Remember to honor your child, picky eating is not always a choice

Physiologically, eating may just be the most complicated thing we do.

Swallowing, alone, involves 26 muscles, and every meal engages the respiratory, endocrine and metabolic systems, as well as the entire GI tract and all 5 senses. Eating triggers psycho-emotional associations, and affects both the sympathetic and parasympathetic nervous systems. It is no small wonder that things often go wrong. It is extremely important for both professionals and parents to read children’s cues and look for patterns with food refusal.

As a general rule, kids don’t refuse to eat simply to be difficult, but they do have difficulty articulating why they are not eating. They may not have the language to express why it is difficult (it hurts, it makes me gag, I don’t like the texture, I am afraid) or lack the understanding that their eating habits are atypical. Many picky kids have unknown medical conditions, like acid reflux, iron and zinc deficiencies, diarrhea, or constipation. A kiddo with undiagnosed food allergies may experience pain when eating. He may not even be aware that it does not have to be painful to eat. You must also take into account a child’s motor skills, as sometimes children are not developmentally ready to advance textures even though it may seem age appropriate. Sensory Food A version, a commonly seen feeding disorder characterized by consistent refusal to eat certain foods based on taste, texture, smell or appearance, may produce strong visceral reactions that leave a child unable to eat. Some children may only refuse a few foods while others may exclude entire food groups such as vegetables, fruits, or meats. Children with Sensory Food A version can become very distressed at meals, often leading to heightened anxiety for both the child and the parent or caregiver.

Typically, these kids will eat preferred foods, but their diet may be lacking in key vitamins and minerals. Often these preferred foods are predictable to them, meaning that the food will look, taste, smell, and feel the same way every time. Typically, sensory related aversions are not isolated to food. These children will often refuse touching certain textures such as sand, playdoh, or wet grass, and have adverse reactions to brushing their teeth or washing their hands or face.

Psychologically, children may have negative memories associated with a past food experience. They may associate food with fear, pain or discomfort. Furthermore, children may lack the confidence to try new foods or to experience new textures that cause them fear, anxiety or scary sensations. Children often look to their parents for modeling and reassurance. I f the parent is anxious, coaxing, bribing or bargaining, this can lead to increased anxiety for the child and less eating. W hen children have a negative association with eating they are in react mode, leading to increased adrenaline. Elevated adrenaline in turn causes suppression in appetite, an inability to calm, and increased difficulty with swallowing.

Kids eat when they feel well, when they feel confident with their skills, and when they have positive social interaction with their parents, peers, and caregivers. Appropriately addressing any issues with choosy eating should include treating any contributing medical condition, correcting any resulting malnutrition, and empowering children to feel safe with new foods in order to build a solid foundation for a lifelong healthy relationship with food. If your child seems fearful or anxious at the table, you may want to consult with a feeding expert for guidelines to ensure your child will become a healthy, happy eater. Remember to create regular meal times, provide a variety of food (keeping in mind that children get overwhelmed with more than three choices,) let your child choose what and how much they will eat, and praise your child for self-feeding skills and being brave about exploring new foods!