by Laura Rubino, PhD student in clinical psychology at Drexel University and2024 CEED Summer Research Fellow
A common refrain among parents is, “Why won’t you eat it?” “Please just try it, you’ll like it!” and “My child is such a picky eater!” Although picky eating is common (kids aren’t doing it just to be difficult!), it can be incredibly frustrating for parents and caregivers when their child refuses to eat a food—especially when they know it is good for their child.
In response to this frustration and in efforts to help increase the variety of foods kids eat—specifically fruits and vegetables—Dr. Nimali Fernando (aka “Dr. Yum”) and her interdisciplinary team of child experts in Virginia started the nonprofit organization, The Dr. Yum Project. This post will outline what picky eating is, what happens when it goes to the extreme, the Dr. Yum Project, and strategies to help work on picky eating at home.
What is picky eating?
Picky eating is when someone eats a limited number of foods. It is more common in young children, but adults can also be picky eaters. Picky eating is normal in some developmental stages. From 18 months of age onwards, children show a preference for sweet and rejection of bitter or sour foods. Picky eating can lead to both weight gain and weight loss, depending on the foods a child eats, and it can become a problem when it prevents children from getting all the nutrients they need.
What happens when picky eating is extreme?
Although picky eating is relatively common in children (and adults!), sometimes it can be very severe. In severe cases, picky eating sometimes reaches diagnostic threshold for avoidant restrictive food intake disorder (ARFID). Picky eating is elevated to ARFID when one or more the following are present:
Being underweight or not meeting expected weight gains
Significant nutritional deficiency (e.g., low iron)
Dependence on enteral feeding or oral nutritional supplements
Marked interference with psychosocial functioning (Note: can be hard to assess. Examples include parents have to pack special meals for children to engage in any social activities, or even complete avoidance of activities where food is or might be present) (American Psychiatric Association, 2013).
If you are concerned that you or your child has ARFID, there are resources and therapies shown to help. Learn more about ARFID here.
What can I do to help my child eat more? What is Dr. Yum?
“Dr. Yum’s Preschool Food Adventure” was designed to help increase the variety of foods, particularly of fruits and veggies, that children eat by training teachers and parents to present foods with a joyful, multisensory cooking experience. When implemented in preschool classes by teachers, this program has shown some early success in increasing food enjoyment and decreasing pickiness. Although further testing is needed, it provides preliminary guidance on how to help children increase the variety of foods they eat.
How does Dr. Yum work?
The program works by making trying new foods fun! Children are taught about the nutrients in the food in an approachable, age-appropriate way.
First, they are taught to make friends with the food. They are invited to touch it, smell it, name it, get to know it. This helps make the food more approachable and familiar.
Then, children are taught about where the food comes from. Does it grow on a tree, underground, on a bush? This helps children start to understand different sources of food and how food that comes directly from the earth is good for us!
After that, children are taught about the food’s superpowers (vitamins, minerals, and fiber) and how that food can help them stay healthy. For example, a pineapple has vitamin C which helps fight germs, kiwifruit have vitamin K, which heals cuts and scrapes, and kale has folate which helps you grow.
Finally, kids cook with the food and try it!
As a parent, how can I try this at home?
Although Dr. Yum is a school-based program, there are take-aways and strategies for parents to try at home.
Try to make eating new foods fun! (e.g., Is there a certain animal your child loves? What happens if they try to eat like that animal?)
Have kids try new foods in low stakes (e.g., just try 1 bite and then you can go back to your preferred food).
Continued exposure. Try to have kids give each food several tries. It can take up to 15 attempts before a child accepts a new food (15 strikes and you’re out) (Spill et al., 2019). The more a child is exposed to a food, the more they are likely to eat it.
Avoid trade-offs! Try not to have punishments for not eating foods and avoid power-struggles.
Use other senses to build confidence with foods. Smelling and touching can be a great bridge to tasting foods in the future. Cooking together regularly is a great way to engage all the senses.
Remember, everyone has foods they do and don’t like. It’s okay if your child doesn’t eat everything! But it can be fun to increase their willingness and flexibility around trying new foods.
Learn more:
Thank you to Dr. Sarah LeMay-Russell for the introduction to and presentation on Dr. Yum and providing insight and information on Dr. Yum, picky eating, and ARFID. Thank you to Dr. Nimali Fernando for the feedback and insight into the program.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Spill, M. K., Johns, K., Callahan, E. H., Shapiro, M. J., Wong, Y. P., Benjamin-Neelon, S. E., Birch, L., Black, M. M., Cook, J. T., Faith, M. S., Mennella, J. A., & Casavale, K. O. (2019). Repeated exposure to food and food acceptability in infants and toddlers: a systematic review. The American journal of clinical nutrition, 109(Suppl_7), 978S–989S. https://doi.org/10.1093/ajcn/nqy308
