9/19/11

The Timeless Struggle with Picky Eaters

Most parents would, ideally, say that one goal of raising a family is to know your child in the deepest and most profound of ways. It seems both cliche in an age of obsessive parenting and patently obvious that there is no other choice.

Yet many parents would also accede that, for years, nuance and complexity of the child are summarily ignored. Instead, the database about said child grows from endless comparison with other children. So a parent accumulates information in binary form: good sleeper/bad sleeper, obedient/oppositional, engaging/shy. That paradigm extends to food: good eater/picky eater.
As the data grows, any curious adult wonders what it all means. It's easy to accept and revel in the positive checkmark, but what about the less desirable chits? Should a parent accept these as a child's traits, work hard to eradicate impending faults, or assume personal responsibility for faulty parenting? 
The recent trend in the psychological literature takes parents off the hook. The increasing weight on the nature component of the nature/nurture debate means adults aren't responsible for everything anymore. What a relief? Perhaps, except that this shift doesn't seem to apply to food.
Parents do have to teach kids how to eat and the role of food in our lives, but kids aren't a blank slate when it comes to eating either. Even though nature plays a role here too, that's not yet common knowledge. We still live in a world where a picky eater is undoubtedly the parent's fault. It's a lot easier to attribute delayed milestones like walking or talking to a pre-programmed developmental clock than to avoid self-reproach for a child only willing to eat cheerios, plain pasta and white bread.
In addition, there is nothing to dissuade lucky parents from taking full ownership over a child's accomplishments. And there is little more discouraging that the parent endlessly bragging about a child's accomplishments.
It's one thing if this is a nine month old who walks or the three year old reader. The the "each in his own time" theory can assuage the creeping worry.
But what about the three year old who eats sushi? Parents of picky eaters are going to have a much harder time absolving themselves of responsibility. Maybe the child needed exposure to whole grains earlier? Maybe the parent was too lenient about giving the same dinner every night, for a year? Precocious eating is practically a new developmental milestone, and picky eating a harbinger of that dreaded codeword: delay.
But, as I wrote in the last post, refusing food is a child's prerogative. It's how kids express themselves and fight to get heard. Obedience and a varied palate in a child says a lot about personality, preference and the adult-child relationship, but is certainly no sign of brilliance. One way to repackage the information is that all children are picky about something, and food, for many reasons, is an obvious and powerful option.
There are a few ways to approach picky eating. First, resist the daily fight! Nothing will entrench parent and child more than the expected duel at each meal. The child has the ultimate power to allow the food in or not. Any parent will be extremely frustrated by the regular food refusal and has to work hard to avoid forcing food or regular punishment. While repeating the mantra "no child will starve," the parent can place the plate in front of the child and just observe what happens. Yes, easier said than done but still the most effective strategy.
Some children may lose interest when denied the satisfaction of adult anger and just abandon the picky eater track. One possible result, though, of a more passive approach is a child pegged for many years as a picky eater. Considering that even limited diets in the Western world are more than sufficient to have a healthy child, family peace and normal development are much more likely if the child is allowed to assume that identity. Given some freedom to assert independence and exert choice on a regular basis gives many children peace of mind and allows family life to run more smoothly. Even these children gradually incorporate more food into their diet.
The most difficult picky eater emails I receive from families concern a child above age ten who eats perhaps three or four foods. The underlying fear is that these behaviors are the start of an eating disorder. There is no clear correlation between picky eating and eating disorders such as anorexia and bulimia. Any early warning of an eating disorder always comes with other psychological and emotional signs of distress that drive the eating behaviors.
The very rare case of a chronic, adult picky eater appears to stem from a physiological cause. Some variant of taste and preference leads these children to only be able to tolerate very limited foods. Although those foods may expand some into adulthood, a few of these children may maintain a fairly limited diet into adulthood.
For a child at risk, it's important for a pediatrician to be sure the child is healthy and rule out any underlying medical cause. Judicious use of vitamin and dietary supplements in addition to the limited but sufficient diet can keep the child healthy in the long run. Rather than creating a family crisis, parents are better off working within the limitations. As long as parents continue to gently offer new options and provide adequate food at mealtime, the child will be healthy, the ultimate goal.
As mentioned, the next post will address the tricky subject of healthy foods.

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