- The Washington Times - Saturday, July 19, 2003

The noodles must not touch the chicken. Spaghetti, no sauce. PB and J, no crust. And for crying out loud, nothing green. For parents of picky eaters, mealtime can resemble a battle zone or a short-order kit-chen. It can become a battle of the wills or the triumph of the toddler, with Junior winning the fight to eat noodles and cheese seven nights a week.

It is a scene familiar to Laura Gorbach. Isabel, 4, the middle of Mrs. Gorbach’s three girls, primarily subsists on shrimp cocktail (no sauce), jelly sandwiches (with the crusts cut off), chocolate milk, and eggs with salsa.

Still, Mrs. Gorbach says she doesn’t make separate dinners each night. She provides some of those foods, along with whatever the family is eating.

“I always make sure there is something on the table Isabel will eat,” says Mrs. Gorbach, who lives in Sterling. “I make her try things. Sometimes she is willing to take a bite. I think she will outgrow it one day.”

Mrs. Gorbach is taking the right approach, says Dr. Christine Wood, a California pediatrician and author of the book, “How to Get Kids to Eat Great and Love It!” Dr. Wood says there are as many definitions for a picky eater as there are tricks and trials to break out of the habit.

Nonetheless, making the dinner table (or lunch box or breakfast nook) a battle ground is not the way to overcome finicky eating habits.

“It is a parent’s responsibility to provide sensible foods to eat, and it is up to the child to decide how much to eat,” Dr. Wood says. “It is not the parents’ battle to fight.”

Keith Ayoob, a registered dietitian in New York City and a spokesman for the American Dietetic Association, agrees.

“Parents can let a food battle go,” he says.

Don’t make a big deal if your child finally starts to eat, Mr. Ayoob says. “For some kids, this is a matter of control and manipulation. Parents say, ‘But he’ll starve.’ I have never known a child able to starve himself.”

Examining the situation

In observing a child’s eating habits, both Mr. Ayoob and Dr. Wood say, look at the big picture first. Sometimes, finicky eating habits may be a sign of a further problem, such as a developmental or neurological problem or a chronic illness. In older children, newfound picky eating could indicate an eating disorder.

If a parent suspects eating problems may be the sign of a more complex situation, he should ask a pediatrician for further evaluation, Dr. Wood says.

If a serious problem has been ruled out, then it is time to look at picky eating from the beginning, she says.

Often, picky eating habits take parents by surprise. One day, their baby is happily in the high chair, gobbling whatever is offered — including peas and squash. The next day, baby is a toddler refusing anything that isn’t chicken nuggets or cantaloupe.

“In my mind, what seems picky is more of a parental concern than a problem,” Dr. Wood says. “It can be extraordinarily frustrating, though. Around age 1, a child’s appetite will decrease as he moves into walking, talking and becoming more defiant. It is very normal, and if a parent were to keep putting large portions in front of a toddler, he would be headed for a weight problem.”

Dr. Wood tells parents of children in this stage to look at what a child eats over the course of a day, not at just one meal. Very likely, a toddler will eat a larger breakfast or lunch and meager dinner.

“We think of dinner as our big meal,” she says. “A young child doesn’t.”

Also, look at how much a child is drinking during the day, says Dr. William Wilkoff, a pediatrician and author of the book, “Coping With a Picky Eater: A Guide for the Perplexed Parent.” When a toddler constantly carries around a bottle or a sippy cup, he may be taking in so much juice or milk that he is not hungry.

“Children should do all their drinking at the table,” Dr. Wilkoff says from his office in Brunswick, Maine. “They should have one four-ounce cup of milk at each meal, one four-ounce cup of juice at two snacks, and unlimited water. That usually solves a lot of problems.”

Ann Loranger, a registered dietitian at Children’s National Medical Center in the District, says it is typical for children to gravitate toward one food and push away others. She says parents should provide the food their youngster likes — but in a limited amount, along with other varieties of nutritious, child-friendly foods.

“You shouldn’t tell a 5-year-old, ‘You shouldn’t be eating just macaroni,’” Miss Loranger says. “You just shouldn’t put it on the table. Parents control the environment.”

Existing on three or four foods may seem dull to an adult. There is really nothing wrong with it, as long as those foods are healthy and the parent doesn’t mind making custom-made meals, Dr. Wood says.

“Children do get hung up on certain foods,” she says. “Offer other ones. Show your enjoyment when eating them. Just make sure your choices are not terribly unhealthy. If you are only eating french fries and candy, then I would be worried.”

What about older children?

Dena Fleisher dreams about the day she can make one dinner for her family. The way it is now, she makes one dinner for her 7-year-old, Jack (who prefers pasta, string cheese and Sesame Street brand fruit juice), another for her 4-year-old, Ben (who is slightly more adventurous), and another for herself and her husband, Ric.

“I just want to cook a meal and have everyone eat it,” says Mrs. Fleisher of Herndon. “It is totally frustrating, because my husband and I love all kinds of food. We love ethnic food, and we love to go to restaurants.”

Having a picky, school-age child is almost as common as a finicky toddler, Dr. Wood says. The good news is, there is still time to break some of the habits.

For today’s children, the situation is more complex than it was years ago. With so many “kid food” choices — such as pizza, macaroni, chicken fingers and fish sticks — many children don’t have a reason to eat chicken that isn’t a nugget.

“It used to be there were about two ‘kid’s foods,’” Mr. Ayoob says. “Now there are about a dozen, most of them fried or fatty. What I tell parents is to think about healthy limits, such as saying you will serve kid favorites like chicken tenders or pizza twice a week, but no more.”

On the days parents are serving a more adult menu, they can let children feel more in control of the situation by letting them pick what else goes with the meal, such as fruits or vegetables.

Dr. Wilkoff advises easing a child into trying new foods by offering a food he likes, such as pasta, along with a small portion of something he doesn’t or has never tried, such as green beans. Offer a small portion of the pasta, so he doesn’t fill up on the favorite, and an even smaller portion of the new food, so the child can fathom actually eating the portion.

“I always tell my kids they have to take a ‘thank you’ bite, just to try everything on their plate,” says Roberta Gosling, a mother of two girls in Oak Hill, Va. Anna, 7, tends to eat from the cake, pasta and fruit groups, while Ellie, 7, will eat anything, including crabs, salmon and artichokes.

“I think Anna is just predisposed to not liking certain foods,” Mrs. Gosling says.

Dr. Wood calls this the “one bite rule.” It often works — if parents give it enough time.

“If kids will at least try something, sometimes it takes 20 times before they like it,” she says. “My own son used to take ‘one bite’ of croutons with salad. Now he loves salad.”

If a child does start eating salad, rejoice quietly, but don’t make a big deal about it, Dr. Wilkoff says. Don’t bribe children (“Eat the meat and you can have dessert — and a new Rescue Hero”) or make them feel guilty (“There are starving children in Iraq”), he says.

The backlash from doing the above can result in a child who associates mealtime with guilt and pressure, Dr. Wilkoff says.

“Bribery just doesn’t work,” he says. “Studies show it may work in the short term, but in the long run he may actually eat less.”

Finally, vitamins are a good idea to fill in the gaps for a picky eater. They should not be used in place of foods, though.

“There is a misperception that you can throw all the nutrition rules out the window because vitamins will give you what you need,” Dr. Wilkoff says. “But food offers fiber, variety and trace elements that you can’t get in a pill. I don’t want to feed the notion that the answer can be found in the medicine cabinet.”

MORE INFO:

BOOKS —

• “COPING WITH A PICKY EATER: A GUIDE FOR THE PERPLEXED PARENT,” BY DR. WILLIAM G. WILKOFF, FIRESIDE, 1998. THIS BOOK BY A PEDIATRICIAN EXPLAINS HOW PARENTS CAN SET LIMITS TO BREAK CHILDREN OF PICKY EATING HABITS.

• “FEEDING THE PICKY EATER: AMERICA’S FOREMOST BABY AND CHILDCARE EXPERTS ANSWER THE MOST FREQUENTLY ASKED QUESTIONS,” BY DR. WILLIAM SEARS, LB BOOKS, 2001. DR. SEARS, A NOTED PEDIATRICIAN, AND OTHERS OFFER TIPS ON HEALTHY EATING.

• “CHILD OF MINE: FEEDING WITH LOVE AND GOOD SENSE,” BY ELLYN SATTER, DIMENSIONS, 2000. THIS UPDATED BOOK HAS IDEAS ON HEALTHY EATING AND CHILD BEHAVIOR.

• “HOW TO GET KIDS TO EAT GREAT AND LOVE IT!” BY DR. CHRISTINE WOOD, GRIFFIN PUBLISHING, 2002. THIS BOOK HAS IDEAS FOR COMMON-SENSE “TRICKS” THAT MIGHT WORK TO GET CHILDREN TO EAT NEW FOODS.

ASSOCIATION —

• AMERICAN DIETETIC ASSOCIATION, 120 S. RIVERSIDE PLAZA, SUITE 2000, CHICAGO, IL 60606. PHONE: 800/877-1600. WEB SITE: WWW.EATRIGHT.ORG. THIS PROFESSIONAL GROUP HAS FACT SHEETS, NUTRITION TIPS, IDEAS ON HOW TO REFORM PICKY EATERS AND REFERRALS TO REGISTERED DIETITIANS.

ONLINE —

• PEDIATRICIAN CHRISTINE WOOD HAS A WEB SITE, WWW.KIDSEATGREAT.COM, DEVOTED TO THE TOPIC OF FINICKY EATERS.

• AT WWW.EMPOWEREDPARENTS.COM, PARENTS OF OLDER CHILDREN WHOSE EATING HABITS MAY BE A SIGN OF AN EATING DISORDER CAN GET ADVICE ON WHAT SIGNS TO LOOK FOR AND WHAT TO DO. THE SITE IS SPONSORED BY ABIGAIL NATENSHON, A LICENSED CLINICAL SOCIAL WORKER WHO SPECIALIZES IN EATING DISORDERS.

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