The Best Advice You Never Considered for Picky Eating 10 Tips for Picky Eaters

Before specializing in pediatrics, I could have never imagined how much stress picky eating could cause parents and caregivers.

At first parents may feel their child just likes certain foods more than others. Then maybe they don’t like fruits and vegetables. Then parents may begin to watch what other kids eat, how much they eat, how often they eat, how easy meal time may be for other parents, etc. They then begin “noticing” their kid may only eat processed foods, beige foods, warm foods, or food not prepared at home! The worrisome thoughts begin to creep in. Is my child’s diet negatively impacting their brain development?! What about their growth potential?! Is it making them groggy and unable to absorb what their learning in school? Will they begin to fall behind in school? What if there is something medically wrong with them now because their will not eat meat or vegetables! Are they dehydrating themselves?! I can continue to list the scary thoughts I have heard, but it’s beginning to make me anxious, and I definitely don’t want to make you anxious!

Well I have great news! This is not a situation where stressing about it and “being on top of it” will make it better. Actually, it will make it way worse.

My advice as a pediatric dietitian? Ignore it!

Draw as little attention to your child’s picky eating behaviors as possible. Serve them what you want them to eat and that is the end of it. Children pick up on our stressors. If meal time is a stressful time for you and you’re worried about what they will eat, they pick up on it and it has become a negative experience for them. Negative experiences are obviously unenjoyable and children can act out – hence picky eating.

As moms, these are our personal experiences, but more importantly these findings (and recommendations for handling picky eating) have been researched and studied. The Abbott Nutrition Health Institute recently conducted a study on “Picky Eating Behaviors in Children and Family Stress.”

They concluded: “…parents of children who do not consume enough of specific food groups feel stress over mealtime occasions, as demonstrated by statements in the study family stress tool, such as “I feel myself getting more anxious as meal time approaches” or “Meals always end in a quarrel”. Because of possible deleterious effects of picky eating behaviors over time, it is important to modify or improve these behaviors, especially for the health of the family and their relationship with their child(ren). Additionally, negative eating behaviors appear to be cyclical if parents react adversely with controlling, threatening, angry, or permissive actions. Picky eating behaviors do tend to decrease with age; however, some children continue to retain undesirable eating behaviors later in life with possible effects on physical, mental, and psychosocial facets of a child’s life.12, 13 Picky eating behaviors should be considered worthy of discernment, and a strategy should be developed for modifications and improvement.

How do parents begin to combat picky eating behaviors? Here is Feed To Succeed’s list! I can promise you, as parents, we implement these tips at home also.

  1. Cook and serve only what you want your child to eat.
    Don’t be a “short-order” cook. You are the parent, so you know what is best for your child. Make meals family events, and serve everyone the same foods. It’s okay to have one “safe” item out for the picky child (such as plain bread or rice).
  2. Eat together as a family.
    Eat meals together as often as possible. Serve the same meal to everyone. Model good eating behaviors by eating a variety of nutritious foods in front of your children.
  3. Never force a child to eat.
  4. Introduce new foods frequently.
    Offer a new food item daily and expect it to take up to 15 attempts with a particularly picky eater before he/she will accept the food. Consider it progress for extremely picky kids if they simply allow the food to sit on their plate.
  5. Have a schedule.
    Offer 3 meals and 2 snacks at approximately the same time every day. Allow a minimum of 2 hours between meals/snacks. Offer nothing to eat or drink between meals/snacks except water.
  6. Always eat at the table.
    Serve all meals and snacks at the table with screens turned off. Eat together as a family as often as possible.
  7. Offer milk with every meal.
    Soda, juice, Kool-Aid, and sweet tea do not add anything nutritious to your child’s diet, so they are not necessary.
  8. Offer foods from each food group at most meals.
  9. Limit meal time to 20-30 minutes.
    If your child tantrums, asks for something else, refuses to eat, or gets up from the table, wait 15 minutes and try again. If the problem continues, end the meal or snack and wait until the next scheduled meal/snack time to offer anything (except water). Do not make a big deal out of this or give it attention. Do not make it like a punishment. Just be matter of fact.
  10. Keep your emotions in check, and stay in control of the situation.
    Give a neutral/unemotional reaction when your child eats poorly. Don’t over react. Don’t discuss eating or food at mealtime, except for two things:

    • “Do you want more?”
    • “Are you done?” When your child does eat well, give a mild positive reaction such as: “Oh, you must be hungry today. Good eating.”

Fourth of July Festive Treats

Happy Fourth of July weekend to all our Feed to Succeed families! Make sure to celebrate with family time and of course, lots of good eats!

Try adding fresh mint leaves to your fruit salad. It tastes like summer!

Try adding fresh mint leaves to your fruit salad. It tastes like summer!

 

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Put your kids to work on these skewers, and they’re guaranteed to eat it!

There are loads of ideas for fun 4th of July activities and crafts for families online. Most of the desserts, though, contain lots of sugar and food coloring. This one is full of fruit, whole grains and uses less refined sugar. Happy 4th! Enjoy!

Healthier American Pie (aka fruit pizza!)

Healthier American Pie (aka fruit pizza!)

FRUIT PIZZA ‘AMERICAN PIE’
For the crust:
2 cups whole wheat flour
2 tsp. baking powder
1/2 tsp. salt
1/2 cup softened butter
1/4 cup brown sugar
1/4 cup sugar
1 tsp. vanilla extract
1/2 cup milk

Preheat oven to 350 degrees. Sift together the flour, baking powder and salt in a large bowl. Add the butter, brown sugar, sugar, vanilla and milk and mix well.

If dough is too soft, refrigerate for 20 minutes or more. Roll the dough into a large ball and flatten out on a greased baking sheet until it’s about 1/2-inch thick and in the shape of a rectangle or oval. Bake for 15-17 minutes and then let cool on a wire rack.

For the ‘sauce’ and toppings:
1/2 cup cream cheese
1 Tbs. maple syrup
1 pint blueberries
1 sliced banana
1 pint sliced strawberries

Combine cream cheese and maple syrup well and spread over cooled crust. Add the blueberries in the top left corner and then fill the rest of the cookie with banana and strawberry slices.

For the glaze (optional but yummy):
1/4 cup orange juice
1 tsp. maple syrup
1 tsp. corn starch

Combine the OJ and maple syrup in a bowl and then slowly add the corn starch while whisking. Drizzle the mixture over the flag and refrigerate for 30 minutes or more.

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Understanding Food Allergies By Gia Diakakis, RD

Believe it or not, FPIES, Food protein-induced enterocolitis, was beginning of my love story with Feed to Succeed. I first met Betsy, the owner of Feed To Succeed, at a dinner lecture on FPIES. We quickly realized we had lots in common in the pediatric nutrition world, which eventually led to me becoming a pediatric dietitian with Feed to Succeed.

So what exactly is food protein-induced enterocolits (FPIES)? Well food allergies can be divided into IgE-mediated and non-IgE mediated reactions. FPIES is a non-IgE mediated food allergy. This means IgE antibodies do not cause this reaction to food. Since IgE antibodies are not involved, this allergic reaction to food is delayed (anywhere from several hours to several days) and causes symptoms over a long period of time (as opposed to anaphylaxis or throat closing reaction). FPIES presents with gastrointestinal symptoms such as vomiting, diarrhea and dehydration. The most common culprits are cows milk (CM), soy, and grain. However, any food may cause FPIES.

If your child is presenting with these gastrointestinal symptoms, it is important to discuss this with your pediatrician or pediatric gastroenterologist. If a diagnosis of FPIES is made, working with a pediatric dietitian is important in order to make diet modification to help manage their nutrition. Nutritional management will consist of eliminating the food or foods that your child or infant is allergic to, while making sure they continue to receive all the necessary nutrients. For example, if your child or infant is allergic to cows’ milk, they will need diet modification to assure they are receiving adequate protein, calcium and phosphorus (among other nutrients).

The Journal of Allergy and Clinical Immunology recently published guidelines on the management of FPIES. In those guidelines, they have a couple of tables with really useful nutrition information. One of them nicely outlines what foods can be incorporated into you child or infant’s diet to assure appropriate nutrition in eliminating some of the most common FPIES triggers.

FPIES

These guidelines also provide a table for introducing foods (or weaning from formula if CM is the trigger) to your infant diagnosed with FPIES.

fpies 2

Please keep in mind, with a diagnosis of FPIES, it is imperative to work closely with a pediatric gastroenterologist and pediatric dietitian for the correct medical management and nutritional management of your child. While these guidelines are helpful and informative, they do not substitute working with medical professionals.

Nowak-Węgrzyn, Anna, et al. “International consensus guidelines for the diagnosis and management of food protein–induced enterocolitis syndrome: Executive summary—Workgroup Report of the Adverse Reactions to Foods Committee, American Academy of Allergy, Asthma & Immunology.” Journal of Allergy and Clinical Immunology 139.4 (2017): 1111-1126.

 

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