Why are children choosy about food

Good advice for concerned parents

If toddlers are picky, refuse to eat or eat very one-sidedly, this can make parents very insecure. They often worry about their health, want stress-free meals again, and feel helpless. Competent advice from your family doctor can help you deal with the situation. In this way, the information that this is usually a temporary situation can provide relief. If parents perceive their role model function and support the child in his need for autonomy and the experience of hunger and satiety, they offer the best conditions for improving the situation at the table.

Melanie K. is insecure. Her son Tim (2 ½ years) is increasingly picky about food. Food that he ate until recently, he now spits out or rejects them from the outset. At first she hoped it was just a phase, but it is getting worse every day. She reports to her family doctor that Tim currently only wants to eat pasta or bread without anything. Meat sausage and salami also worked, but then without bread. Only toast with chocolate spread is accepted as bread with toppings. If she offers him something to play with at the same time, it could also be a few pieces of carrot that he eats. Only biscuits always went, but that was not a solution. She feels helpless and the meals are stressful for her. In addition, she was afraid that Tim would not get enough vitamins and that he would not be able to develop healthily as a result, she reported in the conversation.

At times, many toddlers only eat a few foods. They don't even want to try the unknown. For parents, this phase can be a test of patience. Finally, the child should take part in family meals and learn about the variety of foods. What recommendations can family doctors give parents if their child is picky or refuses a lot of foods?

The recommendations for action of the "Healthy in Life" network on nutrition and exercise for small children provide orientation and support [7]. These nationwide uniform recommendations for action developed by consensus are supported by all relevant specialist societies and professional associations (see box). Seven aspects are named here that are important for advice.

Patience and composure are required

The rejection subsides again. While children between around six months and two years of age are particularly open to new taste experiences, a phase then begins in which they often reject new dishes. This aversion, also known as neophobia, peaks between the ages of two and six years [4]. With patience, the rejection phase usually passes by itself. Refusing a new food doesn't always have something to do with taste or texture. The incipient periods of defiance, the desire to eat alone, parental behavior and other factors can also have a major influence. A relaxed approach and observance of the following aspects can help relieve the situation.

Accept rejection

If the child refuses a food during the meal, that is fine. The rejected food is not removed from the menu, but comes back on the table every now and then and the child is encouraged to taste, but not forced. If the child finishes the meal early or does not want to eat, one or two attempts by the parents are sufficient to encourage the child to eat. You shouldn't offer extra meals as a substitute. A child's "no" remains a "no" - regardless of whether it is spoken out loud or signaled through facial expressions and gestures such as turning away or keeping mouth closed [1, 3].

Children themselves know when they are full

It is important that parents respect the child's hunger and satiety signals. You first offer a small portion or the child takes a portion as soon as they can help themselves. The child can demand or follow up until it is full.

Just as parents are responsible for a balanced and varied food supply, the child decides for himself how much of it to eat. Parents can lovingly accompany this process and can trust in their child's ability to adjust the consumption amount to the physiological needs. If the child is healthy, active and satisfied, parents can assume that they are eating enough. However, it is also an important learning process for the child to remain seated at meals and to take time to eat and get full. The duration of the meals can be very different. However, a main meal for small children should not last longer than 30 minutes.

Meal planning and meal rhythm are important

Meals in community and with enough time and rest are desirable [2, 11, 12]. Parents should allow their child to focus on eating. They avoid distractions (e.g. from the television set, mobile phone) and do not animate their child with tricks ("... then the sun will shine tomorrow!") And persuasion strategies ("A spoon for grandma!"), Promises ("If you do that." eats, then ... ") or punishment (" Then you don't get ... "). Games to eat are also undesirable.

A friendly atmosphere at meals ensures a positive dining experience and can encourage the development of food preferences. "Difficult" topics should not be discussed at the table. Critical to complacent comments from other family members about the meal should also be avoided.

So that hunger "has a chance", no snacks, sugary drinks or milk should be offered during the meal breaks between meals, as these can satiate the child. The child can and should be able to consume water at any time. Young children should have their meals on a regular basis. The number, rhythm and type of daily meals are influenced by culture [10]. In this country, three main meals and two snacks, which alternate with meal-free times, have proven successful. Fixed meal times, setting the table together and a ritual at the beginning ensure reliable structures.

Network Healthy in Life
The recommendations summarized here are an excerpt from the recommendations for action of the Gesund ins Leben Network - Young Family Network "Nutrition and Exercise in Small Children" (authors: B. Koletzko, M. Armbruster, C.-P. Bauer et al.) [7] . The complete recommendations for action with a lot of background information are available online at www.gesund-ins-leben.de, under the heading for specialists. The print version can be ordered from www.ble-medienservice.de (order number 3418). The 16-page booklet "What small children need" to be passed on to parents seeking advice can be ordered up to 100 copies free of charge: www.ble-medienservice.de (order number 0361).

Put on getting used to it

Taste acceptance is formed through repeated tasting. In addition, the parents offer new foods and dishes several times [2] and without compulsion [6, 8, 11]. Preparing food in different ways (e.g. vegetables whole on the hand, raw, finely grated, cooked soft or firm to the bite, fried, pieces for dipping, pureed as soup, in smoothies) can facilitate the acceptance of new foods. Combination with a familiar taste or favorite dish is ideal [2, 9].

Children should be encouraged to try new foods / dishes and discover them with all their senses: the look and smell, how they feel, what taste and consistency they have [5].

Parents serve as role models

Children learn in a variety of ways, especially through observation and imitation of parents and other caregivers. It is difficult to teach children something that is not lived in the community. Parents support their child by happily trying new things, by eating varied and enjoyable food, and by offering the food in an appetizing and child-friendly way. Parents create a "learning environment" that makes them feel good. It can often arouse the child's curiosity more than asking them to try it. It is also important - not only in toddler age - that parents set an example of what they want for their children: whole grain products instead of white baked goods, water or tea instead of lemonade or the Vegetable and fruit components as an integral part of all meals.

Children want to eat alone

Children in toddler age often develop a great need for autonomy. If a child knocks the spoon away, it may not refuse the food, but rather no longer wants to be fed. Parents should enable their child to eat independently. You support it e.g. B. by appropriate equipment (robust, heavy plate, small spoon or cake fork, large bib or cloth) or the appropriate tolerance if something falls next to a plate or chair. At the beginning, people often eat with their fingers and spills are part of it.

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2. Birch LL, Anzman-Frasca S (2011) Promoting children’s healthy eating in obesogenic environments: lessons learned from the rat. Physiol Behav 104: 641-645
3. Butte N, Cobb K, Dwyer J et al (2004) The start healthy feeding guidelines for infants and toddlers. J Am Diet Assoc 104: 442-454
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5. Heindl I, Methfessel B, Schlegel-Matthies K (2011) Nutritional socialization and education and the emergence of "culinary reason". In: Ploeger A, Hirschfelder G, Schönberger G (Hrsg) The future on the table. Analyzes, trends and perspectives on tomorrow's nutrition. VS Verlag für Sozialwissenschaften / Springer Fachmedien, Wiesbaden, 187–202
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7. Koletzko B, Armbruster M, Bauer CP et al. (2013) Recommendations for Action Diet and Exercise in Small Children. Monthly Pediatrics: Reprint. http://www.gesund-ins-leben.de/fileadmin/SITE_MASTER/content/Dokumente/Downloads/Medien/3418_2013_he_kleinkinder.pdf. Accessed 02/07/2017
8. Nicklas TA, Hayes D; American Dietetic Association (2008) Position of the American Dietetic Association: nutrition guidance for healthy children ages 2-11 years. J Am Diet Assoc 108: 1038-1044, 1046-1047
9. Pliner P, Stallberg-White C (2000) "Pass the ketchup, please": familiar flavors increase children’s willingness to taste novel food. Appetite 34: 95-103
10. Schlegel-Matthies K (2011) Meal in Transition - the de-ideologization of an institution. In: Schönberger G, Methfessel B (Hrsg) Meals: old burden or new pleasure? VS Verlag für Sozialwissenschaften / Springer Fachmedien, Wiesbaden
11. Schwartz C, Scholtens PA, Lalanne A et al (2011) Development of healthy eating habits early in life. Review of recent evidence and selected guidelines. Appetite 57: 796-807
12. Shutts K, Kinzler KD, DeJesus JM (2013) Understanding infants ‘and children’s social learning about foods: previous research and new prospects. Dev Psychol 49: 419-425

Head of Healthy Into Life - Young Family Network at the Federal Center for Nutrition (BZfE)

Conflicts of Interest: The author has not declared any.

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