Picky Eating in Children: What’s Normal and When to Seek Help

Experts: Robyn Lev, MS, OT/L; Julia Marvil, OTD, OTR/L; Jessie Menzel, PhD

There is a reason most restaurants offer a kids’ menu—because children will usually turn their noses up at roasted wild salmon with Brussels sprouts and leap at the chance to eat a plate full of overpriced mac and cheese. It can be aggravating as a parent always to make sure your home is stocked up on Uncrustables and dino-shaped chicken nuggets, but it’s to be expected, and most of us have just learned to roll with it. 

You may wonder how in the world your kid can enjoy the monotony of eating the same buttered noodles for dinner five nights a week, but it’s important to know that there’s a difference between a child who will eat a variety of kid-friendly foods and one with such a limited diet that their health could be at risk. What many adults consider picky eating may actually be perfectly healthy for a child, and in some cases, too much intervention and pressure to try new foods can cause more harm than good. 

Still, there are situations when support is necessary for your child—but how do you identify that point? To help us dig into the topic of picky eating in kids, we interviewed Robyn Lev, MS, OT/L, an independent occupational therapist with a background in pediatrics, Jessie Menzel, PhD, vice president of program development at Equip, an online treatment program for eating disorders, and Julia Marvil, OTD, OTR/L, occupational therapist and pediatric feeding specialist with Cortica, an organization offering therapies for autism spectrum disorder. These experts helped shed light on what true picky eating looks like, why it may be happening, and what parents should (and shouldn’t) do to help their children. 

At What Age Does Picky Eating Start? 

In many cases, when you first begin introducing solid foods to your baby, you may think you are one of the few parents who ended up with a little one who loves everything from avocados to sweet potatoes to mangos to basically anything else they can get their cute little hands on. Then, a year or two goes by, and suddenly you’re lucky if you can sneak some spinach into their smoothie without them noticing. 

This progression is relatively normal, according to Marvil. “Picky eating is a common behavior among children that typically emerges between the ages of 2 and 4 years old.” She says that during this stage, “children may begin to refuse to try new foods, refuse familiar foods that are presented differently, show a strong preference for specific foods, or have a limited range of foods that they will consistently eat.” 

While a toddler’s shrinking range of food choices can be incredibly inconvenient for caregivers, Dr. Menzel says this behavior may actually be a good thing. “As children become more mobile, narrowing their range of preferred foods is not unusual. Researchers think this behavior may [instinctually] prevent children from ingesting something unfamiliar and potentially harmful.” 

Though not as common, in some cases, Lev says signs of picky eating may emerge before toddlerhood. “Some infants between 8 and 12 months old may demonstrate an aversion to different tastes and textures,” she explains.  

What Are Signs of Picky Eating Habits?

In the case of a baby between 8 and 12 months old, turning their head away from food, crying, and spitting out their food may indicate that they are beginning to demonstrate signs of picky eating, says Lev. 

As for toddlers, the signs are (thankfully) a bit easier to spot. Some signs the experts share include:

• Unwilling to come to the table or adamantly refusing to partake in meals. 
• Eating the foods they choose and leaving the other foods on their plate.
• Becoming upset if foods are touching each other on their plate. 
• Showing signs of stress and anxiety over the activity of eating.
• A narrowing list of preferred foods and demonstrating an unwillingness to try new or unfamiliar foods.
• Becoming more particular about the preparation, brand, or temperature of preferred foods. 
• Demonstrating sensitivity to the sensory properties of foods. 
• Consistently and exclusively eating specific foods.
• Showing a strong preference for specific textures and flavors—like crunchy foods, including crackers, chips, and dry cereal.
• Demonstrating limited acceptance of mixed textured foods—such as a lasagna or turkey and cheese sandwich. 
• Throwing tantrums or demonstrating other unwanted behaviors during mealtimes, like throwing items off their plate. 

If your child is showing some of these signs, it’s certainly worth paying attention to, but don’t jump to conclusions or panic right away. “It’s important to remember that, to some extent, it’s normal for all people, including young children, to have strong preferences when it comes to food,” says Dr. Menzel, adding, “Adults are just generally more tolerant of foods that are outside their preferences compared to children.”

Possible Reasons for Picky Eating

What happens once you’ve noticed signs of picky eating in your child? While many Millennials and Gen Xers grew up with the rule that you ate what you were served or you didn’t eat—period—now we know that there are a number of reasons why a child may be a picky eater (and it’s probably not out of sheer defiance). 

One big thing all three experts say often contributes to a child’s picky eating behaviors is sensory sensitivity. Marvil says “certain textures, tastes, colors, or smells” all fall into the sensory category and may affect a child’s eating habits. Lev emphasizes the significance of food texture, saying, “[Children] may feel such a huge aversion to food textures, which for us would be comparable to eating live worms.” 

Another factor related to picky eating is past experiences. Dr. Menzel explains, “Children who have early, negative experiences around eating may also be more wary to try new foods or eat something familiar.” She also says research has found that “disgust, fear of trying new foods, and rigid, inflexible thinking are all related to picky eating.” 

According to Lev, a child may be a picky eater because they don’t have “the oral motor development to eat certain foods, which means they cannot coordinate the food in their mouths to swallow safely.” Palate sensitivity is another thing Lev says is important to consider as a toddler with a sensitive palate may need bland foods, while others may have the opposite and “need more flavor or spice to feel the foods.”

Routine and predictability may also influence a child’s eating habits, Marvil says. “Children typically like routine. They may be naturally hesitant about trying something if it is completely unfamiliar. This is particularly noticeable with new foods, in which they may prefer eating the same foods because they know what to expect.” She also says a child’s desire for independence may result in picky eating behaviors, or there could be social influence involved, where a child “[mimics] the food preferences or aversions of those around them.” 

Finally, Marvil notes that it might be as simple as portion sizing. “Large portions of newer foods on their plate can be overwhelming, resulting in a reluctance to try the foods,” she says. Introducing one new food at a time in small quantities may offer better results. 

How To Help Your Picky Eater

Trying to help your little one overcome food aversions or anxieties associated with mealtime can be challenging, but in most cases, all three experts say the first steps of intervention can start at home. That said, any attempt to help your child expand their list of preferred foods should come from a place of love, not frustration (which can be understandably difficult at times). Some tips Dr. Menzel, Lev, and Marvil suggest include: 

• Serve foods in different ways. “If your child won’t eat puréed sweet potatoes, try sweet potato fries or sweet potato cupcakes,” recommends Lev.
• Create a safe and relaxed environment to ease anxiety. Marvil suggests minimizing distractions, such as loud noises or bright lights. 
• Model eating habits. Dr. Menzel says, “Keep many different kinds of foods available in the house and model eating them yourself.”
• Make mealtime fun. Offer kid-friendly utensils with characters or fun shapes, or skip utensils altogether and opt for toothpicks instead, Marvil recommends. 
• Let your child be part of the process. Have them help you cook or prepare the food to get them excited—just be sure to keep the focus on the fun and try not to stress out over the inevitable mess.
• Consistently present new and non-preferred foods to your child. “To help your child overcome hesitation, start by presenting a new or non-preferred food in each meal along with two other foods that are their ‘safe’ foods … by pairing new foods with familiar, well-liked foods, they can feel safe to explore, knowing that they have other food for consumption,” says Marvil. 
• Give your child some control. Lev suggests bringing your child to the grocery store with you and letting them choose what fruits and vegetables they want. Similarly, Marvil recommends offering more control at mealtimes by asking them to choose one food item they’d like to have as part of the meal (and the parents can choose the rest). 
• Change the goal from eating to exploration. “Children with a history of difficulties at mealtime often associate new foods with stress, anxiety, and a pressure to eat,” explains Marvil, so it’s helpful to encourage your child to explore rather than eat. “Children can explore foods by playing games using their senses: smelling, touching, describing (crunchy, salty, sweet, sticky, sour, etc.), licking, and breaking it apart to hear if it makes sounds, or changing the way the food looks or is presented (ex: in a bowl instead of on a plate).”
• Remember that your child is an individual. Lev stresses the importance of resisting the urge to compare your child to other children; every child is different, and so is their relationship with food. 

All three experts also note the importance of continuing to try, even when your child refuses to try new foods, more often than not. “Exposure is key,” says Dr. Menzel. “Just because your child has started to reject a particular food doesn’t mean you should stop serving it. Keep offering, or try to give it a short break and then re-offer it in smaller amounts,” she suggests. Lev echoes the significance of consistently offering new foods alongside safe foods, even when you feel defeated. “Bottom line,” she says, “if you keep feeding your child chicken nuggets, then that’s all they will eat.” 

What Not To Do

How you approach exploring new foods with your child can have long-lasting effects on their relationship with mealtimes into the future. So while consistency and resilience are important on your part, there are also things Lev, Marvil, and Dr. Menzel say should be avoided in order for your child to be successful.

• Don’t get upset. “Understand that being a picky eater creates stress and anxiety at mealtimes,” says Lev. “Getting upset with your child will only create anxiety for them.” 
• Don’t force feed. “Forcing a child to eat particular foods that they don’t want can have long-term consequences,” warns Marvil. “It may create increased negative associations with those foods, lead to disordered eating habits, reinforce them not listening to their body’s internal cues, or create greater resistance to trying new foods. Respect for the child’s autonomy and preferences is crucial for their healthy relationship with food and overall development.”
• Don’t focus on getting your child to like new foods. Dr. Menzel says the goal is to get your child to try new foods, not necessarily like them. “It can take people many times to try a food before developing a liking for it,” she says. “So, as long as your child continues to try and experiment with new foods, even if they don’t end up eating a whole serving of it, you’re on the right track.”
• Don’t relinquish all control. Having your child constantly reject new foods can become exhausting, but Marvil urges caregivers not to just give in to serving only preferred foods. “Giving into every food quest of a young child may lead to significant imbalances in their nutrition and the development of unhealthy eating habits,” she says. “It’s important to set boundaries … and to consistently offer a variety of nutritious foods to help them develop a well-rounded palate and positive relationship with a variety of foods. 
• Don’t withhold preferred foods. “It’s more important for mealtime to focus on nourishment and eating enough food for your child to grow. It should feel like a safe space to experiment and try new things,” Dr. Menzel explains. “If meals are feeling like a high-stakes environment where there are big emotional consequences for rejecting food, that’s probably not going to set your child or your family up for success.”
• Don’t bribe or offer rewards for trying new foods. “Bribing children to eat non-preferred foods can be as simple as making them eat their vegetables before having dessert,” says Marvil. “In general, we want to avoid this language, as it can lead to unhealthy eating habits, such as seeing specific foods as ‘good’ vs. ‘bad,’ and dependence on rewards. It may also undermine their intrinsic motivation to try new foods.”

When To Seek Help For Your Child’s Picky Eating

While at-home interventions work for many children with picky eating habits, sometimes seeking professional help is the best option for others. All three of our experts agree that parents who suspect there is something more going on with their child—even if it’s just a gut feeling—should talk to their health care provider for more insight. 

“The general rule of thumb is that if a child is selective but eating greater than approximately 30 foods, it is typical,” explains Marvil. “If a child is eating less than 20-25 foods and is not receiving enough balanced nutrition, don’t hesitate to speak with your child’s health care provider or a feeding specialist for additional support.”

Your child’s pediatrician is a good place to start, but Lev says reaching out to a pediatric occupational therapist is another option. “The occupational therapist will perform a full evaluation to assess developmental skills and age-appropriate development and perform a sensory profile/assessment,” she says, adding, “The therapist will [also] ask you questions on how your child behaves in different situations.” In some cases, regular occupational therapy may be suggested; in others, they may refer you to another specialist. To get the most out of this appointment, Lev suggests coming prepared with a list of questions and concerns you want to discuss with the provider. 

Dr. Menzel says that in some cases, picky eaters can go on to develop an eating disorder called ARFID (avoidant/restrictive food intake disorder). “[ARFID is] the most common eating disorder in school-aged children,” she warns. “It is a serious illness that can have significant consequences for a child’s emotional and physical well-being, and it does not get better on its own.” She further explains that picky eating becomes considered an eating disorder “when your child stops growing, loses weight, develops a vitamin or mineral deficiency, they become dependent on liquid supplements—like Ensure and Carnation Instant Breakfast—to get their nutrition, or when their eating habits start to get in the way of school, family, or friendships.” 

Still, given the potential consequences, while you shouldn’t ignore picky eating, Marvil says it’s also important to remember that it is a typical part of development for most kids. “Having a child that is selective with their foods can be a challenging and time-consuming task,” she says, “but with patience, persistence, and the right strategies, it is possible to help your child overcome their feeding challenges and establish healthy eating habits.”