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Rachael Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare Executive, and Medical Economics.
Many parents struggle with picky eaters, and it is a common complaint among parents who use federal supplemental nutrition programs, too. Recent research highlights how pediatricians can help.
Tackling the issue of picky eaters is common across the span of childhood and is also a common concern raised among parents who rely on the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Parents may have a hard time finding food choices that appeal to their children and experience guilt over picky eating habits. In an editorial published in the Journal of Nutrition Education and Behavior, Julie Reeder, PhD, MPH, MS, CHES, senior research analyst for the Oregon Health Authority WIC Program, Portland, Oregon, chair of the American Public Health Association (APHA) Food and Nutrition Section, and associate editor of the Journal of Nutrition Education and Behavior, highlights 2 recent studies addressing picky eaters and cooking training programs.
The editorial,1 which focuses primarily on picky eating, emphasizes the role of parental guilt, noting that it is internalized much more by mothers than fathers. “In fact, mother’s concern explained the relationship between perceived fussy eating and nonresponsive feeding practices,” Reeder notes.
In one of the studies, focusing on maternal and paternal responses to picky eating, researchers dove into the relationship between parents and their picky eaters.2 The takeaway was that the concerns of the parents, particularly mothers, about their child’s eating habits can provide great insight and some ideas for interventions. Taking the time to really talk to parents about what their child is eating and not eating, and what factors play a role in this, is the first step to providing help, Reeder notes.
The other study reviewed in the editorial discussed a 6-week cooking class for low-income parents and their children focused on vegetable preparation.3 The 2-hour classes taught the parent and child how to prepare a dish and then sent them home to replicate the recipe. The study addressed problems with cooking confidence, knowledge, and access, and found improvements in how parents felt about cooking with vegetables, the variety they used, and how much they used vegetables in home meals after the courses were complete.
Addressing picky eating is difficult for all parents, but Reeder explains how managing this issue differs among low-income parents and WIC participants.
“First, WIC staff are well versed in addressing these concerns, giving you a reliable partner to help address these issues with families. Taking time to meet your local WIC staff, inquiring how they address these topics with families, as well as coming to agreement about your shared messaging and resources can help families receive consistent advice and support,” Reeder says, adding some advice to pediatricians. “Updating your knowledge of the food items offered in the current WIC packages can also help shape your conversations with families in WIC, as it is likely those foods will be in their household.”
Pediatricians can offer families guidance on new food ideas and strategies to help children try new foods.
“The second way it differs is that for families with a limited income, the common adage of it taking 10 or 12 times of introducing a new food before a child accepts it, and therefore to just keep buying and offering no matter if they eat it, may not seem realistic,” Reeder says. “Lower-income families are quite thrifty shoppers and are not likely to purchase foods they know their children won’t like and will end up being wasted.”
Lastly, Reeder says parental guilt must be considered by clinicians when offering counseling in order to find effective interventions.
“Many lower-income parents may be experiencing food insecurity currently themselves or grew up with uncertainties about an adequate supply of food. This may increase their feelings of anxiety or guilt related to their child’s unwillingness to eat a greater amount of variety of foods. Although concerns about food security and limited income to purchase foods that may be wasted are ones to keep in mind, they do not mean that feeding and picky eating concerns should not be raised with families in WIC,” Reeder says. “Rather, asking parents about their child’s most- and least-favorite ‘WIC foods’ opens a way to discuss eating concerns with foods that will be present in the household.”
How to help
Reeder suggests that pediatricians supplement efforts by WIC staff by having conversations with parents of picky eaters and may utilize programs such as WIC, asking parents open-ended questions to assess their child’s eating habits and any feelings of guilt the parent might be having.
“Simply asking ‘how does that make you feel’ when a mom shares that her 3-year-old only wants to eat chicken nuggets every day for a month can be a good way to start. Reassuring parents that almost all children go through periods when they can seem quite picky and that it is a natural way for them to assert their growing independence can go a long way toward lessening a parent’s guilt or anxiety,” Reeder suggests. “Rather than jumping to tricks or tips to try to push the child to eat more in quantity or variety, which often backfires, focus on bringing a more holistic notion of a nourishing mealtime to the conversation.”
Reeder says she hopes the editorial will help pediatricians, WIC staff, dietitians, and other clinicians better assess their approaches to discussing eating concerns with their patients and families. Work toward reducing pressure and guilt for the parent and child and offer support.
“Family mealtimes are about much more than just the ingestion of a certain quantity of calories and nutrients,” she says. “Asking the parent to name one thing the child eats now that they didn’t before, celebrating even the smallest of successes, and bringing joy back to mealtime will help eliminate pressure and guilt for both parent and child.”
1. Reeder J. Being responsive to parents’ concerns about fussy eaters. J Nutr Educ Behav. 2018;50(8):756.
2. Harris H, Jansen E, Mallan KM, Daniels L, Thorpe K. Concern explaining nonresponsive feeding: a study of mothers’ and fathers’ response to their child's fussy eating, J Nutr Educ Behav. 2018;50(8):757-764.
3. Overcash F, Ritter A, Mann T, et al. Impacts of a vegetable cooking skills program among low-income parents and children. J Nutr Educ Behav. 2018;50(8):795-802.