Picky eating is a common problem during childhood: it affects 8–50% preschool children . It is characterized by refusal to eat or a diet restricted to certain foods, an unwillingness to try new food (called 'food neophobia'), low enjoyment of food and slow eating .
Having a picky eater can be stressful for parents, as they often worry about their child's nutrient intake, may experience conflict during mealtime, and have to provide a separate meal that's different from the rest of the family. Health professionals, however, may dismiss parents' concerns as they tend to regard picky eating as a normal aspect of early childhood which eventually passes .
When to be concerned?
- Persistent picky eating that doesn't end by age 6 or develops after age 6 should be assessed by a clinician, as it may be a risk factor for adverse mental health outcomes .
- More severe behaviors, which could indicate infantile anorexia: food refusal for at least 1 month that is not explained by problems with the oropharynx or gastrointestinal tract; acute and/or chronic malnutrition, parental concern about the toddler's eating expressed by coaxing the toddler to eat more, allowing or introducing distractions and play during feeding, feeding the toddler frequently, and at night, offering many types of food, experiencing and expressing worry and frustration, intense parent-toddler conflict at mealtime, and/or force-feeding the toddler on at least 2 occasions .
What can parents do to avoid picky eating?
- Having a healthy diet during pregnancy, as exposure to flavors through amniotic fluid may increase food acceptance [4,7].
- If mother is breastfeeding, having a healthy and diverse diet and delaying the introduction of complementary foods until 6 months may increase the chance that the child will learn flavors in all foods consumed by mother [4, 7].
- Highlighting the fun of preparation and cooking food and co-participation in food-related activities such as grocery shopping or gardening [5, 6].
- Frequently exposing children to different foods .
- Creating a positive, stress-free emotional climate at mealtime and not engaging in controlling practices such as restriction of unhealthy foods or pressure to eat healthy foods:
- Restriction of food leads to increased requests for the restricted foods, eating in the absence of hunger, overeating when gaining access to the food, and a higher body weight.
- Pressure to eat healthy food might promote problematic relationship with eating and body image [5, 6].
- Giving the child autonomy and respect: a belief that parents should decide how much their children need to eat and that the children should obey this decision can lead to less healthy eating .
- Don't just talk the talk; walk the walk too: children learn to accept foods by observing others eat them, rather than through moral reasoning [6, 7]
 Mascola, A.J., Bryson, S.W., & Agras, W.S. (2010). Picky eating during childhood: A longitudinal study to age 11 years. Eating Behaviors, 11(4), 253-257.
 Cardona Cano, S., Tiemeier, H., Van Hoeken, D., Tharner, A., Jaddoe, V.W.V., Hofman, A., . . . Hoek, H.W. (2015). Trajectories of picky eating during childhood: A general population study. International Journal of Eating Disorders, 48(6), 570-579.
 Chatoor, I., Ganiban, J., Hirsch, R., Borman-Spurrell, E., & Mrazek, D.A. (2000). Maternal characteristics and toddler temperament in infantile anorexia. Journal of the American Academy of Child & Adolescent Psychiatry, 39(6), 743-751.
 Shim, J.E., Kim, J., & Mathai, R.A. (2011). Associations of infant feeding practices and picky eating behaviors of preschool children. Journal of the American Dietetic Association, 111(9), 1363-1368.
 van der Horst, K. (2012). Overcoming picky eating. Eating enjoyment as a central aspect of children's eating behaviors. Appetite, 58(2), 567-574.
 Dovey, T.M., Staples, P.A., Gibson, E.L., & Halford, J.C. (2008). Food neophobia and 'picky/fussy' eating in children: A review. Appetite, 50(2-3), 181-193. doi: 10.1016/j.appet.2007.09.009
 Addessi, E., Galloway, A.T., Visalberghi, E., & Birch, L.L. (2005). Specific social influences on the acceptance of novel foods in 2-5-year-old children. Appetite, 45(3), 264-271.