About a million years ago (OK, about a dozen years ago) I had a client that only ate microwave popcorn, toaster oven pizza, and gummy vitamins (the round ones, not the bears. I pity the fool that tried to feed him the bears).  He survived, even grew to be kind of tall for his age, eating those three foods for about 6 months.  I was working with his family on language development and extreme tantrums, but once we gained some momentum in those areas, I knew we needed to tackle the food thing.  His mom, a nurse, was distraught by his limited diet and had real concerns for his continued growth and development.  In a case like this, this extremely restricted diet would be referred to as “food over-selectivity” which is just a fancy way of saying that he was a suuuuuuper picky eater.

After a few months of intervention, he was eating over 25 different healthy foods and knew the drill  (did not throw a Hulk-style tantrum) when a new food was to be introduced.  Most parents are not dealing with an eater THIS picky, but there are several approaches that are drawn from my work with severe cases that might just get a typical picky eater out of a food rut.

I think everyone has heard (a million, OK, a dozen times) the basic “picky eater” tips: introduce a food without the expectation that your child will eat it, don’t force food, don’t make 25 different dinners when your kid goes into a tantrum when you present the sweet-potato casserole that took you 3 days to make, etc.  Here are some good tips to get started if you are not familiar with the basics. A softer approach and more progressive perspective can be found here.

If you have a child who simply won’t try something new (and commits with an army and a brass band to avoiding the new thing), but once they do they LOVE a new food, here is something you can try:  ask your child to try a tiny (I mean teensy weensy itty-bitty garden-fairy on a diet sized) portion of a new food FOLLOWED by a generous (like GIANT linebacker sized) portion of a favorite food.  It really could be as extreme as a pencil eraser bit of avocado followed by a giant bowl of ice cream.  Before you try and have me arrested by the nutrition police, keep in mind that this is TEMPORARY (and it doesn’t have to be ice cream!).  Once the teensy portion is comfortably accepted, make it a bit bigger.  At the same time, make the “after” food a bit less generous.  Continue this until the NEW food is so easily accepted that it has become a favorite.  You now have another food to put in the “after” column!  Here is an example of the introduction of spinach puree to a kiddo who had never taken a bite of ANYTHING green (unless McDonald’s makes some type of green food I am not aware of)…You can see that for a PICKY eater, you need a PICKY program to make it work. For a less difficult kiddo, you can be more relaxed and casual about the way you change the amounts.

The method of “hiding” food in other food is popular and well-established. Every time I eat a brownie, I’m scared that the person who made it read Jessica Seinfeld’s cookbook and they snuck kale or something in there.  That works pretty well if you have a kid who is used to different textures and tastes already and will pretty much accept that her milkshake is always going to have bits of twigs in it.  Twigshake.

Other kids will insist on sameness in their food and demonstrate real revulsion to new tastes and textures.  You can use a procedure called micro-blending with food and micro-titration with beverages to get around those (very real!) aversions and fears of new things.  The key, like with the procedure above (bonus points—the previous procedure is called a contingent presentation procedure) is to think small to start off with.  You want to make sure that the amount being added is so minuscule that it wont “set off the alarms” and trigger the avoidance behaviors that your child uses to get away from something that she finds scary.  Check out an example of adding real fruit to yogurt for a kiddo that gagged any time a new texture was introduced. There is also an example of doing the same thing for a beverage.  Check it out here.

The bottom line is that kids are pretty clear when they REALLY don’t want to do something, and often develop habits that are seemingly impossible to break.  Food is so emotional, so tied to our social selves, that it feels like real challenge to address picky eating.  The good thing about the interventions listed above is that once you do them a few times, most kids just roll with a new food and the tricky, complex procedures are forgotten (as they should be!).  If, however, you find that the picky eating needs a little more specific help, ask your pediatrician for a referral to a behavioral eating specialist once a medical cause has been ruled out.

Next week I will give some tips for keeping kids at the table to eat and where to find the Fountain of Youth.  I’m kidding about the second one, but I know some parents who would find the two promises equally unlikely! –Liz Schwandt