How to Tell if a Picky Eater Might Become Malnourished

Kids can be very particular eaters. And that can make parents nervous. In an era of generalized food anxiety, with restaurants that cater to the crudest of children’s palates, early exposure to fruit juices all but given, and confusing organic labeling proliferating, it’s hard to decide what kids should be eating, much less how much. So parents may be relieved to hear that kids who focus on one food for a few months aren’t necessarily cheating themselves out of the nutrients they need. In fact, many children go through phases of unusual eating while still maintaining totally healthy BMIs.

“It is very common for young children to go through phases where they eat very few foods and seem to be ‘stuck’ on one food in particular,” explains Katie Mulligan, a registered dietitian nutritionist and childhood feeding expert. “Think about when your child has a favorite toy, stuffed animal or shirt – it can be the same for food.”

It’s also important to note that parents aren’t the best at judging a healthy weight in a child. Their understanding of whether or not a kid looks healthy is often dependent on comparison with other kids in their peer group. So just because a kid looks skinny, doesn’t mean it’s a concern. They could look skinny compared to other children in their class but still have an appropriate body mass index, the measurement of height and weight used to understand if a child is growing adequately.

But sometimes picky eaters are in real danger of not meeting nutritional needs. If parents are concerned about their child’s caloric intake, they can check where their child plots on the growth chart during their regular pediatrician appointments. Or if they feel the issue is particularly pressing they can simply make an appointment. Children grow in a predictable pattern from birth – a child’s weight or height trending down can indicate a serious problem such as “avoidance restrictive food intake disorder”. That can require intervention from the pediatrician, or a referral to a qualified practitioner like a registered dietitian.

How to Tell if Your Kid is Getting the Proper Nutrition

• Understand that children go through food phases and become obsessed with certain foods, but still get the nutrients they need to grow.
• Just because a kid looks skinny does not mean they have a problem. It could be a matter of perception. A pediatrician should be consulted if parents are worried.
• Use the USDA Super Tracker to keep an eye on your kid’s nutritional intake, share this with your pediatrician, but it’s best not to involve the child.
• Eat with your child to model good habits, but don’t get too pushy, it can cause a child to become even more hesitant to eat.

If parents don’t want to wait until the annual visit to see if poor nutrition has affected their child’s growth – or don’t want poor nutrition to get so bad that it does affect their child’s growth – they can check for themselves. The USDA manages a tool called Super Tracker to record nutritional intake. Parents can input the foods their child eats in a day and compare it to USDA recommendations. It can even suggest how the diet can be improved, says Mulligan. But it isn’t something that parent and child should do together.

“I would not recommend including your child in this process,” warns Mulligan. “Food can get very personal and the last thing any parent wants to do it make any child, especially a picky eater, hypersensitive about food and food intake.”

If a child is not achieving their recommended caloric intake or nutritional needs, or if parents want to just encourage a diverse menu, there are options. But whatever parents decide to do, they need to be patient. Childhood hang-ups about food and eating can lead to a wide variety of problems in adulthood.

Probably the most important task for parents is to simply eat with the child. Eating as a family is pretty crucial anyway; it encourages the child to try new things, as well as having a lot of other benefits. Serve the child what the family is eating – it’s important for kids to see dad eating the same thing, and liking it. Additionally, parents can use food children love to introduce other, complimentary food. A child who only eats yogurt is more likely to eat fruit if it’s in a parfait, for example. It’s okay if the child complains or refuses – they probably will at first.

Whatever happens, don’t give up – but don’t get pushy. “Practice patience without pressure,” advises Mulligan. “Continue offering your child new foods on their plate, daily, but do not pressure them to eat it. At this stage, you are just introducing things and allowing your child to explore this new world. It can take kids 20 tries to accept a new food.”