I’m excited about the newly released book: Helping Your Child with Extreme Picky Eating: A Step-by-Step Guide for Overcoming Selective Eating, Food Aversion and Feeding Disorders. Katja Rowell has teamed up with Jennifer McGlothlin to fill a real void out there for struggling kids and parents. Their book is research-based, extensive and written in a supportive way. But instead of me going on about it, I asked the authors to answer the most frequent questions I receive from parents.
What is the telltale sign(s) a child’s picky eating is extreme and not just the typical eating stage that many children go through?
Perhaps the most important sign is the child’s attitude around eating and food. Does she get overly upset about new foods, or entire food groups? Is she missing out socially because of food? Is your family meal a battleground or negotiation session rather than a time to enjoy each other and share food?
Has your preschooler never eaten a single vegetable or fruit? Does your toddler gag regularly or have trouble chewing or manipulating foods in his mouth? Does he pass on all meats except those that require little chewing (think nuggets)? Has he struggled from the beginning or did he eat well until 18 months and then begin whining for favored foods? Does he seek out or avoid certain sensory qualities: only wanting spicy or salty foods, or preferring crunch and avoiding soft, moist foods? These are all indications that parents may be dealing with more than typical picky eating.
There is almost always an underlying reason that starts a child and his parents down the path of feeding difficulties. We encourage parents to gain a deeper understanding of where their child is coming from and have divided common challenges into five basic categories— from the child’s point of view.
- Medical: “It hurts! It doesn’t feel good!”
- Oral Motor: “I can’t”
- Sensory: “I don’t like how this feels/tastes/looks/sounds. I’m uncomfortable.”
- Temperament and Mood: “I don’t want to! I want to do it my way.”
- Negative Experiences: “I’m scared _______ will happen again.”
Generally, if a parent is spending a lot of time and energy trying to get a child to eat more or different foods, then it is likely more than just typical picky eating.
I often hear from parents that they have tried the soft approach (DOR) and more forceful types, only to throw in the towel. Can you describe your approach for dealing with extreme picky eating and what realistic success looks like?
We believe strongly that pressuring, bribing, and coercing is counterproductive for the overwhelming majority of children. The Division of Responsibility is the foundation of our STEPs+ approach, with the what, when, and where up to the parents and the child choosing whether and how much to eat (always with at least one safe option available). However, if a child is panicking or gagging around new foods, or is “underweight”, this feels hard to put into practice. Our book explains in detail how to make the transition with 5 key steps to support a child’s eating:
Step 1: Decrease stress, anxiety (yours and your child’s), and power struggles
Step 2: Establish a routine
Step 3: Enjoy pleasant family meals
Step 4: Build skills in “what” and “how” to feed
Step 5: Strengthen and support oral motor and sensory skills with specific therapy based tips at home.
Parents may have a hard time letting go of bribing, or pushing ounces or vegetables. It all boils down to trust, and parents can have a hard time trusting their children to eat well— understandably! Many parents have been told that their child “can’t” sense hunger, or that “only neurotypical” children can be trusted with eating. This is not supported by research, and many children have never had the opportunity and support to tune in to appetite.
Parents need to be encouraged to respond to their child’s unique needs while nurturing and facilitating progress, even with more than one challenge. For example, we suggest ways to wean from distractions like iPads, how to introduce and bridge to new flavors and textures, how to ease a child into a routine if he’s used to sipping Pediasure all day… Our strategies are centered around relationship-building, feel better than fighting over every bite, and won’t feel like therapy!
For children with medical, oral motor, or sensory challenges, involving a skilled feeding therapist to help your child build skills can speed up progress. We review different therapy approaches, how to find a therapy partner, and red flags for counterproductive therapy.
Parents who are unsure of the process, or who want their child eating five new foods by Friday will likely be disappointed, throw in the towel and resort to pressure. If anxiety and gagging are entrenched, or there has been a lot of pressure and even force-feeding, the healing process takes months (occasionally years). If parents only follow parts of the approach, while still forcing certain foods, this slows or stops the rebuilding of trust.
Negotiating, bribes and pressure increase anxiety. (“How many bites will I have to eat of X tonight?” or “Will I gag if they make me eat one bite of cherry tomato?”…) Anxiety decreases appetite, so creating a situation where the child feels comfortable and safe at the table goes a long way to improving a child’s ability to tune in to hunger signals and eat to fullness. If a child has butterflies in her stomach, there’s no room for food!
The first glimmer of progress parents need to look for is not how many bites or how much green smoothie a child sips, but the attitude around food. With progress, parents begin to trust their child around food. Parents notice less anxiety, more calm moments and smiles at the table, and a willingness to be around unfamiliar foods. Then the child expresses curiosity about foods, and later begins to engage with new foods, eventually asking to try some, or slipping it onto their plate. We’ve had children try new foods and discover hunger cues within a matter of days, while for others it may take a while— but the lifelong relationship they are building with food will pay off in the end. Attitude has to improve before the child feels safe to branch out.
Once you decide a course of action, how can you get other family members on board (spouses/ex-spouses, daycare/school staff and relatives)?
We often see one parent who believes in and wants to follow the STEPs+ approach, while the other is unsure or worried, or there are skeptical grandparents. Learn as much as you can and address fears. (Maybe your child is getting more than enough protein, or a supplement with snack can fill in a nutrition gap while you are waiting for eating to improve). Find support from other parents; Mealtime Hostage has a private forum on Facebook that is an excellent resource.
With that said, helping others come to the same understanding is difficult. It can help to ask them to “follow your lead”. Many families find that allowing one parent/caregiver to take the lead works well. Before you make big changes, review what you have tried so far and how things are now. (Our book includes several “food for thought” exercises to help with these discussions.) If nothing you have tried has helped and may have made matters worse, agreeing on the need for a new approach is a start.
Sharing objective information (articles, books, blog posts) helps explain what you are doing (and why) in a non-emotional way. Most importantly, sharing progress (no matter how insignificant it seems) helps everyone see how the new approach is helping.
For example:
- your son stayed calmly at the table while you sat next to him eating stew where a few weeks ago he would have cried and gagged
- he came happily to the table without complaint or anxiety about what he would eat
- he passed the beans without gagging or complaining
- he asked about a new food
- he sampled a new food at school
Keeping a journal is a great way to track progress. (Chapter 9 reviews what the stages of progress looks like and what to expect.)
For more info on extreme picky eating check out Helping Your Child with Extreme Picky Eating or visit the Extreme Picky Eating Help website.
I would like Helping Your Child with Extreme Picky Eating because I need any help I can get. I have two picky eater children. My oldest is slightly better at trying new things, but once he tries it he doesn’t progress from there. My youngest is impossible, but she’s 3 (will be four in October). I just need help. I’m at my wits end!
I also liked the facebook page for an extra entry!
I am a pediatric Occupational Therapist and I would love this book to add to my repertoire of info and resources for the parents and families that I work with!!
I’d like a new strategy for dealing with food. My daughter rarely eats a vegetable or meat that isn’t hiden and it stresses me out!
I also like the facebook page 🙂 thank you all the great info!
I would love this book so I can use these techniques to help my ASD son & his younger brother who has learned to copy his “extreme picky eating” behaviors. Thank you!
I “liked” Extreme Picky Eating Help on Facebook! I’d “love” it if I could!
I would love to win this book and learn how to help my picky 2 year old daughter. I also have twin 5 month old girls that I feel may have similar food pickiness like their older sibling 🙂
I’ve liked Extreme Picky Eating Help on fb 🙂
I would love to have this book if it could help with my son’s eating (or lack of eating). He’s almost 13 years old & weighs only 68 pounds. We have talked to the pediatrician and have worked with a therapist with no improvement in eating habits. If the techniques in this book could help, it would be wonderful.
I have liked Extreme Picky Eating Help on Facebook
I’d love a copy of this book! I have two extremely picky eaters. They both have a very short list of foods they can eat (at ages 10 and 8), and it has become a very difficult issue in our lives. (Our 3 year old is a great eater, enjoys trying everything — so our techniques thus far haven’t seemed to play a role in helping/ hurting with our eaters.) Just not sure what to do!
I am so grateful to you for referring me to Katja over a year ago. She has helped me so much by turning a bad situation into one that is so enjoyable and simple. I have this book and it is so full of great advice and techniques. I think every parent could benefit from this book.
I am a pediatrician and would love to add this book to our library!
We have huge troubles with our 2-year old; she doesnt want to try any fruits. Same goes for veggies. We are simply worried that she’s not getting enough vitamins. We tried everything, blending, masking, fruit yogurts, juices and nothing works. She has extremely sensitive taste buds that she notices if we add small slices of apples in her cereals.
I need help with my picky eater because I’m scared he’s not getting the proper nutrients. He’s too often hungry and miserable yet I can’t get him to eat properly! I’m at my wits end.
I’d love to get a copy of this book. I’ve followed Ellyn Satter’s DOR for about 1.5 years now, and while meal times are more comfortable, I am pretty unhappy with the extremely limited palate my 5-year old has. He was born 6 weeks premature, and had reflux for the first 9 months of his life. He was very slow to start with eating, since he was very sensitive to textures and gagged a lot. I feel like his list of foods he’ll eat has actually whittled down a little since DOR, although the atmosphere at the table is much better! Thanks for hosting this giveaway!
I would love to read this for my 6 year old. My 3 year old is a wonderful eater and I think my 6 year old is slowly showing signs of improvement but more help never hurts. Thanks
I need this book. We have 11 and 7-year olds who are beyond picky!! They’ve needed therapy, and we haven’t provided it. Help! Not to mention that my husband is even pickier. Yep. Stress.
I liked the Extremely Picky Eating Facebook page…honestly, my family could have a reality show about their extremely picking eating.
I would love to have this book to help my 7 year old son, who is an “extreme picky eater” with special needs.
I also liked the Extremely Picky Eating Facebook page.
Most people are 50-65% water, my son is at least 75% pasta. He’s eleven years old and I keep waiting for it to get better. It isn’t. I’m now invoking impending puberty as a reason to eat a more varied diet. He says he wishes he could but pretty much takes micro-nibbles of anything new. The new foods don’t stick. My pediatrician’s opinion is that I could go the specialist route but that I could end up making it worse. She says not to make it an issue, but I can’t help but think there must be something I should be doing different. His younger sisters are also refusing food at dinner out of principle.
I would love a copy of this book please. My 2.5-year-old has been very slow to wean (in fact I feel like I’m still weaning him). You can count on one hand the number of different foods he eats. It’s been a shock to start weaning my youngest this month – I didn’t realise that they could just open their mouth for food! I would love to be able to do more for my eldest…
I am the grandmother of 7 grandchildren, all who seem to have their very own eating agenda. I would love to share this with their parents, besides reading it myself. I grew up with the clean plate generation and I’m convinced it created eating problems in some of my children. I would use this book not only to educate myself but to share with my children. I would also love to review it on my blog.
I liked extremely picky eating facebook page
This this book would be helpful because my two year old son went undiagnosed with a tongue tie till he was 2 years old. he is now 4 with very picky eating habits his main obstacles are textures and temperatures. he also struggles with chewing tough foods especially meats. right now it’s been a struggle to get him to eat any vegetables. I believe this book could really be a useful tool in helping my son as well as myself overcome the dinner time struggles.
As a dietitian, I am constantly counseling parents whose children seem to have developed picky habits. I would love to delve deeper into this world and be able to offer sound advice. Thanks
I would love to receive a copy of this book. My young daughter struggles with eating foods with even the mildest texture because of a storied history of food allergy reactions. Our family has been trying to figure out how best to help her. Maybe this book is the ticket!
As a dietitian who frequently consults with clients who are moms with young kids, are currently pregnant, or are planning to become pregnant, this would be a truly helpful addition to my library and professional toolkit!
I would love a copy of this book to help me with my 2 year old son who is still only eating pureed food and cheese. Dinner time is a challenge everyday, especially when we are traveling and I can’t make my usual purees for him. We need help!
As a mother of two children and pediatrician, I have experience with picky eating both first hand as well as within my clinical practice. Being a mother has helped me better appreciate how truly challenging it can be to ensure children have a healthy diet and develop a positive relationship with eating and food. I greatly look forward to reading “Helping Your Child with Extreme Picky Eating” and getting further guidance on fostering the growth of both my own children as well as my patients.