Sunday, October 4, 2015

Reader question: Help! My child is a picky eater.

Nutritionist Beth Wallace Smith offers advice to a mom about helping her young child eat healthier.

Reader question: Help! My child is a picky eater.


Editor's Note: We would like to thank the readers who have submitted questions to Healthy Kids! Our experts will periodically answer questions in their areas of expertise.


My 4-year-old daughter is a picky eater. She loves oatmeal, Greek yogurt and fruit, but it is really difficult to get protein into her. She eats PB&J every day. She will begrudgingly eat a scrambled egg, and she’ll eat edamame. It's a fight to get her to eat Quorn veggie chicken nuggets (prefers over real) or fish sticks, but I do make her eat each at least once a week. I’ve tried different brands and flavors (organic). Chicken or turkey breast is a no way. I don't want to give her red meat or pork and she has never wanted to eat it anyway.  

Veggies aren’t much better. She likes baby carrots, but won’t do anything else. Should I keep forcing her to eat chicken nuggets and fish? Is it ok for her to have a healthy, but kid-friendly cereal for dinner (Mini Wheats, Honey Nut Cheerios or bran mixed with vanilla granola) a couple of times a week? I also add flax meal and wheat germ to oatmeal and veggie purees to mac and cheese. Should I be concerned or do you think she’s getting enough? -Jennifer

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Reply from Beth Wallace Smith, RD:

To be quite honest, I think your daughter is eating a nice variety for a 4-year old.  Most preschool aged children are selective with their foods and preferences, and that is very normal.  Sometimes it’s quite comforting to realize that most nutrition professionals would tell you that parents really only have three responsibilities for feeding their children:   

  1. Offer a variety of nutritious foods at each meal
  2. Set regular times for meals and snacks
  3. Provide a pleasant, low stress setting for mealtimes

Your child is responsible for the rest: 

  1. What they choose to eat from the foods your provided
  2. How much they eat during the meal 
  3. Deciding when to try new foods

Really.  That’s it.  To more specifically answer your question, it is ok for children to eat similar foods over the course of days or several weeks as long as they are growing well and gaining an appropriate amount of weight.  Many children go through periods of food jags (ie, only eating foods that are yellow, or refusing all meat), but over the big picture, they receive enough of a variety to remain well nourished.  While you may want your child to increase their variety today, be patient.  Sometimes kids need up to twenty exposures to a new food before they will be willing to try it. 

Some strategies to encourage your child to eat more veggies are to make them in familiar shapes (like zucchini “fries”), let your child pick a dip to try the vegetable with, or incorporate them in some of their favorite meals (add butternut squash to macaroni and cheese, or carrots to chicken noodle soup). 

If you are worried about your child eating enough protein, remember that dairy is a good source of protein (typically 8 grams per serving), or try to mix some of your traditional grains with higher protein options (add farro to oatmeal, and lentils or quinoa to pasta dishes). 

A multivitamin might be helpful to fill in some of the holes in a child’s daily diet. Always remember that it’s best to talk to your child’s health care provider if you are concerned about their growth or weight gain. 

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Registered Dietitian at Children's Hospital of Philadelphia
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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

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Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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