9 tips for feeding a picky eater

In Singapore, a balanced meal recommended for a two year old would include food from each of the four food groups - rice and alternative, fruit, vegetables, meat and alternatives as well as milk.

While this sounds good in theory, getting your child to eat from all the food groups is often an uphill task.

One thing to note is that children are genetically wired to avoid strange foods.

According to author Elizabeth Pantley of The No-Cry Picky Eater Solution: Gentle Ways to Encourage Your Child to Eat, babies are born with a biological mechanism that protects them from eating something rancid or poisonous.

She explains that babies are born with more taste buds than adults, and when a child detects a sour or bitter flavour, his natural instinct is to spit it out.

Unfortunately, vegetables often fall into the bitter category, hence explaining a child's natural aversion to the food group.

This means that a child will need to see and have vegetables presented to them repeatedly to learn to eat them, said Dr Glenn Berall, Chief of Pediatrics and Medical Program Director, North York General Hospital, Toronto, ON and the Assistant Professor in the Department of Pediatrics and Nutritional Sciences, University of Toronto. 

"They do better if the mother ate vegetables during pregnancy and if they are presented with vegetables before four to six months as their acceptance of vegetables is much better when this occurs," he told YourHealth.

"The other influence in the literature is if mothers and fathers eat vegetables regularly the child will see it as normal and learn to do so also.

He says that parents must always keep in mind they determine the 3 Ws of feeding: What they eat, when they eat, and where they eat.

But respect that on the children's side, they are responsible for how much they eat.

He was speaking on the invitation of Abbott at the Scientific Updates in Paediatric Feeding Difficulties Seminar held here in March.

Dr Berall shares some tips on how to deal with a picky eater:

Maintain appropriate boundaries

1. Maintain appropriate boundaries

This means that the parent is in charge of deciding where, when, and what the child eats, while the child is allowed to decide how much of the food is eaten.

"Parents must provide well balanced and wholesome meals that are developmentally appropriate for their child," said Dr Berall.

"Meals and snacks should be presented with some form of structure, and children should be given an opportunity to eat."

If you are worried that by not forcing your child to eat, the child is not getting enough nutrition, Dr Berall assured parents that a child is more likely to learn to pay attention to their food if you let them fail a few times by not eating well enough and facing the consequences of their choice by being hungry later.

2. Avoid distraction

Feed your child in an environment that is free of noise and distraction

Some parents might resort to using TV to distract their children so they can sit still long enough to finish the meal.

This is a huge no-no. Dr Berall cautioned that TV interferes with their developmental exploration of their food and their awareness of their hunger signal.

The use of a high chair to help confine the toddler to the feeding environment is recommended. The child's chair should be at the table and the child should be encouraged but not forced to sit there for the duration of the meal.

Parent may offer a toy to get the child settled, but the toy should be removed once the meal starts.

Limit duration

3. Feed to encourage appetite

Parents should allow three to four hour intervals between meals and in the meanwhile, avoid snacks like juice and milk and provide only water to quench thirst.

For toddlers, time the meal frequency to coincide with the parent's meals. For example, three meals and an afternoon snack is typical.

Parents can be good role models by eating meals with their children, and by not avoiding any particular food groups themselves.

4. Maintain a neutral attitude

You may have seen it on television, but it is not a good idea to fly aeroplanes into the mouth.

Keep calm and do not get overly excited or animated. Although it may be hard to do, never become or even appear angry.

5. Limit duration

Eating should begin within 15 minutes of the start of the meal, and meals should last no longer than 30 to 35 minutes.

Do not become a short-order cook - basically someone who quickly prepares, cooks, and serves food according to the "customer's" request.

Serve age-appropriate food in reasonably small helpings (eg, the size of the child's fist), and offer food commensurate with the child's oral motor development.

Do not feed your child food as as when he or she asks for it. Remember: You control "when" they eat.

The idea is to let the child be responsible for how much they eat. So they may choose to eat from 0 per cent to 100 per cent.

"That means if they run off the meal is over. They don't get to choose when so they can't come back later and take more," Dr Berall said.

The child will quickly learn that running off leaves them hungry and they will reconsider after a few partially missed meals.

Systematic introductions

7. Systematically introduce novel food

A child is biologically wired to reject things that are new and unfamiliar. This "neophobia" should be respected, and you should offer a food repetitively for about 10 to 15 times before giving up on it.

If a child eats the unfamiliar food, reward him or her with praise for the very young, and possibly a small toy or stickers for an older child

One thing parents should avoid is the using of food as a reward for good behavior. Such foods tend to be high in fat, salt or sugar, such as chocolate, biscuits or sweets, and is unhealthy for your child.

8. Encourage independent feeding

For example, the toddler should have his or her own spoon.

9. Tolerate age-appropriate mess

Use a bib with a trough to catch falling pieces or have a sheet under the high chair or booster seat.

Do not irritate the child by wiping the mouth with a napkin after each mouthful.

If your toddler is very young, make sure that the meat is very soft and easy to chew.

"Sometimes we make the meat too chewy for our toddlers," said Dr Berall.

The meat must be soft enough to chew with your fingers, he advised.

Dark meat is softer when marinated and steamed, and boiled meats in small pieces and even blended meats worked into meatballs or patties work well.

Alternatively, you can cook soft fish without the bones, eggs or tofu beans.

What's a balanced meal for my child?

What's a balanced meal for my child?

In general, the proportion of food provided from each food group aims to achieve around 45 to 65 per cent energy from carbohydrates; five to 20 per cent energy from protein and 30 to 40 per cent of energy from fat.

But Dr Berall cautioned parents not too focus too much on these types of numbers, as you might lose the forest for the trees.

Focus on what is good for your child long term, rather than focus on short-term gains.

Local guidelines for proportions of food from each food group are available in each country.

In Singapore, the Health Promotion Board recommends the below food servings.

If you are wondering why there is a range of servings recommended for the rice and alternatives and meat and alternatives food groups, it is to reflect the different needs of individuals.

According to HPB, smaller and more sedentary people should adhere to the lower end of the range of recommendations, while bigger and more active people can eat more and bigger servings.

* rice bowl ** 250ml mug *** 250ml cup +10 inch plate

++ While 3 eggs are equivalent in protein content to other items listed under the meat and alternatives group, egg yolks are high in cholesterol. Thus, eat no more than 4 egg yolks per week.