development will likely be the first and primary goal of the nutrition support.
• Older Age – Picky eating does tend to improve gradually with age. If the amount of foods eaten is not improving, or more foods are being cut out from their diet, it may be useful to speak to a professional to see if there are underlying issues that can be addressed and create a plan for adequate intake moving forward.

Still, it can be difficult to differentiate between some of these behaviors and more typical picky eating. That is why it is often beneficial to speak to a nutritionist.

The Role of a Child Nutritionist in Picky Eating

A child nutritionist is trained to help children develop healthy eating habits, adequate and balanced intake, and a healthy relationship with food.. When picky eating becomes a concern, nutritionists can assess dietary gaps and provide tailored advice that supports both the child and the family. Child nutritionists can help by:

• Creating a Balanced Eating Plan – A nutritionist can assess your child’s nutritional intake and create a plan that incorporates necessary nutrients while respecting your child’s current food preferences. They can help come up with creative ways to promote variety, balance, and optimal nutrition for growth. Over time, they can also gradually help expand the range of foods your child accepts.
• Introducing New Foods With A Step-Wise Approach – Nutritionists are experienced in helping children explore new foods in a non-threatening, positive way. They can suggest small, manageable steps to widen your child’s food variety without overwhelming them. This often starts with parents helping to model a varied diet and allowing the child to explore new food items with all of their senses (seeing, smelling, touching) before they may be ready to taste something.
• Addressing Underlying Causes of Picky Eating – Sometimes picky eating stems from sensory processing issues, anxiety, lack of appetite or interest in food, or other behavioral concerns. A nutritionist can work in collaboration with other healthcare professionals (such as physicians, occupational therapists, and psychologists) to address the root causes of your child’s food aversions.
• Providing Family Support and Strategies – Nutritionists not only work with the child but also (and more often, depending on the age of the child) offer parents practical strategies to support healthy eating habits at home, reducing mealtime stress, and improving the overall family dynamic around food.

Appleman Nutrition is a NYC nutrition counseling and consulting practice that works with children and adults, and has the ability to see clients in New York, Connecticut, and our newest office opening in Florida, as well as virtually. We are accepting new clients and are more than happy to work with those of any background. If you would like to learn more about Appleman Nutrition, or get started, please reach out to our team today.