Getting children to eat can feel like a Sisyphean task. Why are some kids picky eaters and what should parents do?

Kati Wyatt’s youngest child, TJ, ate like a normal toddler until around the time he turned 3.

Then, Wyatt said, “He started cutting foods out. The one that I remember the most is applesauce. He cut it out because, ‘That’s for babies.’”

And that was the explanation TJ repeated as he gradually stopped eating meat, fruit and vegetables — one after another. Today TJ is almost 6 and, Wyatt said, “The closest he’ll come to a fruit is a lemon-flavored Oreo.”

But TJ didn’t just eliminate foods groups. He became increasingly selective in other ways, as well. “He wouldn’t eat just any cheese stick,” Wyatt said. “It had to be a specific brand of cheese stick — it has to be the Sargento brand. Or the Tillamook cheddar.”

The family’s pediatrician wasn’t worried; TJ’s weight was low, but his growth followed the normal curve for his age. But Wyatt and her husband were concerned enough to seek out a food therapist.

The idea of having a food therapist — a credentialed expert in getting children to eat — may seem odd in a nation where childhood obesity is considered a public health crisis. But for parents confronting the problem of a child who won’t eat, sometimes professional help is required to evaluate what is behind the child’s aversion to food.

In other words, your child may be a “picky eater” but that doesn’t mean that he or she has been spoiled. There are all sorts of things that can cause resistance to eating, including medical problems like allergies or a sensory processing disorder.

Wyatt had tried the standard parenting tricks, which had worked with her two daughters, like offering money or another reward for eating.

“But with him, he was like, ‘Nope, I don’t need a dollar. I don’t need that toy after all, it’s OK.’”

Wyatt was baffled. But she wasn’t worried until her son started kindergarten, when he would come home from a full day of school having eaten nothing but a cheese stick. “He was looking like he was leaning out a little bit,” said Wyatt. “He wasn’t dropping weight drastically, but I could definitely tell his pants were looking a little looser than they had over the summer.”

Enter the food therapist.

Where does picky eating start?

First, some context: Sometimes pickiness is just a matter of one’s inborn temperament, according to Norma Olvera, a University of Houston professor who specializes in childhood obesity. Even nursing mothers observe that some babies are more interested in breastfeeding than others, she said.

But, usually, parents see a shift a bit later, when they watch their child morph from a happy baby in a high chair, cheerfully sampling everything you put in front of them, into a scowling toddler or preschooler who categorically refuses to even have take a single bite of asparagus. 

In the midst of such battles, parents can feel very alone. However, we can take heart in the fact that picky eating is so ubiquitous across cultures that many experts consider it a normal developmental phase that have been useful as humans were evolving. 

“There is an evolutionary theory that as toddlers gained independence and ventured further from their parents, a ‘fear of new foods’ would protect them from eating poisonous substances in the wild,” said Hazel Wolstenholme, a psychologist who specializes in feeding and helps clients around the world with their picky eaters. “This is one reason why we often see eating challenges starting at around 18 months of age, along with many other developmental changes that happen at that time.”

Generally speaking, picky eating peaks around two years of age, coinciding with the rise of what psychologists call “neophobia,” a fear of new things,” said Sharon Donovan, a nutritional sciences professor at the University of Illinois-Urbana Champaign.

“For example, they may become afraid of strangers or new places or activities,” said Donovan, who also holds the Melissa M. Noel Endowed Chair in Nutrition and Health. “Fearing new foods is consistent with this developmental stage.”

Around this time, children also become more willful and they begin to attempt to exert an impact on their environments — including food and those who offer it.

Strategies to try

Experts have numerous strategies to get your picky eater to put some food in that body of theirs. While the strategy a family takes should also be determined by the reasons the child became a picky eater in the first place, Wolstenholme said, experts agree on one thing: food should be taken out of the realm of rewards and punishment. That means no bribing and no using food as a reinforcement. For anything — whether it’s success at school or eating one’s vegetables.

Rolling back the tide of picky eating starts even before we get to the table. Children should have a predictable routine consisting of three meals a day and two to three snacks. Parents should not allow their children to graze in between these set times, Wolstenholme said.

At the grocery store, let children select healthy foods they are curious about or want to try. At home, parents should involve the children in meal preparation however they can. A child who helps mom or dad make dinner is more likely to taste the food, Olvera said, who added that parents should also encourage children to experiment. Olvera offered the example of a boy who combined spinach, shredded carrots and ground beef to make hamburgers. 

Once you’re at the table, keep meal time casual and low pressure. Wolstenholme suggested putting the food in the center of the table buffet-style, handing children an empty plate and letting them choose what they want. But if you want to continue serving your children, keep portions small and don’t push your kids to clean their plates. 

In order to keep anxiety low, at every meal or snack there should be something that the child already eats, Wolstenholme said, adding that parents shouldn’t get alternative foods for children during or after the meal.

And while it’s important to offer a variety of foods and to introduce new foods, don’t pressure children to try them. “Even gentle encouragement, or feeling watched at the table, can feel like a lot of pressure to children,” Wolstenholme said. “Do everything you can to take the focus off their eating.” 

Talk about your day, letting food become not the focus of the meal but, rather, part of the atmosphere. 

Use empathy to connect

Believe it or not, there are also ways to turn the curse of picky eating into a blessing that helps you deepen your connection with your child — with the side benefit of getting them to eat more, too, said Stephanie Meyers, a registered dietitian and nutritionist who is also the author of “End the Mealtime Meltdowns: Using the Table Talk Method to Free Your Family from Daily Struggles over Food and Picky Eating.” 

Just as teachers and parents of young children are advised to get down, physically, on the child’s level when talking to them so they aren’t towering above the child and can make eye contact, Meyers suggests that parents get on the kids’ level. 

“Be curious about our kids’ rejection or resistance. They’re like, ‘I hate broccoli.’ Rather than trying to defend why broccoli is a wonderful endeavor just ask them, ‘What are you noticing about broccoli with your nose?’” said Meyers. And then follow through by asking about their other senses, as well. How does it look? How does it feel? How does your stomach feel when you look at it? 

“When you are a deep listener as a parent asking your child an open-ended question about their experience of broccoli, that shifts how they feel about themselves as an eater,” said Meyers. It also holds the potential to strengthen your bond with them. (Meyers discusses these methods at greater length in this episode of the podcast “Your Anxious Child.”)

When to seek help

While it’s unlikely that your child’s picky eating will go beyond a normal developmental stage and morph into avoidant/restrictive food intake disorder, known as ARFID, it is possible. If parents are concerned that a child isn’t getting enough nutrients or that their child’s restrictive diet is negatively impacting their growth and weight, they should consult their pediatrician.

Parents should also seek professional help if they feel that their child’s picky eating is “impacting family life by creating stress or making it difficult to go to school, events, birthday parties and family holidays,” said Wolstenholme, who added, “A parent should seek help at any point they have questions or feel worried — regardless of what their child’s eating looks like.” 

By the time the Wyatt family got to food therapy, not only was Wyatt frustrated and worried, but her son’s pickiness was affecting family life. “We can’t go anywhere without thinking, ‘Did we get food for TJ?’” she said.

In food therapy, Wyatt learned some new approaches to handling her son’s selectiveness. For example, with the therapist’s help, Wyatt used food chaining, which is supposed to expand children’s palates by starting with a food the child already likes and then having them point out the differences and similarities in other foods. For example, the therapist had Wyatt bring in Ritz crackers, one of TJ’s favorites, along with round tortilla chips. And then she had him compare the two. The idea was to use these connections to get TJ all the way to eating an apple.

The therapist also gave TJ a chart of steps to take to try new foods. The first steps were looking at a food, smelling it, touching it, and then progressed to licking the food or holding it in his teeth. The last steps were ant bites, wolf bites and, finally, a big alligator bite.

The chart also helped the Wyatts honor TJ’s efforts and victories. “As he would go through the steps, we would just celebrate however far we got,” Wyatt explained. “There would be days where he’d be like, ‘Mom, I touched a new food! Mom, I licked a new food!’”

Despite these successes, Wyatt is backing off of food therapy for now. Instead, they’re focusing on some of the behaviors that might be driving the pickiness.

“At this point, I don’t know what to do. I’ve reached my max,” said Wyatt. “I’m worried and hopeful and all the different emotions all in one.”