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More approaches to picky eating Regarding "Is the picky eater a cause for concern?" (March 2005), here are a few additional points:

Some children are picky eaters because they consume a large number of calories as juice, milk, or snacks between meals. Often, a simple switch to water and one or two scheduled snacks improves the picky behavior, because the child is hungrier.

The attitude of the parents is extremely important and should be discussed at the 12-month well-child visit. Parents who announce that they dislike certain foods in front of the child give the child permission to be picky.

It is essential that parents do not become short-order cooks for their child. If at least one thing is served that the parents know the child will eat, it's not necessary to make a separate meal for the child. Parents should approach it matter-of-factly: "This is what's for dinner tonight." When my children were younger, we had a rule that, if they said, "Yuck!" or criticized the food before they tasted it, they got no dessert. (Of course, they were free to say "yuck" after tasting it!)

Deborah A. Sedberry, MDWalnut Creek, Calif.

Author reply: Dr. Sedberry makes excellent points about monitoring children's consumption of juice, snacking, promoting family meals, and preventing parents from becoming short-order cooks. Several other points merit further discussion.

Research has conceptualized picky eating as a personality trait associated with a shy and inhibited temperament.1 If picky eating is not causing a health concern (and if a shy and inhibited temperament is likewise not causing the child undue distress), it may be more productive in the parent-child relationship to accept the picky eating as a temperamental quality, as opposed to oppositional behavior that must be eliminated or reduced.

In addition, Mennella and colleagues recently demonstrated that children have genetically-determined variable sensitivity to bitter flavors.2 Mothers who did not possess the same alleles of a particular gene for bitterness sensitivity as their child (and therefore could not taste bitterness as well as their child) perceived their child as having a more difficult temperament and being more emotional. In summary, sensitivity to bitterness and consequent "pickiness" appear to be, in large part, genetically endowed. As Mennella concluded, the fact that parents and their child often live in different sensory worlds begins to explain the obstacles parents face in attempting to shape a child's eating behavior.

It is unclear how effective it is for a parent to feign liking a food he or she finds unpalatable in an attempt to convince the child to eat it. Although parental modeling of eating is effective at altering childhood food preference in infancy,3 data for its efficacy beyond infancy are sparse. Even an 18-month-old can appreciate that a parent may hold different taste preferences.4 I suggest that it may be more effective to honestly express likes and dislikes for various flavors. That way, when the parent presents the child with a food in the future and tells her, "You'll like this," the child will have reason to believe the parent. (Feigning a preference for what the parent knows will be an unpalatable food for the child is akin to telling the child who is about to receive a shot, "This won't hurt a bit.")

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