Expert advice on how to deal with picky eaters
Is your child a picky eater? If you want valuable insights and information, check out this interview with 3 medical experts from NUH, Singapore.
There is an old saying which says ‘You are what you eat’ and this applies to children as well. Nutrition is incredibly important to the growth and development of a child but unfortunately picky eating is becoming an increasingly common problem among children.
In order to get some advice on this common parenting woe, we interviewed three prominent medical experts from National University Hospital (NUH) – Associate Professor Daniel Goh, Head of Paediatric Department, Ms Ng Siau Hwei, Clinical Psychologist, Department of Paediatrics and Ms Charlotte Lin, Dietitian.
What types of food do kids need for learning and development? What should they be avoiding?
Prof Daniel Goh: There are no specific “good” food types but a good balance of types from all food groups would be essential for optimal growth and development. Too much of a good thing can also be harmful; certainly deficiency of any type can potentially be bad.
Ms Charlotte Lin: In essence, a healthy balanced diet that consists of foods from the various food groups, in the appropriate portions, will help children to attain optimal growth and development. Kids should be avoiding excessive intake of sugary foods, sugary drinks, foods that are high sources of saturated and trans fats. These foods are of limited nutritive value.
How should parents deal with kids who always eat “bad” food?
Ms Charlotte Lin: Firstly, parents need to be role models themselves when it comes to food choices. In a recent study conducted by Department of Paediatrics, NUH and Abbott Nutrition, children with a family history of picky eating were also more likely to be picky eaters. If the parent eats foods that are of low nutritive value, the child is more likely to consume those foods as well (‘Monkey see Monkey do’!).
Secondly, parents should ensure that children have fixed meal and snack times. If these boundaries are not provided, the child will more likely graze on calorie-laden, non-nutritive foods, leaving behind very little space at main meals to consume foods of higher nutritional value.
Lastly, getting children involved in the preparation of foods and encouraging food play out of meal times will encourage children to have a greater appreciation and intake of foods from the various food groups. For example, he could stamp shapes out of raw vegetables, or pretend to be a rabbit chewing on a carrot.
How does picky eating affect a child’s growth and development?
Prof Daniel Goh: Picky eating may lead to nutrient deficiencies or inappropriate balance of nutrients in the diet of a child. Some children may consume adequate calories, but the diet may be insufficient in vital nutrients. Poor eating habits developed in childhood may carry through into adult life.
Over time, this may impact growth and development. This may even contribute to increased risk for the development of chronic lifestyle diseases such as diabetes and heart disease.
In the study cited above respondents who thought their child was a picky eater also tend to perceive the child as less energetic or healthy. Nearly half the respondents reported that they were ‘very much concerned’ that their child was a picky eater. They were also worried about their child’s physical and mental development.
Picky eating may also negatively affect cognitive development in young children. Another study found that Mental Development Index (MDI) scores of picky eaters 1 to 3 years old were 14 points lower than those of healthy eaters in addition, difficulty and stress at mealtimes can lead to poor family bonding and relationship issues that can have far reaching impact on the family and community.
Go to page two for more on what causes picky eating and how to identify a picky eater
What causes picky eating?
Prof Daniel Goh: The causes of picky eating are multi-faceted. There are also psychological factors such as a struggle for autonomy, changing emotions and moods, and the level of affection or adverse interaction between mother and child.
In the NUH and Abbott Nutrition study, children with a family history of picky eating were also more likely to be picky eaters. Peer influence and the example set by parents during mealtimes within the family could also affect children’s eating behaviours and habits.
There are possibly genetic factors too; studies have suggested a higher risk of picky eating when there is a family history of similar problems.
How do you identify a picky eater?
Prof Daniel Goh: Parents can look out for the following picky eating behaviours:
List of picky eating behaviors
- Complain about what is served
- Refuse certain foods eg vegetables/fruits, meats
- Push, hide or throw food during mealtime
- Eat the same food for all the meals
- Accept only a few types of food
- Does not like to try new foods
- Eat slowly or hold food in the mouth
- Eat snacks instead of meals
- Throw tantrums at mealtimes
- Prefer only foods of certain textures eg liquids rather than solids
How serious does a child’s picky eating problem have to be in order to warrant medical/psychological treatment?
Prof Daniel Goh: The approach would be to pick up the problem early in its course and intervene promptly and appropriately; if the child exhibits the features of picky eating and the parents or caregivers are concerned, it would be appropriate to discuss with the family doctor to evaluate and find strategies to improve the situation.
The problem need not be “serious” before parents or caregivers approach a professional for help. The earlier it is tackled, the easier it is to manage and the outcomes are also better.
Ms. Ng Siau Hwei: Picker eaters typically do not have underlying medical conditions. Their growth and development may be affected as a result of poor balance of food types and poor nutritional intake. Follow up with the paediatrician and dietitian is recommended to ensure optimal nutritional intake for growth and development.
A variety of methods can be used, depending on the underlying reason for picky eating. A predominantly behavioural-based approach is usually helpful.
Examples include the use of rewards, gradually exposing non-preferred foods to the child, and pairing preferred foods with non-preferred ones. For an older child, talking to him/her to find out what makes eating certain food so difficult may also be helpful.