Picky Eater Or Feeding Concern? When To Call The Pediatrician

Mealtimes can be tricky when your child only wants to eat a very limited number of foods. Fortunately, although it can be frustrating, lots of preschool kids go through a period of picky eating. "It can be developmentally typical for a child to have strong food preferences, eat more on some days than others, or go through periods when they seem to eat only a handful of foods," Lisa Kelly, a pediatric nurse practitioner with Nemours Children's Health in Delaware, assured Mom exclusively.

In some cases, however, parents might feel that their child's habits go beyond standard pickiness. "Parents should pay attention to signs such as poor weight gain, declining growth patterns, low energy levels, frequent illness, constipation, or noticeable changes in school performance or physical activity," said Dr. John Stutts, pediatric medical director and nutritionist at Abbott.

Keep an eye on your child's behavior at the table, too. Other red flags can include difficulty chewing or swallowing, taking an excessive amount of time to eat, or a child who avoids mealtime altogether, Kelly explained. "I also look at the variety of foods a child is eating," she said. "For example, a child who eats a limited number of foods but still has some variety across food groups may be very different from a child whose diet has become extremely narrow or who is eliminating entire categories of foods." It's also a good idea to consult a pediatrician if you have an older child or teen who is continuing to struggle with picky eating, since this can affect how they socialize with other kids their age and may signal body image issues.

To prep for a pediatrician appointment, Lisa Kelly recommends tracking your child's preferred foods and food groups, as well as any refused items or poor reactions to new foods. This data can be helpful for noticing patterns, like if a kid has an aversion to a particular category. When in doubt, go with your gut. "If something about their child's eating doesn't feel right, it is reasonable to bring it up with the pediatrician even if the child is still growing normally," Kelly advised. A consultation with an expert can help put your mind at ease or provide resources to take action.

Sometimes all it takes is a little perseverance. "One of the most effective strategies is to keep offering a variety of foods without pressure," Dr. John Stutts explained. "Children often need many exposures to a new food before they're willing to try it." For instance, you could help kids explore vegetables by doing meal prep together. You can also offer a choice of two items from the same food group, or serve family dinners buffet style to give them plenty of healthy options. If your kid enjoys yogurt, you could use it as a dip to make less-familiar foods more enticing. 

With older kids and teens, collaborate on menu planning and cooking, as well as discussing their food preferences, while making suggestions together for foods to taste. "What I encourage parents to avoid is forcing bites, using food as a reward or punishment, or turning mealtimes into a negotiation," Stutts advises. "A calm, supportive environment helps children build confidence and healthy eating habits over time."